4501S.02C
1
SENATE COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 1248
AN ACT
To repeal sections 190.245 and 537.035, RSMo, and to
enact in lieu thereof two new sections relating to
peer review committees.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 190.245 and 537.035, RSMo, are
repealed and two new sections enacted in lieu thereof, to be
known as sections 190.245 and 537.035, to read as follows:
190.245. 1. Failure of a hospital to provide all
medical records and q uality improvement documentation
necessary for the department to implement provisions of
sections 190.241 to 190.245 shall result in the revocation
of the hospital's designation as a trauma center, STEMI
center, or stroke center. Any medical records o btained by
the department shall be used only for purposes of
implementing the provisions of sections 190.241 to 190.245
and the names of hospitals, physicians and patients shall
not be released by the department or members of review teams.
2. Any person licensed under sections 190.001 to
190.245 shall be considered a health care professional for
purposes of section 537.035, and any quality improvement or
quality assurance activity required under sections 190.001
to 190.245 shall be considered an activity of a peer review
committee for purposes of section 537.035.
537.035. 1. As used in this section, unless the
context clearly indicates otherwise, the following words and
terms shall have the meanings indicated:
(1) "Health care professional", a physician or surgeon
licensed under the provisions of chapter 334, or a dentist
2
licensed under the provisions of chapter 332, or a
podiatrist licensed under the provisions of chapter 330, or
an optometrist licensed under the provisions of chapter 336,
or a pharmacist licensed under the provisions of chapter
338, or a chiropractor licensed under the provisions of
chapter 331, or a psychologist licensed under the provisions
of chapter 337, or a nurse licensed under the provi sions of
chapter 335, or a physician assistant licensed under the
provisions of chapter 334, or a person licensed under the
provisions of sections 190.001 to 190.245, or a social
worker licensed under the provisions of chapter 337, or a
professional counselor licensed under the provisions of
chapter 337, or a mental health professional as defined in
section 632.005, while acting within their scope of practice;
(2) "Peer review committee", a committee of health
care professionals with the respo nsibility to evaluate,
maintain, or monitor the quality and utilization of health
care services or to exercise any combination of such
responsibilities.
2. A peer review committee may be constituted as
follows:
(1) Comprised of, and appoint ed by, a state, county or
local society of health care professionals;
(2) Comprised of, and appointed by, the partners,
shareholders, or employed health care professionals of a
partnership or professional corporation of health care
professionals, or employed health care professionals of a
university or an entity affiliated with a university
operating under chapter 172, 174, 352, or 355;
(3) Appointed by the board of trustees, chief
executive officer, or the organized medical staff of a
licensed hospital, or other health facility operating under
constitutional or statutory authority, including long -term
3
care facilities licensed under chapter 198, or an
administrative entity of the department of mental health
recognized pursuant to the provisions of subdivision (3) of
subsection 1 of section 630.407;
(4) Any other organization formed pursuant to state or
federal law authorized to exercise the responsibilities of a
peer review committee and acting within the scope of such
authorization;
(5) Appointed by the board of directors, chief
executive officer or the medical director of the licensed
health maintenance organization.
3. Each member of a peer review committee and each
person, hospital governing board, health ma intenance
organization board of directors, and chief executive officer
of a licensed hospital or other hospital operating under
constitutional or statutory authority, chief executive
officer or medical director of a licensed health maintenance
organization who testifies before, or provides information
to, acts upon the recommendation of, or otherwise
participates in the operation of, such a committee shall be
immune from civil liability for such acts so long as the
acts are performed in good faith, without malice and are
reasonably related to the scope of inquiry of the peer
review committee.
4. Except as otherwise provided in this section, the
interviews, memoranda, proceedings, findings, deliberations,
reports, and minutes of peer review committees, or the
existence of the same, concerning the health care provided
any patient are privileged and shall not be subject to
discovery, subpoena, or other means of legal compulsion for
their release to any person or entity or be admissible int o
evidence in any judicial or administrative action for
failure to provide appropriate care. Except as otherwise
4
provided in this section, no person who was in attendance at
any peer review committee proceeding shall be permitted or
required to disclose any information acquired in connection
with or in the course of such proceeding, or to disclose any
opinion, recommendation, or evaluation of the committee or
board, or any member thereof; provided, however, that
information otherwise discoverable or admissible from
original sources is not to be construed as immune from
discovery or use in any proceeding merely because it was
presented during proceedings before a peer review committee
nor is a member, employee, or agent of such committee, or
other person appearing before it, to be prevented from
testifying as to matters within his personal knowledge and
in accordance with the other provisions of this section, but
such witness cannot be questioned about testimony or other
proceedings before a ny health care review committee or board
or about opinions formed as a result of such committee
hearings. The disclosure of any interview, memoranda,
proceedings, findings, deliberations, reports, or minutes to
any person or entity, including but not limited to
governmental agencies, professional accrediting agencies, or
other health care providers, whether proper or improper,
shall not waive or have any effect upon its confidentiality,
nondiscoverability, or nonadmissibility.
5. The provisions of subsection 4 of this section
limiting discovery and admissibility of testimony as well as
the proceedings, findings, records, and minutes of peer
review committees do not apply in any judicial or
administrative action brought by a peer review com mittee or
the legal entity which formed or within which such committee
operates to deny, restrict, or revoke the hospital staff
privileges or license to practice of a physician or other
health care providers; or when a member, employee, or agent
5
of the peer review committee or the legal entity which
formed such committee or within which such committee
operates is sued for actions taken by such committee which
operate to deny, restrict or revoke the hospital staff
privileges or license to practice o f a physician or other
health care provider.
6. Nothing in this section shall limit authority
otherwise provided by law of a health care licensing board
of the state of Missouri to obtain information by subpoena
or other authorized process from p eer review committees or
to require disclosure of otherwise confidential information
relating to matters and investigations within the
jurisdiction of such health care licensing boards.