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AN ACT relating to the exercise of ethics and diversity within the medical 1
profession. 2
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 3
SECTION 1. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 4
READ AS FOLLOWS: 5
As used in Sections 1 to 4 of this Act: 6
(1) "Conscience" means the religious, moral, ethical, or philosophical beliefs or 7
principles held by any healthcare provider, healthcare institution, or healthcare 8
payer. Conscience with respect to institutional entities or corporate bodies, as 9
opposed to individual persons, is determined by reference to that entity's or body's 10
governing documents, including but not limited to any published religious, 11
moral, ethical, or philosophical guidelines, directives, mission statements, articles 12
of incorporation, bylaws, policies, or regulations; 13
(2) "Disclosure" means a formal or informal communication or transmission. This 14
does not include a communication or transmission concerning policy decisions 15
that lawfully exercise discretionary authority, unless the healthcare provider 16
providing the disclosure or transmission reasonably believes that the disclosure 17
or transmission is: 18
(a) A violation of any law, rule, or regulation; 19
(b) A violation of any standard of care or other ethical guideline for the 20
provision of any healthcare service; or 21
(c) Gross mismanagement, waste of funds, abuse of authority, or a substantial 22
and specific danger to public health or safety; 23
(3) "Discrimination" means any adverse action taken against or any threat of 24
adverse action communicated to any healthcare provider, healthcare institution, 25
or healthcare payer as a result of his, her, or its decision to decline to participate 26
in a healthcare service on the basis of conscience. Discrimination includes but is 27 UNOFFICIAL COPY 22 RS BR 1907
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not limited to termination of employment; transfer from current position; 1
demotion from current position; adverse administrative action; reassignment to a 2
different shift or job title; increased administrative duties; refusal of staff 3
privileges; refusal of board certification; loss of career specialty; reduction of 4
wages, benefits, or privileges; refusal to award or renew a grant, contract, or 5
other program; refusal to provide residency training opportunities; denial, 6
deprivation, or disqualification of licensure; withholding or disqualifying from 7
financial aid and other assistance; reducing, excluding, terminating, materially 8
altering the terms or conditions of, or otherwise making unavailable or denying, 9
any grant, contract, subcontract, cooperative agreement, guarantee, loan, or 10
other similar program or benefit; impediments to creating any healthcare 11
institution or payer or expanding or improving that healthcare institution or 12
payer; impediments to acquiring, associating with, or merging with any other 13
healthcare institution or payer; the threat thereof with regard to any of the 14
preceding; or any other penalty, disciplinary, or retaliatory action, whether 15
executed or threatened; 16
(4) "Healthcare institution" means any public or private hospital, clinic, medical 17
center, professional association, ambulatory surgical center, private physician's 18
office, pharmacy, nursing home, medical school, nursing school, medical 19
training facility, or any other entity or location in which healthcare services are 20
performed on behalf of any person. Healthcare institutions may include but are 21
not limited to organizations, corporations, partnerships, associations, agencies, 22
networks, sole proprietorships, joint ventures, or any other entity that provides 23
healthcare services; 24
(5) "Healthcare payer" means any employer, healthcare plan, health maintenance 25
organization, insurance company, management services organization, or any 26
other entity that pays for or arranges for the payment of any healthcare service 27 UNOFFICIAL COPY 22 RS BR 1907
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provided to any patient, whether that payment is made in whole or in part; 1
(6) "Healthcare provider" means any individual who may be asked to participate in 2
any way in a healthcare service, including but not limited to a physician; doctor 3
of osteopathy; podiatrist; optometrist; dentist; chiropractor; physician's assistant; 4
advanced practice registered nurse; nurse; nurse's aide; nurse midwife; medical 5
assistant; pharmacist; medical researcher; medical or nursing school student or 6
faculty; clinical psychologist; psychology or counseling student or faculty; 7
clinical social worker; laboratory technician; and any other such provider from 8
whom an employee's group health plan will accept medical certification to 9
substantiate a claim for benefits; 10
(7) "Healthcare service" means healthcare procedures, treatments, or services 11
rendered by a provider within the scope of practice for which the provider is 12
licensed or certified and includes physical and behavioral healthcare. This 13
includes but is not limited to initial examination; testing; diagnosis; referral; 14
dispensing or administering any drug, medication, or device; psychological 15
therapy or counseling; medical research; prognosis; therapy; and any other care 16
or necessary services performed or provided by any healthcare provider; 17
