S760

An Act concerning health care professionals, and amending P.L.2003, c.96 (C.45:9-22.21 et seq.).

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 2 of P.L.2003, c.96 (C.45:9-22.22) is amended to read:

2. a. The Division of Consumer Affairs in the Department of Law and Public Safety, in consultation with the [State Board of Medical Examiners and the New Jersey State Board of Optometrists] State boards that regulate health care professions, shall collect and maintain information concerning all [physicians, podiatrists and optometrists, respectively] health care professionals, as defined pursuant to P.L.2002, c.104 (C.45:1-28), licensed in the State for the purpose of creating a profile of each [physician, podiatrist and optometrist] health care professional pursuant to this act. The profiles shall be made available to the public through electronic and other appropriate means, at no charge to the public. The division shall establish a toll-free telephone number for members of the public to contact the division to obtain a paper copy of a [physician, podiatrist or optometrist] health care professional’s profile and to make other inquiries about the profiles.

b. A [physician, podiatrist or optometrist] health care professional shall be required to provide the appropriate board or division or its designated agent with any information necessary to complete the profile as provided in section 3 of this act.

c. [Either] A board may request any additional information it deems necessary to complete the profiles on the [biennial] license renewal form submitted by [physicians, podiatrists and optometrists] health care professionals, as applicable.

d. The appropriate board shall provide to the division or its designated agent any information required pursuant to this act that is available to the board concerning a [physician, podiatrist or optometrist] health care professional, for the purpose of creating the [physician, podiatrist and optometrist] health care professional’s [profiles] profile.

e. The Division of Consumer Affairs shall provide on the web-based License Verification System maintained by the division a disclaimer that the License Verification System only contains information on the license status of a health care professional and extensive background information on New Jersey-licensed health care professionals is available on the public website maintained by the division under the requirements of the “New Jersey Health Care Consumer Information Act,” P.L.2003, c.96 (C.45:9-22.21 et seq.).

(c.f. P.L.2004, c.115, s.5)

2. Section 3 of P.L.2003, c.96 (C.45:9-22.23) is amended to read:

3. a. The following information shall be included for each profile of a [physician, podiatrist or optometrist] health care professional, as applicable:

(1) Name of all [medical or optometry] schools, programs, or any other course of study attended for the purpose of obtaining the education required by the board regulating the health care profession in which the health care professional is licensed and dates of graduation;

(2) Graduate [medical or optometry] education, if applicable, including all internships, residencies and fellowships;

(3) Year first licensed;

(4) Year first licensed in New Jersey;

(5) Location of the [physician's, podiatrist's or optometrist's office practice] site or sites, as applicable, where the health care professional performs the services the individual is licensed to perform;

(6) A description of any criminal convictions for crimes of the first, second, third or fourth degree within the most recent 10 years. For the purposes of this paragraph, a person shall be deemed to be convicted of a crime if the individual pleaded guilty or was found or adjudged guilty by a court of competent jurisdiction. The description of criminal convictions shall not include any convictions that have been expunged. The following statement shall be included [with the information] in the segment of the profiles of physicians, optometrists, or midwives about criminal convictions: "Information provided in this section may not be comprehensive. Courts in New Jersey are required by law to provide information about criminal convictions to the State Board of Medical Examiners [(or], the New Jersey State Board of Optometrists, or the Midwifery Committee of the State Board of Medical Examiners[)].";

(7) A description of any final board disciplinary actions within the most recent 10 years, except that any such disciplinary action that is being appealed shall be identified;

(8) A description of any final disciplinary actions by appropriate licensing boards in other states within the most recent 10 years, except that any such disciplinary action that is being appealed shall be identified. [The] For a New Jersey-licensed physician, the following statement shall be included with the information about disciplinary actions in other states: "Information provided in this section may not be comprehensive. The State Board of Medical Examiners (or the New Jersey State Board of Optometrists) receives information about disciplinary actions in other states from

physicians (or optometrists) themselves and outside sources.";

