Medical Licensing

Requires licensed or registered professional health care
providers to provide background information to the department of
commerce and consumer affairs.  Requires the department to create
a data repository of the information collected and to make such
information available to the public.

THE SENATE                              S.B. NO.           133
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that health care consumers
 2 are becoming increasingly more sophisticated and the demand for
 3 information to help guide their health care decision making has
 4 increased dramatically.  The legislature recently responded to
 5 this demand by passing the Patients' Bill of Rights and
 6 Responsibilities Act in 1998.  This new law allows consumers to
 7 access information about health plans previously unavailable to
 8 them and enables consumers to choose a health plan that offers
 9 benefits and services that best match their health care needs.
10      Due to the fact that health care providers, not health
11 plans, deliver care to consumers, more information must be made
12 available to allow consumers to choose the best provider for
13 them.  Aside from board certification, the Patients' Bill of
14 Rights did not require the disclosure of any information about
15 the qualifications or experience of health care providers.  
16      Choosing a provider is one of the most important health care
17 decisions a consumer can make, yet there is no easily accessible
18 relevant information about health care providers available to the
19 public.  The State needs to develop public policy that supports

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 1 the right of consumers to have essential information that allows
 2 them to make better informed health care decisions when selecting
 3 their health care providers.  
 4      Forty states have mandated the collection, analysis, and
 5 public distribution of health care data.  The purpose of this Act
 6 is to ensure consumer protection in health care by requiring all
 7 providers to submit to their respective licensing boards,
 8 specific information that will be disseminated by those boards
 9 under the department of commerce and consumer affairs to the
10 public.
11      SECTION 2.  Section 436B-2, Hawaii Revised Statutes, is
12 amended by adding a new definition to be appropriately inserted
13 and to read as follows:
14      ""Provider" means professional health care providers that
15 are licensed or registered pursuant to chapters 442, 448, 453,
16 459, 460, 463E, and 465."
17      SECTION 3.  Section 436B-7, Hawaii Revised Statutes, is
18 amended to read as follows:
19      "436B-7  Powers and duties of licensing authority.  (a)  In
20 addition to any other powers and duties authorized by law, each
21 licensing authority may:
22      (1)  Adopt, amend, or repeal rules, issue declaratory
23           rulings or informal non-binding interpretations, and

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 1           conduct contested case proceedings pursuant to chapter
 2           91;
 3      (2)  Grant, deny, forfeit, renew, reinstate, or restore
 4           licenses, including the issuance of conditional
 5           licenses;
 6      (3)  Revoke, suspend, or otherwise limit the license of any
 7           licensee for any violation of the provisions in this
 8           chapter, the licensing laws, or any rule or order of
 9           the licensing authority;
10      (4)  Develop requirements for licensure through the
11           applicable licensing law or rules;
12      (5)  Investigate and conduct hearings regarding any
13           violation of this chapter, the licensing laws, and any
14           rule or order of the licensing authority;
15      (6)  Monitor the scope of practice of the profession or
16           vocation regulated by the licensing authority;
17      (7)  Prepare, administer, and grade examinations, provided
18           that the licensing authority may contract with a
19           testing agency to provide those services, and the
20           licensing authority may also reserve the right to
21           modify, amend, change or regrade the examination;
22      (8)  Create fact-finding committees which may make
23           recommendations to the licensing authority for its

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 1           deliberations;
 2      (9)  Contract with qualified persons, including
 3           investigators, who may be exempt from chapters 76 and
 4           77 and who shall assist the licensing authority in
 5           exercising its powers and duties; and
 6     (10)  Subpoena witnesses and documents, administer oaths, and
 7           receive affidavits and oral testimony, including
 8           telephonic communications, and do any and all things
 9           necessary or incidental to the exercise of the
10           licensing authority's power and duties, including the
11           authority to conduct contested case proceedings under
12           chapter 91.
13      (b)  Each licensing authority shall collect provider
14 information pursuant to section 436B-10(c) which shall be used by
15 the department to create a data repository consisting of profiles
16 of each provider.  The provider profiles shall be made available
17 by the department in written form and electronically, where
18 available, for dissemination to the public.  Each licensing
19 authority may formulate appropriate disclaimers or explanatory
20 statements to be included with any information released by the
21 department." 
22      SECTION 4.  Section 436B-10, Hawaii Revised Statutes, is
23 amended to read as follows:

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 1      "436B-10 Application and requirements for licensure.(a)
 2 Application for a license shall be made on an application form to
 3 be furnished by the licensing authority.  An applicant shall
 4 provide the following information on the application form:
 5      (1)  The applicant's legal name;
 6      (2)  Affirmation that the applicant is beyond the age of
 7           majority;
 8      (3)  The applicant's current residence, business and mailing
 9           addresses, and phone numbers;
10      (4)  The applicant's social security number if the licensing
11           authority is authorized by federal law to require the
12           disclosure;
13      (5)  The date and place of any conviction of a penal crime
14           directly related to the profession or vocation in which
15           the applicant is applying for licensure, unless the
16           conviction has been expunged or annulled, or is
17           otherwise precluded from consideration by section 831-
18           3.1;
19      (6)  Proof that the applicant is a United States citizen, a
20           United States national, or an alien authorized to work
21           in the United States;
22      (7)  Disclosure of similar licensure in any state or
23           territory;

