[ ON CASCA LETTERHEAD ]
Concerning the Establishment of Professional Review Committees
by Ambulatory Surgical Centers
This bill will provide equivalent treatment for licensed ambulatory surgical centers
(ASCs) as now exists for hospitals, health systems and other entities performing physician peer
review to protect the quality of care delivered to surgical and other patients.
BACKGROUND
What is Physician Peer Review (Professional Review)?
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Peer review committees are composed of physicians who assess the qualifications,
physician conduct, and appropriateness of patient care
Effective physician peer review by peer review committees of health care entities:
○ Improves the quality of care and patient safety
○ Limits physician staff membership to those who meet the entity’s quality
standards
○ Requires reporting of disciplinary actions to the Colorado Board of Medical
Examiners and the National Practitioner Data Bank
What Are Common Impediments to Effective Physician Peer Review?
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Threats of litigation against health care entities and peer review committee members by
disciplined physicians (e.g., antitrust, defamation, breach of contract)
Risk of discovery of peer review information in medical malpractice actions
What Laws Now Protect Physician Peer Review?
-- Federal Health Care Quality Improvement Act of 1986 (“HCQIA”)
42 U.S.C. § 11101, et seq.
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Provides qualified immunity for peer review activities involving physicians
and dentists
Immunity applies to damages for federal and state law violations
(e.g., antitrust)
Requires reports of physician disciplinary actions to the National Practitioner
Data Bank
-- Colorado Professional Review Act (1989) (the “Colorado PR Act”)
C.R.S. § 12-36.5-101, et seq.
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Provides qualified immunity for peer review activities involving physicians
Immunity applies to civil suits based on state law (e.g., defamation, breach of
contract)
Protects peer review information (e.g., minutes, expert reports) from
discovery in medical malpractice actions through a statutory privilege
Requires reports of physician disciplinary actions to the Colorado Board of
Medical Examiners
What Entities Are Now Covered by Colorado Law?
-- Colorado PR Act Provides Peer Review Immunity and Privilege To:
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Medical Staff of a Hospital
Medical Staff of a Hospital Related Corporation
Medical societies and associations
Malpractice insurers
Independent Practice Associations, Preferred Provider Organizations, Health
Maintenance Organization – captive physicians
Other health care entities approved by the Colorado Board of Medical
Examiners such as Health Maintenance Organizations and Health System
Affiliates
Will This Bill Affect the New Michael Skolnick Law?
-- Medical Transparency Act C.R.S. § 12-36-115
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Physicians must disclose peer review discipline to the Colorado Board of
Medical Examiners
The Colorado Board of Medical Examiners makes this information available
to the public
The physician’s disclosure is not a waiver of the privilege and confidentiality
of peer review information
Reporting and transparency obligations are not affected
WHY IS THIS BILL NEEDED?
-- To modernize the existing Colorado PR Act enacted in 1989, by including ASCs
-- When the Colorado PR Act was enacted, ASCs were in infancy and outpatient
surgery was not common
-- Today, some 80% of all surgery is outpatient, and over 100 ASCs are licensed by the
Colorado Department of Public Health and Environment
-- Physician peer review is an important quality initiative for ASCs as well as hospitals
-- The Bill promotes detailed oversight of all outpatient surgery, whether performed in a
hospital or an ASC
-- Consumers are the ultimate beneficiaries of this effort to improve patient care
For further information, contact Asan Kahn, [ list Asan’s title ] at akhan@fasa.org or
(303) 761-3596.
fb.us.2449441.01