(9) [In the case of physicians and podiatrists, a] A description of: the revocation or involuntary restriction of privileges at a New Jersey-based or out-of-State health care facility for reasons related to the practitioner's competence or misconduct or impairment taken by a health care facility's governing body or any other official of the health care facility after procedural due process has been afforded; the resignation from or nonrenewal of [medical] staff membership at the health care facility for reasons related to the practitioner's competence or misconduct or impairment; or the restriction of privileges at a health care facility taken in lieu of or in settlement of a pending disciplinary case related to the practitioner's competence or misconduct or impairment. Only those cases that have occurred within the most recent 10 years [and that were reported by the health care facility pursuant to section 2 of P.L.2005, c.83 (C.26:2H-12.2b)] shall be included in the profile; and

(10) All [medical] malpractice court judgments and all [medical] malpractice arbitration awards reported to the applicable board, in which a payment has been awarded to the complaining party during the most recent five years, and all settlements of [medical] malpractice claims reported to the board, in which a payment is made to the complaining party within the most recent five years, as follows:

(a) Pending [medical] malpractice claims shall not be included in the profile and information on pending [medical] malpractice claims shall not be disclosed to the public;

(b) A [medical] malpractice judgment that is being appealed shall be so identified;

(c) The context in which the payment of a [medical] malpractice claim occurs shall be identified by categorizing the number of judgments, arbitration awards and settlements against the [physician, podiatrist or optometrist] health care professional into three graduated categories: average, above average and below average number of judgments, arbitration awards and settlements. These groupings shall be arrived at by comparing the number of an individual [physician's, podiatrist's or optometrist's medical] health care professional’s malpractice judgments, arbitration awards and settlements to the experience of other [physicians, podiatrists or optometrists] health care professionals within the same [speciality] specialty. In addition to any information provided by a [physician, podiatrist or optometrist] health care professional, an insurer or insurance association authorized to issue [medical] malpractice liability insurance in the State shall, at the request of the division, provide data and information necessary to effectuate this subparagraph; and

(d) The following statement shall be included with the information concerning [medical] malpractice judgments, arbitration awards and settlements: "Settlement of a claim and, in particular, the dollar amount of the settlement may occur for a variety of reasons, which do not necessarily reflect negatively on the professional competence or conduct of [the physician (or podiatrist or optometrist)] this health care professional. A payment in settlement of a [medical] malpractice action or claim should not be construed as creating a presumption that [medical] malpractice has occurred.";

(11) A description of violations of the “New Jersey Insurance Fraud Prevention Act,” P.L.1983, c.320 (C.17:33A-1 et seq.) within the most recent five years;

(12) A description of Medicaid and Medicare exclusions pursuant to section 1320a-7 of the federal “Social Security Act;”

(13) Any actions taken by federal regulators, including the United States Food and Drug Administration and the Drug Enforcement Agency; and

(14) Any other information as determined by the director pursuant to regulation.

b. If requested by a [physician, podiatrist or optometrist] health care professional, the following information shall be included in [a physician's, podiatrist's or optometrist's] that health care professional’s profile:

(1) Names of the [hospitals] health care facilities where the [physician, podiatrist or optometrist] health care professional has privileges;

(2) Appointments of the [physician or podiatrist] health care professional to [medical school faculties, or the optometrist to optometry school] faculties of schools, programs, or any other course of study providing the required education for the health care profession in which the health care professional is licensed, within the most recent 10 years;

(3) Information regarding any board certification granted by a specialty board or other certifying entity recognized by [the American Board of Medical Specialties, the American Osteopathic Association or the American Board of Podiatric Medicine or by any other] national professional [organization] organizations that [has have been demonstrated to have comparable standards] represent the health care professions licensed by the Division of Consumer Affairs;

(4) Information regarding any translating services that may be available at the [physician's, podiatrist's or optometrist's office practice] site or sites where the health care professional performs the services for which the individual is licensed to perform, as applicable, or languages other than English that are spoken by the [physician, podiatrist or optometrist] health care professional;

(5) Information regarding whether the [physician, podiatrist or optometrist] health care professional participates in the Medicaid program or accepts assignment under the Medicare program;

(6) Information regarding the [medical] health insurance plans in which the [physician, podiatrist or optometrist] health care professional is a participating provider;

(7) Information concerning the hours during which the [physician, podiatrist or optometrist conducts his practice] health care professional performs the services for which the individual is licensed to perform; and

(8) Information concerning accessibility of the practice site or sites, as applicable, to persons with disabilities.

