Minnesota Session Laws - 1985, Regular Session

  

                         Laws of Minnesota 1985 

                        CHAPTER 184-S.F.No. 364 
           An act relating to health; expanding the purposes of 
          health care review organizations; providing an 
          exception to liability; amending Minnesota Statutes 
          1984, sections 145.61, subdivision 5; and 145.63. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1984, section 145.61, 
subdivision 5, is amended to read: 
    Subd. 5.  "Review organization" means a committee whose 
membership is limited to professionals and administrative staff, 
except where otherwise provided for by state or federal law, and 
which is established by a hospital, by a clinic, by one or more 
state or local associations of professionals, by an organization 
of professionals from a particular area or medical institution, 
by a health maintenance organization as defined in Minnesota 
Statutes, Chapter 62D, by a nonprofit health service plan 
corporation as defined in Minnesota Statutes, Chapter 62C or by 
a professional standards review organization established 
pursuant to 42 U.S.C., Section 1320c-1 et seq. to gather and 
review information relating to the care and treatment of 
patients for the purposes of: 
    (a) Evaluating and improving the quality of health care 
rendered in the area or medical institution; 
    (b) Reducing morbidity or mortality; 
    (c) Obtaining and disseminating statistics and information 
relative to the treatment and prevention of diseases, illness 
and injuries; 
    (d) Developing and publishing guidelines showing the norms 
of health care in the area or medical institution; 
    (e) Developing and publishing guidelines designed to keep 
within reasonable bounds the cost of health care; 
    (f) Reviewing the quality or cost of health care services 
provided to enrollees of health maintenance organizations; 
    (g) Acting as a professional standards review organization 
pursuant to 42 U.S.C., Section 1320c-1 et seq.; 
    (h) Determining whether a professional shall be granted 
staff privileges in a medical institution or whether a 
professional's staff privileges should be limited, suspended or 
revoked; or 
    (i) Reviewing, ruling on, or advising on controversies, 
disputes or questions between: 
    (1) health insurance carriers or health maintenance 
organizations and their insureds or enrollees; 
    (2) professional licensing boards acting under their powers 
including disciplinary, license revocation or suspension 
procedures and health providers licensed by them when the matter 
is referred to a review committee by the professional licensing 
board; 
    (3) professionals and their patients concerning diagnosis, 
treatment or care, or the charges or fees therefor; 
    (4) professionals and health insurance carriers or health 
maintenance organizations concerning a charge or fee for health 
care services provided to an insured or enrollee; or 
    (5) professionals or their patients and the federal, state, 
or local government, or agencies thereof; or 
    (j) Providing underwriting assistance in connection with 
professional liability insurance coverage applied for or 
obtained by dentists, or providing assistance to underwriters in 
evaluating claims against dentists. 
    Sec. 2.  Minnesota Statutes 1984, section 145.63, is 
amended to read: 
    145.63 [LIMITATION ON LIABILITY FOR MEMBERS OF REVIEW 
ORGANIZATIONS.] 
    No person who is a member or employee of, who acts in an 
advisory capacity to or who furnishes counsel or services to, a 
review organization shall be liable for damages or other relief 
in any action brought by a person or persons whose activities 
have been or are being scrutinized or reviewed by a review 
organization, by reason of the performance by him of any duty, 
function or activity of such review organization, unless the 
performance of such duty, function or activity was motivated by 
malice toward the person affected thereby.  No person shall be 
liable for damages or other relief in any action by reason of 
the performance of him of any duty, function, or activity as a 
member of a review committee or by reason of any recommendation 
or action of the review committee when the person acts in the 
reasonable belief that his action or recommendation is warranted 
by facts known to him or the review organization after 
reasonable efforts to ascertain the facts upon which the review 
organization's action or recommendation is made, except that any 
corporation designated as a review organization under the Code 
of Federal Regulations, title 42, section 466 (1983) shall be 
subject to actions for damages or other relief by reason of any 
failure of a person, whose care or treatment is required to be 
scrutinized or reviewed by the review organization, to receive 
medical care or treatment as a result of a determination by the 
review organization that medical care was unnecessary or 
inappropriate. 
    Approved May 23, 1985