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Key: (1) language to be deleted (2) new language

                            CHAPTER 120-S.F.No. 560 
                  An act relating to health; modifying review 
                  organization provisions; allowing review organizations 
                  to participate in Internet-based information sharing 
                  systems; amending Minnesota Statutes 2000, sections 
                  145.61, subdivision 5; and 145.64, subdivision 1, and 
                  by adding subdivisions. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 2000, section 145.61, 
        subdivision 5, is amended to read: 
           Subd. 5.  [REVIEW ORGANIZATION.] "Review organization" 
        means a nonprofit organization acting according to 
        clause (k) (l), a committee as defined under section 144E.32, 
        subdivision 2, or a committee whose membership is limited to 
        professionals, administrative staff, and consumer directors, 
        except where otherwise provided for by state or federal law, and 
        which is established by one or more of the following:  a 
        hospital, a clinic, a nursing home, an ambulance service or 
        first responder service regulated under chapter 144E, one or 
        more state or local associations of professionals, an 
        organization of professionals from a particular area or medical 
        institution, a health maintenance organization as defined in 
        chapter 62D, a community integrated service network as defined 
        in chapter 62N, a nonprofit health service plan corporation as 
        defined in chapter 62C, a preferred provider organization, a 
        professional standards review organization established pursuant 
        to United States Code, title 42, section 1320c-1 et seq., a 
        medical review agent established to meet the requirements of 
        section 256B.04, subdivision 15, or 256D.03, subdivision 7, 
        paragraph (b), the department of human services, a health 
        provider cooperative operating under sections 62R.17 to 62R.26, 
        or a nonprofit corporation organized under chapter 317A that 
        owns, operates, or is established by one or more of the above 
        referenced entities, 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 or by the entity or 
        organization that established the review organization; 
           (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 or in the 
        entity or organization that established the review organization; 
           (e) developing and publishing guidelines designed to keep 
        within reasonable bounds the cost of health care; 
           (f) developing and publishing guidelines designed to 
        improve the safety of care provided to individuals; 
           (g) reviewing the safety, quality, or cost of health care 
        services provided to enrollees of health maintenance 
        organizations, community integrated service networks, health 
        service plans, preferred provider organizations, and insurance 
        companies; 
           (g) (h) acting as a professional standards review 
        organization pursuant to United States Code, title 42, section 
        1320c-1 et seq.; 
           (h) (i) determining whether a professional shall be granted 
        staff privileges in a medical institution, membership in a state 
        or local association of professionals, or participating status 
        in a nonprofit health service plan corporation, health 
        maintenance organization, community integrated service network, 
        preferred provider organization, or insurance company, or 
        whether a professional's staff privileges, membership, or 
        participation status should be limited, suspended or revoked; 
           (i) (j) reviewing, ruling on, or advising on controversies, 
        disputes or questions between: 
           (1) health insurance carriers, nonprofit health service 
        plan corporations, health maintenance organizations, community 
        integrated service networks, self-insurers and their insureds, 
        subscribers, enrollees, or other covered persons; 
           (2) professional licensing boards and health providers 
        licensed by them; 
           (3) professionals and their patients concerning diagnosis, 
        treatment or care, or the charges or fees therefor; 
           (4) professionals and health insurance carriers, nonprofit 
        health service plan corporations, health maintenance 
        organizations, community integrated service networks, or 
        self-insurers concerning a charge or fee for health care 
        services provided to an insured, subscriber, enrollee, or other 
        covered person; 
           (5) professionals or their patients and the federal, state, 
        or local government, or agencies thereof; 
           (j) (k) 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; 
           (k) (l) acting as a medical review agent under section 
        256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph 
        (b); 
           (l) (m) providing recommendations on the medical necessity 
        of a health service, or the relevant prevailing community 
        standard for a health service; 
           (m) (n) providing quality assurance as required by United 
        States Code, title 42, sections 1396r(b)(1)(b) and 
        1395i-3(b)(1)(b) of the Social Security Act; 
           (n) (o) providing information to group purchasers of health 
        care services when that information was originally generated 
        within the review organization for a purpose specified by this 
        subdivision; or 
           (o) (p) providing information to other, affiliated or 
        nonaffiliated review organizations, when that information was 
        originally generated within the review organization for a 
        purpose specified by this subdivision, and as long as that 
        information will further the purposes of a review organization 
        as specified by this subdivision; or 
           (q) participating in a standardized incident reporting 
        system, including Internet-based applications, to share 
        information for the purpose of identifying and analyzing trends 
        in medical error and iatrogenic injury. 