(8) "Participate in a healthcare service" means to provide, perform, assist with, 18
facilitate, refer for, counsel for, consult with regard to, admit for the purposes of 19
providing, or take part in any way in providing, any healthcare service or any 20
form of such a service; and 21
(9) "Pay" or "payment" means to pay for, contract for, arrange for the payment of 22
(whether in whole or in part), reimburse, or remunerate. 23
SECTION 2. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 24
READ AS FOLLOWS: 25
(1) A healthcare provider, healthcare institution, or healthcare payer shall have the 26
right not to participate in or pay for any healthcare service which violates his, 27 UNOFFICIAL COPY 22 RS BR 1907
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her, or its conscience. 1
(2) No healthcare provider, healthcare institution, or healthcare payer shall be liable 2
civilly, criminally, or administratively for his, her, or its decision to decline to 3
participate in or pay for a healthcare service on the basis of conscience, unless 4
the decision of the healthcare provider violates the standard of care required of 5
that provider. 6
(3) No healthcare provider, healthcare institution, or healthcare payer shall be 7
subject to discrimination in any manner as a result of his, her, or its decision to 8
decline to participate in or pay for a healthcare service on the basis of conscience. 9
(4) Notwithstanding any other provision of Sections 1 to 4 of this Act to the contrary, 10
a religious healthcare provider, healthcare institution, or healthcare payer that 11
holds itself out to the public as religious, states in its governing documents that it 12
has a religious purpose or mission, and has internal operating policies or 13
procedures that implement its religious beliefs shall have the right to make 14
employment, staffing, contracting, and admitting privilege decisions consistent 15
with its religious beliefs. 16
(5) Nothing in Sections 1 to 4 of this Act shall be construed to override the 17
requirement to provide emergency medical treatment to all patients with an 18
emergency medical condition as set forth in 42 U.S.C. sec. 1395dd(e)(1), the 19
Emergency Medical Treatment and Active Labor Act (EMTALA), state and 20
federal laws on sexual assault forensic medical examinations (SAFE exams), or 21
any other federal or state law governing emergency medical conditions and their 22
treatment. "Emergency medical condition" as defined under U.S.C sec 23
1395dd(e)(1) or any other federal or state law shall be applicable to all persons or 24
entities subject to Sections 1 to 4 of this Act. 25
(6) Nothing in Sections 1 to 4 of this Act shall be construed to change the applicable 26
standard of care related to any healthcare service. 27 UNOFFICIAL COPY 22 RS BR 1907
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SECTION 3. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 1
READ AS FOLLOWS: 2
(1) No healthcare provider shall be discriminated against because he or she: 3
(a) Provided, caused to be provided, or is about to provide to his or her 4
employer, the Attorney General, any agency of the Commonwealth charged 5
with protecting healthcare rights of conscience, the United States 6
Department of Health and Human Services, Office for Civil Rights, or any 7
other federal agency charged with protecting healthcare rights of 8
conscience with information relating to any violation, act, or omission the 9
healthcare provider reasonably believes to be a violation of any provision of 10
Sections 1 to 4 of this Act; 11
(b) Testified or is about to testify in a proceeding concerning a violation; or 12
(c) Assisted, participated, or is about to assist or participate in related 13
proceedings. 14
(2) Unless the disclosure is prohibited by law, no healthcare provider shall be 15
discriminated against because he or she disclosed information that he or she 16
reasonably believes to be: 17
(a) A violation of a relevant law, rule, or regulation; 18
(b) A violation of a standard of care or other ethical guideline for the provision 19
of healthcare services; or 20
(c) Gross mismanagement, waste of funds, an abuse of authority, or substantial 21
and specific danger to public health or safety. 22
SECTION 4. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 23
READ AS FOLLOWS: 24
Any person injured by a violation of Sections 1 to 4 of this Act shall have a civil cause 25
of action in the Circuit Court of competent jurisdiction to enjoin further violations, to 26
recover the actual damages sustained, and to recover the costs of the lawsuit and to be 27 UNOFFICIAL COPY 22 RS BR 1907
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provided any other appropriate relief, which may include reinstatement of a healthcare 1
provider to his or her previous position, reinstatement of board certification, and 2
relicensure of a healthcare institution or healthcare payer. If a violation is found to 3
have occurred, the court's order or judgment shall include a reasonable fee for the 4
plaintiff's attorney of record. Any additional burden or expense on another healthcare 5
provider, healthcare institution, or healthcare payer arising from the exercise of the 6
right of conscience shall not be a defense to any violation of Sections 1 to 4 of this Act. 7
Section 5. Sections 1 to 4 of this Act may be cited as the Medical Ethics and 8
Diversity Act. 9