THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY MUNDY, PASHINSKI, CUTLER, DeLUCA, FABRIZIO, FREEMAN, KORTZ, MURPHY, PAYTON, STABACK AND WAGNER, JANUARY 26, 2011

REFERRED TO COMMITTEE ON HEALTH, JANUARY 26, 2011  

AN ACT

Providing for quality health care management system discount;

imposing duties on the Department of Health; and providing

for penalties.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Quality

Management in Health Care Act.

Section 2.  Findings and declarations.

The General Assembly finds and declares as follows:

(1)  It is the purpose of this act to ensure that quality

medical care is available to all citizens of this

Commonwealth through a comprehensive and high-quality health

care system.

(2)  To maintain and improve this system, medical

professional liability insurance has to be obtainable at an

affordable and reasonable cost throughout this Commonwealth.

(3)  Every effort must be made to reduce and eliminate

medical errors by identifying problems and implementing

solutions that promote patient safety.

(4)  Recognition and furtherance of these elements is

essential to the health, safety and welfare of the citizens

of Pennsylvania.

(5)  The costs of medical malpractice insurance premiums

are directly impacted by medical errors.

(6)  Research shows a vast majority of medical errors are

systemic rather than human errors.

(7)  Quality management systems implemented in the health

care industry and by the United States Department of Veterans

Affairs hospital system have reduced medical errors.

(8)  It is a further purpose of this act to improve

patient safety, improve health care quality and lower health

care costs by offering a reduction in medical malpractice

costs to health care providers that institute quality

management systems into health care.

Section 3.  Definitions. 

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Assessment."  The assessment imposed under section 712 of

the act of March 20, 2002 (P.L.154, No.13), known as the Medical

Care Availability and Reduction of Error (Mcare) Act.

"Department."  The Department of Health of the Commonwealth.

"Health care provider."  A primary health care center or a

person which contributes to and participates in the Medical Care

Availability and Reduction of Error Fund established under

section 712 of the act of March 20, 2002 (P.L.154, No.13), known

as the Medical Care Availability and Reduction of Error (Mcare)

Act, including a corporation, university or other educational

institution licensed or approved by the Commonwealth to provide

health care or professional medical services as a physician, a

certified nurse midwife, a podiatrist, hospital, nursing home,

birth center and an officer, employee or agent thereof acting in

the course and scope of their employment.

"Quality health care management system."  A health care

management system which is industrywide, systematic, sustainable

and centered on the quality of the system's operations and

outcomes. The term includes participation and accountability of

its members and an assurance of the availability of resources

and information needed to operate as planned, smoothly

integrated processes and systems, clear communications and

ongoing monitoring, measurement, feedback and corrective or

preventive actions to ensure the system produces intended

results.

Section 4.  Quality health care management system discount. 

A health care provider which implements a quality health care

management system to the satisfaction and approval of the

department shall be entitled to a 20% discount of the health

care provider's assessment for each year the total quality

health care management system is implemented and utilized. The

discount shall apply to the assessment paid by a health care

provider on behalf of other health care providers participating

in the quality management system.

Section 5.  Department.

(a)  Quality management health care system approval.--

(1)  A quality management health care system may apply to

the department for approval. The application shall be on a

form prescribed by the department and shall be accompanied by

a fee set by regulation.

(2)  Within 30 days of receipt of an application under

paragraph (1), the department shall:

(i)  if the department determines the system will

successfully reduce medical errors by a health care

provider, approve the application; or

(ii)  if the department determines the system will

not successfully reduce medical errors by a health care

provider, deny the application. This subparagraph is

subject to 2 Pa.C.S. Ch. 7 Subch. A (relating to judicial

review of Commonwealth agency action).

(3)  If the department fails to act within the time

specified in paragraph (2), the application shall be deemed

approved.

(b)  Quality management health care system implementation.--

The department shall provide health care providers with a

certification of implementation of total quality management

health care systems once the provider's application is approved

under this section. Health care providers shall provide the

certification to the Insurance Department in order to claim the

discount provided for under section 4.

(c)  Regulations.--The department and the Insurance

Department may promulgate regulations to implement this act.

(d)  Report.--On or before January 1, 2012, and each year

thereafter, the department and the Insurance Department shall

jointly provide a report on the effectiveness of this act. The

report shall include:

(1)  The name and number of total quality management

systems approved by the department. 

(2)  The name and number of quality management systems

disapproved by the department. 

(3)  The name and number of health care providers who

have received the discount. 

(4)  The total estimated savings to the health care

system.

Section 6.  Penalties and remedies.

(a)  Penalties and remedies.--Upon a determination by hearing

this act was violated, the Secretary of Health may pursue one or

more of the following courses of action:

(1)  Issue an order requiring the person in violation to

cease and desist from engaging in the violation.

(2)  Suspend or revoke or refuse to issue or renew the

certificate or license of the person in violation.

(3)  Impose a civil penalty of not more than $50,000 for

each violation.

(4)  Impose another appropriate remedy.

(b)  Other remedies.--The enforcement remedies imposed under

this section are in addition to other remedies or penalties that

may be imposed by another applicable statute.

Section 20.  Effective date.

This act shall take effect in 60 days.