Chapter 04-610

2004 -- S 2696

Enacted 08/07/04

A N A C T

RELATING TO THE BOARD OF MEDICAL LICENSURE AND DISCIPLINE

Introduced By: Senators Tassoni, Polisena, and Lanzi

Date Introduced: February 11, 2004

It is enacted by the General Assembly as follows:

 SECTION 1. Sections 5-37-1 and 5-37-22 of the General Laws in Chapter 5-37 entitled

"Board of Medical Licensure and Discipline" are hereby amended to read as follows:

5-37-1. Definitions. -- As used in this chapter:

      (1) "Board" means the Rhode Island board of medical licensure and discipline or any

committee or subcommittee thereof.

      (2) "Chief administrative officer" means the administrator of the Rhode Island board of

medical licensure and discipline.

      (3) "Department" means the Rhode Island department of health.

      (4) "Director" means director of the Rhode Island department of health.

      (5) "Health care facility" means any institutional health service provider licensed

pursuant to the provisions of chapter 17 of title 23.

      (6) "Health maintenance organization" means a public or private organization licensed

pursuant to the provisions of chapter 17 of title 23 or chapter 41 of title 27.

      (7) "Limited registrant" means a person holding a limited registration certificate pursuant

to the provisions of this chapter.

      (8) "Medical malpractice" or "malpractice" means any tort, or breach of contract based

on health care or professional services rendered, or which should have been rendered, by a

physician, dentist, hospital, clinic, health maintenance organization or professional service

corporation providing health care services and organized under chapter 5.1 of title 7, to a patient

or the rendering of medically unnecessary services except at the informed request of the patient.

      (9) "Nonprofit medical services corporation" or "nonprofit hospital service corporation"

means any corporation organized pursuant to chapter 19 or chapter 20 of title 27 for the purpose

of establishing, maintaining, and operating a nonprofit medical service plan.

      (10) (a) "Peer review board" means any committee of a state or local professional

association or society including a hospital association, or a committee of any licensed health care

facility, or the medical staff thereof, or any committee of a medical care foundation or health

maintenance organization, or any committee of a professional service corporation or nonprofit

corporation employing 20 or more practicing professionals, organized for the purpose of

furnishing medical service, or any staff committee or consultant of a hospital service or medical

service corporation, the function of which, or one of the functions of which is to evaluate and

improve the quality of health care rendered by providers of health care service or to determine

that health care services rendered were professionally indicated or were performed in compliance

with the applicable standard of care or that the cost of health care rendered was considered

reasonable by the providers of professional health care services in the area and shall include a

committee functioning as a utilization review committee under the provisions of 42 U.S.C.

section 1395 et seq. (medicare law) or as a professional standards review organization or

statewide professional standards review council under the provisions of 42 U.S.C. section 1301 et

seq. (professional standards review organizations) or a similar committee or a committee of

similar purpose, to evaluate or review the diagnosis or treatment of the performance or rendition

of medical or hospital services which are performed under public medical programs of either state

or federal design.

      (b) Peer review board also means the board of trustees or board of directors of a state or

local professional association or society, a licensed health care facility, a medical care foundation,

a health maintenance organization, and a hospital service or medical service corporation only

when such board of trustees or board of directors is reviewing the proceedings, records, or

recommendations of a peer review board of the above enumerated organizations.

      (11) "Person" means any individual, partnership, firm, corporation, association, trust or

estate, state or political subdivision, or instrumentality of a state.

      (12) "Physician" means a person with a license to practice allopathic or osteopathic

medicine in this state under the provisions of this chapter.

      (13) "Practice of medicine" shall include the practice of allopathic and osteopathic

medicine. Any person shall be regarded as practicing medicine within the meaning of this chapter

who holds himself or herself out as being able to diagnose, treat, operate, or prescribe for any

person ill or alleged to be ill with disease, pain, injury, deformity or abnormal physical or mental

condition, or who shall either profess to heal, offer or undertake, by any means or method to

diagnose, treat, operate, or prescribe for any person for disease, pain, injury, deformity or

physical or mental condition. In addition, one who attaches the title, M.D., physician, surgeon,

D.O., osteopathic physician and surgeon, or any other similar word or words or abbreviation to

his or her name indicating that he or she is engaged in the treatment or diagnosis of the diseases,

injuries or conditions of persons shall be held to be engaged in the practice of medicine.

