§ 2995-A — Physician profiles

New York § 2995-A

• Jurisdiction: New York
• Law PBH: Public Health
• Title 1: Health Information
• Art. 29-D: Health Information and Quality Improvement

Text

§ 2995-a. Physician profiles. 1. The department shall collect the\nfollowing information and create individual profiles on licensees\nsubject to the authority of the office of professional medical conduct,\nin a format that shall be available for dissemination to the public:\n (a) a statement of any criminal convictions (as defined by section\n1.20 of the criminal procedure law) within the most recent ten years,\nunder the laws of New York state or any other jurisdiction, for offenses\nspecified by regulations of the department;\n (b) a statement of any action (other than an action that remains\nconfidential) taken against the licensee pursuant to section two hundred\nthirty of this chapter or any similar action taken by any other state or\nlicensing entity, within the most recent ten years;\n (c) a statement of any current limitation of the licensee to a\nspecified area, type, scope or condition of practice;\n (d) a statement of any loss or involuntary restriction of hospital\nprivileges or a failure to renew professional privileges at hospitals\nwithin the last ten years, for reasons related to the quality of patient\ncare delivered or to be delivered by the physician where procedural due\nprocess has been afforded, exhausted, or waived, or the resignation from\nor removal of medical staff membership or restriction of privileges at a\nhospital taken in lieu of a pending disciplinary case related to the\nquality of patient care delivered or to be delivered by the physician\n(notwithstanding paragraph (a) of subdivision three of section\ntwenty-eight hundred three-e of this chapter, as added by chapter eight\nhundred sixty-six of the laws of nineteen hundred eighty);\n (e) (i) a statement indicating the number of medical malpractice court\njudgments and arbitration awards within the most recent ten years in\nwhich a payment is awarded to a complaining party (notwithstanding\nsubsection (f) of section three hundred fifteen of the insurance law);\nand\n (ii) a statement indicating all malpractice settlements within the\nmost recent ten years in which payment is awarded to a complaining party\n(notwithstanding subsection (f) of section three hundred fifteen of the\ninsurance law),\n (A) if the total number of settlements exceeds two; or\n (B) if the commissioner determines any such settlement could be\nrelevant to patient decisionmaking concerning health care quality. The\nstatement shall include the following: "Settlement payments will appear\nin this profile only if the total number of settlements made within the\npast ten years exceeds two, or if the commissioner of health determines\na settlement to be relevant to patient decisionmaking. Settlement of a\nclaim may occur for a variety of reasons, which do not necessarily\nreflect negatively on the professional competence or conduct of the\nphysician. A payment in settlement of a medical malpractice action or\nclaim does not necessarily mean that a medical malpractice has\noccurred." The commissioner may supplement such statement as may be\nappropriate.\n (iii) judgments, awards and settlements shall be reported in graduated\ncategories indicating the level of significance, date and place of the\njudgment, award or settlement. Information concerning medical\nmalpractice judgments, awards and settlements shall be put in context by\ncomparing an individual licensee's medical malpractice settlements to\nthe experience of other physicians in New York state within the same\nboard specialty. Pending malpractice claims shall not be disclosed to\nthe public under this section. Nothing herein shall be construed to\nprevent the board from investigating or disciplining a licensee on the\nbasis of medical malpractice claims that are pending;\n (f) name of medical schools attended and date of graduations;\n (g) graduate medical education;\n (h) current specialty board certification and date of certification;\n (i) dates admitted to practice in New York state;\n (j) names of hospitals where the licensee has practice privileges;\n (k) appointments to medical school faculties and indication as to\nwhether a licensee has had a responsibility for graduate medical\neducation within the most recent ten years;\n (l) information regarding publications in peer reviewed medical\nliterature within the most recent ten years;\n (m) information regarding professional or community service activities\nor awards;\n (n) (i) the location of the licensee's primary practice setting\nidentified as such; and\n (ii) the names of any licensed physicians with whom the licensee\nshares a group practice, as defined in subdivision five of section two\nhundred thirty-eight of this chapter;\n (o) the identification of any translating services that may be\navailable at the licensee's primary practice location;\n (p) whether the licensee participates in the medicaid or medicare\nprogram or any other state or federally financed health insurance\nprogram; and\n (q) health care plans with which the licensee has contracts,\nemployment, or other affiliation; provided that the reporting of such\ninformation shall not be the responsibility of the physician, but shall\nbe included and updated by the department utilizing provider network\nparticipation information, or other reliable sources of information\nsubmitted by health care plans.