SENATE BILL 198

49th legislature - STATE OF NEW MEXICO - first session, 2009

INTRODUCED BY

David Ulibarri

AN ACT

RELATING TO HEALTH CARE; AMENDING THE REVIEW ORGANIZATION IMMUNITY ACT TO INCLUDE THE DEPARTMENT OF HEALTH'S MORTALITY REVIEW ACTIVITIES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     Section 1. Section 41-9-1 NMSA 1978 (being Laws 1979, Chapter 169, Section 1) is amended to read:

     "41-9-1. SHORT TITLE.--[This act] Chapter 41, Article 9 NMSA 1978 may be cited as the "Review Organization Immunity Act"."

     Section 2. Section 41-9-2 NMSA 1978 (being Laws 1979, Chapter 169, Section 2, as amended) is amended to read:

     "41-9-2. DEFINITIONS.--As used in the Review Organization Immunity Act:

          A. "person" means any individual, corporation, partnership, firm or other entity;

          B. "health care provider" means any person licensed by the state or permitted by law to provide health care services;

          C. "health care services" means services rendered by a health care provider of the type the health care provider is licensed or permitted to provide;

          D. "staff" means the members of the governing board, officers and employees of a health care provider [which] that is not an individual; and

          E. "review organization":

                (1) means an organization whose membership is limited to health care providers and staff, except where otherwise provided for by state or federal law, and [which] that is established by a health care provider [which] that is a hospital, by one or more state or local associations of health care providers, by a nonprofit health care plan, by a health maintenance organization, by an emergency medical services system or provider as defined in the Emergency Medical Services Act 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:

                     [(1)] (a) evaluating and improving the quality of health care services rendered in the area or by a health care provider;

                     [(2)] (b) reducing morbidity or mortality;

                     [(3)] (c) obtaining and disseminating statistics and information relative to the treatment and prevention of diseases, illnesses and injuries;

                     [(4)] (d) developing and publishing guidelines showing the norms of health care services in the area or by health care providers;

                     [(5)] (e) developing and publishing guidelines designed to keep within reasonable bounds the cost of health care services;

                     [(6)] (f) reviewing the nature, quality or cost of health care services provided to enrollees of health maintenance organizations and nonprofit health care plans;

                     [(7)] (g) acting as a professional standards review organization pursuant to 42 U.S.C. Section 1320c-1, et seq.; or

                     [(8)] (h) determining whether a health care provider shall be granted authority to provide health care services using the health care provider's facilities or whether a health care provider's privileges should be limited, suspended or revoked; and

                (2) includes the department of health when it is engaged in mortality review activities pursuant to Subsection U of Section 24-1-3 NMSA 1978."

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