(14) "Medical practice group" means a single legal entity formed primarily for the

purpose of being a physician group practice in any organizational form recognized by the state in

which the group practice achieves its legal status, including, but not limited to, a partnership,

professional corporation, limited liability company, limited liability partnership, foundation, not-

for-profit corporation, faculty practice plan, or similar association.

5-37-22. Disclosures. -- (a) (1) Any physician who is not a participant in a medical

insurance plan shall post a notice, in a conspicuous place in his or her medical offices where it

can be read by his or her patients, which reads, in substance, as follows:

      "To my patients:

      I do not participate in a medical insurance plan. You should know that you will be

responsible for the payment of my medical fees."

      (2) Any physician who fails to post this notice is not entitled to charge his or her patients

any amount for medical fees in excess of that allowed had the physician participated in a medical

insurance plan.

      (b) Every physician shall disclose to patients eligible for medicare, in advance of

treatment, whether the physician accepts assignment under medicare reimbursement as payment

in full for medical services and/or treatment in the physician's office. This disclosure is given by

posting in each physician's office, in a conspicuous place, a summary of the physician's medicare

reimbursement policy. Any physician who fails to make the disclosure as required in this section

is not allowed to charge the patient in excess of the medicare assignment amount for the medical

procedure performed.

      (c) When a patient requests, in writing, that his or her medical records be transferred to

another physician or medical practice group, the original physician or medical practice group

shall promptly honor the request. The physician or medical practice group is reimbursed for

reasonable expenses (as defined by the director pursuant to section 23-1-41) incurred in

connection with copying the medical records.

      (d) Every physician or medical practice group shall, upon written request of any patient

(or his or her authorized representative as defined in section 5-37.3-3(1)) who has received health

care services from the physician or medical practice group, at the option of the physician or

medical practice group either permit the patient (or his or her authorized representative) to

examine and copy the patient's confidential health care information, or provide the patient (or his

or her authorized representative) a summary of that information. If the physician or medical

practice group decides to provide a summary and the patient is not satisfied with a summary, then

the patient may request, and the physician or medical practice group shall provide, a copy of the

entire record. At the time of the examination, copying or provision of summary information, the

physician or medical practice group is reimbursed for reasonable expenses (as defined by the

director pursuant to section 23-1-48) in connection with copying this information. If, in the

professional judgment of the treating physician, it would be injurious to the mental or physical

health of the patient to disclose certain confidential health care information to the patient, the

physician or medical practice group is not required to disclose or provide a summary of that

information to the patient, but shall upon written request of the patient (or his or her authorized

representative) disclose that information to another physician or medical practice group

designated by the patients.

      (e) Every physician who has ownership interest in health facilities or laboratories,

including any health care facility licensed pursuant to chapter 17 of title 23, any residential

care/assisted living facility licensed pursuant to chapter 17.4 of title 23, any adult day care

program licensed or certified by the director of the department of elderly affairs, or any

equipment not on the physician's premises, shall, in writing, make full patient disclosure of his or

her ownership interest in the facility or therapy prior to utilization. The written notice shall state

that the patient has free choice either to use the physician's proprietary facility or therapy or to

seek the needed medical services elsewhere.

(f) Unless otherwise expressly stated in writing by the medical practice group, all medical

records shall be the property of the medical practice group with which a physician is associated

when that physician created all such medical records. A medical practice group shall provide

patients with access to patients' medical records in the same manner as is required of individual

physicians under this chapter. To the extent a medical practice group fails to provide access to

patients in accordance with the requirements of this chapter, the individual officers of the medical

practice group (or in the absence of officers, the shareholders or owners of the medical practice

group), in their capacities as licensees of the board, shall be subject to the disciplinary powers of

the board.

     SECTION 2. This act shall take effect upon passage.

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LC01917

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