\n 1-a. Each physician licensed and registered to practice in this state\nshall within thirty days of the transmittal of an initial profile survey\nand upon entering or updating his or her profile information:\n (a) register and maintain an account with the department's health\nprovider network and any successor electronic system established to\nfacilitate communications between the department and licensed health\ncare providers; or\n (b) provide an e-mail address to the department which shall be used by\nthe department to communicate with the physician. Licensees shall\nprovide notice to the department of changed e-mail addresses within\nthirty days of the change. Licensee e-mail addresses shall be\nconfidential and shall not be published as part of the licensee's\nprofile. The e-mail addresses may be used for department purposes only.\n 2. Nothing in this section shall limit the department's authority to\ncollect, require reporting of, publish or otherwise disseminate\ninformation about licensees.\n 3. Each physician who is self-insured for professional medical\nmalpractice shall periodically report to the department on forms and in\nthe time and manner required by the commissioner the information\nspecified in paragraph (e) of subdivision one of this section, except\nthat the physician shall report the dollar amount (to the extent of the\nphysician's information and belief) for each judgment, award and\nsettlement and not a level of significance or context.\n 4. Each physician shall periodically report to the department on forms\nand in the time and manner required by the commissioner any other\ninformation as is required by the department for the development of\nprofiles under this section which is not otherwise reasonably\nobtainable. In addition to such periodic reports and providing the same\ninformation, each physician shall update his or her profile information\nwithin the six months prior to the submission of the re-registration\napplication, as a condition of registration renewal under article one\nhundred thirty-one of the education law. Except for optional information\nprovided, physicians shall notify the department of any change in the\nprofile information within thirty days of such change.\n 5. The department shall provide each licensee with a copy of his or\nher profile prior to dissemination to the public. In the manner and time\nrequired by the commissioner, a licensee shall be provided the\nopportunity to correct factual inaccuracies that appear in the profile.\nThe physician shall be permitted to file a concise statement concerning\ninformation contained in the profile, which shall be disseminated\ntherewith.\n 6. A physician may elect to have his or her profile omit certain\ninformation provided pursuant to paragraphs (l), (m) and (n) of\nsubdivision one of this section. In collecting information for such\nprofiles and disseminating the same, the department shall inform\nphysicians that they may choose not to provide such information required\npursuant to paragraphs (l), (m) and (n) of subdivision one of this\nsection.\n 7. A physician who knowingly provides materially inaccurate\ninformation under this section shall be guilty of professional\nmisconduct pursuant to section sixty-five hundred thirty of the\neducation law.\n 7-a. For purposes of this section, a physician may authorize a\ndesignee to register, transmit, enter or update information on his or\nher behalf, provided that:\n (a) the designee so authorized is employed by the physician or the\nsame professional practice or is under contract with such practice;\n (b) the physician takes reasonable steps to ensure that such designee\nis sufficiently competent in the profile requirements; and\n (c) the physician remains responsible for ensuring the accuracy of the\ninformation provided and for any failure to provide accurate\ninformation.\n The commissioner shall establish in regulation reasonable parameters\nwith regard to a physician's ability to authorize designees pursuant to\nthis section, which shall include processes necessary to allow the\ndepartment to: (i) grant access to the profile in a reasonably prompt\nmanner to designees authorized by physicians; (ii) require that\nphysicians notify the department upon terminating the authorization of\nany designee; and (iii) establish a mechanism to prevent such terminated\ndesignees from accessing the profile in a reasonably prompt manner\nfollowing such notification.\n 8. The department shall establish a toll-free telephone number through\nwhich it shall answer inquiries about and accept orders for hard copy\nphysician profiles established pursuant to this section and accept\nconsumer complaints about suspected professional misconduct. The\ndepartment may charge a nominal fee for producing and mailing a hard\ncopy physician profile.