           Sec. 2.  Minnesota Statutes 2000, section 145.64, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [DATA AND INFORMATION.] All (a) Except as 
        provided in subdivision 4, data and information acquired by a 
        review organization, in the exercise of its duties and 
        functions, or by an individual or other entity acting at the 
        direction of a review organization, shall be held in confidence, 
        shall not be disclosed to anyone except to the extent necessary 
        to carry out one or more of the purposes of the review 
        organization, and shall not be subject to subpoena or 
        discovery.  No person described in section 145.63 shall disclose 
        what transpired at a meeting of a review organization except to 
        the extent necessary to carry out one or more of the purposes of 
        a review organization.  The proceedings and records of a review 
        organization shall not be subject to discovery or introduction 
        into evidence in any civil action against a professional arising 
        out of the matter or matters which are the subject of 
        consideration by the review organization.  Information, 
        documents or records otherwise available from original sources 
        shall not be immune from discovery or use in any civil action 
        merely because they were presented during proceedings of a 
        review organization, nor shall any person who testified before a 
        review organization or who is a member of it be prevented from 
        testifying as to matters within the person's knowledge, but a 
        witness cannot be asked about the witness' testimony before a 
        review organization or opinions formed by the witness as a 
        result of its hearings.  For purposes of this subdivision, 
        records of a review organization include Internet-based data 
        derived from data shared for the purposes of the standardized 
        incident reporting system described in section 145.61, 
        subdivision 5, clause (q).  
           (b) Notwithstanding paragraph (a), a review organization 
        may release nonpatient-identified aggregate trend data on 
        medical error and iatrogenic injury without violating this 
        section or being subjected to a penalty under section 145.66 and 
        without compromising the protections provided under sections 
        145.61 to 145.67 to the reporter of such information; to the 
        review organization, its sponsoring organizations, and members; 
        and to the underlying data and reports.  
           (c) The confidentiality protection and protection from 
        discovery or introduction into evidence provided in this 
        subdivision shall also apply to the governing body of the review 
        organization and shall not be waived as a result of referral of 
        a matter from the review organization to the governing body or 
        consideration by the governing body of decisions, 
        recommendations, or documentation of the review organization. 
           (d) The governing body of a hospital, health maintenance 
        organization, or community integrated service network, that is 
        owned or operated by a governmental entity, may close a meeting 
        to discuss decisions, recommendations, deliberations, or 
        documentation of the review organization.  A meeting may not be 
        closed except by a majority vote of the governing body in a 
        public meeting.  The closed meeting must be tape recorded and 
        the tape must be retained by the governing body for five years.  
           Sec. 3.  Minnesota Statutes 2000, section 145.64, is 
        amended by adding a subdivision to read: 
           Subd. 4.  [STANDARDIZED INCIDENT REPORTING SYSTEM DATA.] A 
        review organization that is participating in a standardized 
        incident reporting system described in section 145.61, 
        subdivision 5, clause (q), may release data for purposes of the 
        reporting system, provided that the data do not identify an 
        individual and are not released in a manner in which an 
        individual can be identified. 
           Sec. 4.  Minnesota Statutes 2000, section 145.64, is 
        amended by adding a subdivision to read: 
           Subd. 5.  [COMMISSIONER OF HEALTH.] Nothing in this section 
        shall be construed to prohibit or restrict the right of the 
        commissioner of health to access the original information, 
        documents, or records acquired by a review organization as 
        permitted by law. 
           Presented to the governor May 14, 2001 
           Signed by the governor May 17, 2001, 10:30 a.m.