The following disclaimer shall be included with the information supplied by the [physician, podiatrist or optometrist] health care professional pursuant to this subsection: "This information has been provided by the [physician (or podiatrist or optometrist)] health care professional but has not been independently verified by the [State Board of Medical Examiners (or the New Jersey State Board of Optometrists)] board under which this individual is licensed or the Division of Consumer Affairs."

If the [physician, podiatrist or optometrist] health care professional includes information regarding [medical] insurance plans in which the practitioner is a participating provider, the following disclaimer shall be included with that information: "This information may be subject to change. Contact your health benefits plan to verify if [the physician (or podiatrist or optometrist)] this health care professional currently participates in the plan."

c. Before a profile is made available to the public, each [physician, podiatrist or optometrist] health care professional shall be provided with a copy of his profile. The [physician, podiatrist or optometrist] health care professional shall be given 30 calendar days to correct a factual inaccuracy that may appear in the profile and so advise the Division of Consumer Affairs or its designated agent; however, upon receipt of a written request that the division or its designated agent deems reasonable, the [physician, podiatrist or optometrist] health care professional may be granted an extension of up to 15 calendar days to correct a factual inaccuracy and so advise the division or its designated agent.

d. If new information or a change in existing information is received by the division concerning a [physician, podiatrist or optometrist] health care professional, [the physician, podiatrist or optometrist] that professional shall be provided with a copy of the proposed revision and shall be given 30 calendar days to correct a factual inaccuracy and to return the corrected information to the division or its designated agent.

e. The profile and any revisions thereto shall not be made available to the public until after the review period provided for in this section has lapsed.

(c.f. P.L.2005, c.83, s.18)

3. Section 4 of P.L.2003, c.96 (C.45:9-22.24) is amended to read:

4. The Division of Consumer Affairs may contract with a public or private entity for the purpose of developing, administering and maintaining the [physician, podiatrist and optometrist] profiles of health care professionals required pursuant to this act.

a. The contract shall specify the duties and responsibilities of the entity with respect to the development, administration and maintenance of the profile. The contract shall specify the duties and responsibilities of the division with respect to providing the information required pursuant to section 3 of this act to the entity on a regular and timely basis.

b. The contract shall specify that any identifying information concerning a [physician, podiatrist or optometrist] health care professional provided to the entity by the division, [the State Board of Medical Examiners, or the New Jersey State Board of Optometrists or the optometrist or] relevant licensing board, [respectively,] or the [physician or podiatrist] health care professional shall be used only for the purpose of the profile.

c. The division shall monitor the work of the entity to ensure that [physician, podiatrist and optometrist] profiles on health care professionals are properly developed and maintained pursuant to the requirements of this act.

(c.f. P.L.2004, c.115, s.7)

4. Section 8 of P.L.2003, c.96 (C.45:9-22.25) is amended to read:

8. Within 180 days of the effective date of this act, the Director of the Division of Consumer Affairs in the Department of Law and Public Safety, in consultation with the [State Board of Medical Examiners and the New Jersey State Board of Optometrists] relevant licensing boards, shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to effectuate the purposes of this act.

(c.f. P.L.2004, c.115, s.9)

5. This act shall take effect on the first day of the thirteenth month next following enactment.

STATEMENT

This bill would amend the “New Jersey Health Care Consumer Information Act,” P.L.2003, c.96 (C.45:9-22.21 et seq.) by requiring the Division of Consumer Affairs to develop and maintain publicly-accessible profiles of all health care professionals licensed by the division. Currently, only physicians, podiatrists, and optometrists have such profiles. The bill would incorporate, as applicable, these health care professions into the current statute.

The bill would also expand the information collected for a profile on a health care professional to include: 1) restrictions placed on health care professionals in New Jersey-based or out-of-State facilities; 2) any Medicare or Medicaid exclusions; 3) any actions taken by federal regulators such as the U.S. Food and Drug Administration or Drug Enforcement Agency; and 4) any other information required pursuant to regulation from the Division of Consumer Affairs.

The bill would also require the division to post on the website it maintains for the License Verification System a disclaimer that the verification system only contains information on the license status of health care professionals and that extensive background information on New Jersey-licensed health care professionals is available at the website maintained by the division under the requirements of the “New Jersey Health Care Consumer Information Act,” P.L.2003, c.96 (C.45:9-22.21 et seq.).

Lastly, the bill would establish an effective date of the first day of the tenth month next following enactment.