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 1      (8)  Disclosure of disciplinary action by any state or
 2           territory against any license held by the applicant;
 3           and
 4      (9)  Any other information the licensing authority may
 5           require to investigate the applicant's qualifications
 6           for licensure.
 7 Failure to provide the above information and pay the required
 8 fees shall be grounds to deny the application for licensure.
 9      (b)  In addition to any other requirements provided by law,
10 all applicants shall be:
11      (1)  Beyond the age of majority; and
12      (2)  A United States citizen, a United States national, or
13           an alien authorized to work in the United States.
14      (c)  In addition to any other information that may be
15 required from an applicant, each person who applies for initial
16 licensure as a provider or who applies for license renewal as a
17 provider, shall submit to the person's respective licensing board
18 at the time of application, the following information:
19      (1)  Names of professional schools attended and dates of
20           graduation;
21      (2)  Graduate professional education;
22      (3)  Number of years in practice;
23      (4)  Specialty board certification;

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 1      (5)  Type of practice for the most recent ten years;
 2      (6)  Names of the hospitals where the licensee has
 3           privileges;
 4      (7)  Appointments to medical school faculties and indication
 5           as to whether a licensee has a responsibility for
 6           graduate medical education within the most recent ten
 7           years;
 8      (8)  Information regarding publications in peer-reviewed
 9           medical literature within the most recent ten years;
10      (9)  Information regarding professional or community service
11           activities and awards;
12     (10)  Location of the licensee's primary practice setting;
13     (11)  Indication of whether the licensee participates in
14           Medicaid, Medicare, and QUEST programs;
15     (12)  Percentage of ownership interest the provider has in
16           other health facilities, laboratories, equipment, or
17           therapy, to which the provider's patients are, have
18           been, or may be referred, except for ownership interest
19           in the provider's primary practice business;
20     (13)  A description of any criminal convictions for felonies
21           and misdemeanors within the most recent ten years;
22     (14)  A description of any charges to which a provider pleads
23           nolo contendere or where sufficient facts of guilt were

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 1           found and the matter was continued without a finding by
 2           a court of competent jurisdiction;
 3     (15)  Temporary restraining orders issued against a provider;
 4     (16)  A description of any final board disciplinary action
 5           within the most recent ten years;
 6     (17)  A description of any final disciplinary actions by
 7           licensing boards in other states within the most recent
 8           ten years;
 9     (18)  Limitations on practice ordered by the board;
10     (19)  Public letters of reprimand;
11     (20)  Description of revocation or involuntary restriction of
12           hospital privileges, or a reduction in privileges for
13           more than one hundred eighty days, from any state, for
14           reasons related to competence or character after
15           procedural due process has been afforded;
16     (21)  Whether the provider has ever been sanctioned by the
17           federal government within the most recent ten years;
18     (22)  Whether the provider carries professional malpractice
19           insurance, and if so, what kind of insurance;
20     (23)  Whether the provider has ever been denied malpractice
21           insurance for reasons other than inactive status of
22           license or part-time practice;
23     (24)  All final medical malpractice court judgments and all

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 1           final medical malpractice arbitration awards in excess
 2           of $3,000 in which a payment was awarded to a
 3           complaining party during the most recent ten years and
 4           all settlements of medical malpractice claims in which
 5           a payment was made to a complaining party within the
 6           most recent ten years.  Nothing in this paragraph shall
 7           be construed to prevent the board from investigating
 8           and disciplining a licensee on the basis of medical
 9           malpractice claims that are pending;
10     (25)  A statement, signed under oath, by the provider,
11           attesting to the correctness and completeness of the
12           information contained in the profile.
13      The information shall be used by the department to create an
14 individual provider profile as required under section 436-7(b).
15 Each provider who has submitted information pursuant to this
16 subsection shall update the information in paragraphs (13) to
17 (24) in writing by notifying the board within forty-five days
18 after the occurrence of an event. 
19      All other updated information shall be submitted annually in
20 a statement, signed under oath, attesting to the correctness and
21 completeness of the information contained in the updated profile.  
22      The provider may submit an appropriate explanatory statement
23 to be included with any information released by the department."

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 1      SECTION 5.  Section 436B-18, Hawaii Revised Statutes, is
 2 amended to read as follows:
 3      "[[]436B-18[]]  Disciplinary action.  (a)  In addition to
 4 the licensing sanctions or remedies provided by section 92-17
 5 against any licensee, the licensing authority may also impose
 6 conditions or limitations upon a licensee's license after a
 7 hearing conducted in accordance with chapter 91.  The violation
 8 of any condition or limitation on a licensee's license may be
 9 cause to impose additional sanctions against the licensee.
10 Unless otherwise provided by law, any fine imposed by the
11 licensing authority after a hearing in accordance with chapter 91
12 shall be no less than $100 for each violation, and each day's
13 violation may be deemed a separate violation.
14      (b)  If a provider fails to comply with the requirements of
15 section 436B-10(c), the board shall:
16      (1)  Refuse to issue a license to any person applying for
17           initial licensure or license renewal;
18      (2)  Issue a citation to any licensee who fails to submit
19           and update the required information and may fine the
20           licensee up to $50 a day for each day that the licensee
21           is not in compliance with section 436B-10(c); or
22      (3)  Take any other disciplinary action it deems
23           appropriate, including a disciplinary action under the

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 1           appropriate licensing law."
 2      SECTION 6.  If any provision of this Act, or the application
 3 thereof to any person or circumstance is held invalid, the
 4 invalidity does not affect other provisions or applications of
 5 the Act which can be given effect without the invalid provision
 6 or application, and to this end the provisions of this Act are
 7 severable.
 8      SECTION 7.  New statutory material is underscored.
 9      SECTION 8.  This Act shall take effect on July 1, 2001.
11                           INTRODUCED BY:  _______________________