\n 9. The department shall, in addition to hard copy physician profiles,\nprovide for electronic access to and copying of physician profiles\ndeveloped pursuant to this section through the system commonly known as\nthe Internet. The department shall update a physician's online profile\nwithin thirty days of receipt of a completed physician profile survey or\nany change in profile information.\n 10. The commissioner shall require that:\n (a) Practitioner organizations that are representative of the target\ngroup for profiling, and health care consumer organizations, be provided\nthe opportunity to review and comment on the profiling methodology,\nincluding collection methods, analysis, formatting, and methods and\nmeans for release and dissemination.\n (b) Comparisons of practitioner profiles shall be organized according\nto practitioner areas of practice.\n 11. The commissioner shall evaluate the utility and practicability of\nincluding in the profile a comparison of malpractice data by geographic\narea. However, the implementation of the profile shall not be delayed\npending such evaluation.\n 12. The commissioner shall develop and distribute a notice suitable\nfor posting that informs consumers of the availability of physician\nprofiles and the telephone numbers and Internet addresses for accessing\nthem.\n 13. Further study of physician profiles. After the initial\ndissemination of the data identified in subdivision one of this section,\nthe department shall conduct a further study of physician profiles as\nfollows:\n (a) Data sources. The department shall identify the types of physician\ndata to which the public has access, including all information available\nfrom federal, state or local agencies which is useful for making\ndeterminations concerning health care quality determinations. The\ndepartment shall study all physician data reporting requirements and\ndevelop recommendations to consolidate data collection and eliminate\nduplicate and unnecessary reporting requirements, or to supplement\nexisting reporting requirements in order to satisfy the requirements of\nthis section. The department shall study the feasibility of\nincorporating health plan reporting requirements, without imposing any\nextra burden on the physician, regarding network participation into this\nsection to ensure this information is available, accurate, up-to-date\nand accessible to consumers.\n (b) Supplemental information adjustment and security safeguards. The\ndepartment shall develop a methodology for application to collected\nphysician data that accounts for factors such as frequency, severity and\ngeographic area which shall be used to provide context to reported data.\nAny such methodology shall not diminish the information reported\npursuant to subdivision one of this section. In developing such\nmethodology, the department may consult with physicians, including\nrepresentatives of appropriate specialty societies. The department may\nalso consult with organizations representing consumers, other health\ncare providers, and health care plans. Any such methodology shall\ninclude adequate and appropriate safeguards to ensure the security,\naccuracy and integrity of health information created, received,\nmaintained, used or transmitted in connection with the statewide health\ninformation system. Such safeguards shall be sufficient to meet any\nminimum standards set by state and federal laws and regulations.\n (c) Public review. The department shall provide organizations which\nare representative of consumers, physicians, including representatives\nof appropriate specialty societies, other health care providers and\nhealth care plans the opportunity to review and comment on its\ndeterminations and recommendations. The department shall consider such\ncomments, and may amend its determinations and recommendations to\nreflect them.\n (d) Report. The department shall provide a report of its\ndeterminations and recommendations under this subdivision to the\ngovernor and legislature, and make such report publicly available, on or\nbefore January first, two thousand sixteen. The department shall report\nannually thereafter to the legislature on the status of the physician\nprofiles and any recommendations for additions, consolidations or other\nchanges deemed appropriate.\n 14. The physician data so disseminated shall be updated at regular\nintervals to be determined by the department.\n 15. (a) All physician data disseminated shall include the following\nstatements: "THE DATA COLLECTED BY THE DEPARTMENT IS ACCURATE TO THE\nBEST OF THE KNOWLEDGE OF THE DEPARTMENT, BASED ON THE INFORMATION\nSUPPLIED BY THE PHYSICIAN WHO IS THE SUBJECT OF THE DATA. WHILE THE\nDEPARTMENT UTILIZES A VARIETY OF SOURCES OF INFORMATION IN CHECKING THE\nACCURACY OF THE DATA REPORTED, WE CANNOT BE SURE THAT ALL OF THE\nINFORMATION ON THIS WEBSITE IS RIGHT, COMPLETE, OR UP-TO-DATE, AND\nCANNOT BE RESPONSIBLE FOR ANY INFORMATION THAT IS WRONG OR HAS BEEN LEFT\nOUT. CONSUMERS ARE ENCOURAGED TO CONSULT OTHER SOURCES TO VERIFY OR\nOBTAIN ADDITIONAL INFORMATION ABOUT A PHYSICIAN. PENDING LEGAL ACTIONS\nDO NOT IN ANY WAY INDICATE PARTIES' GUILT, LIABILITY OR CULPABILITY.\nCASES MAY BE DISMISSED, WITHDRAWN, OR SETTLED WITHOUT PAYMENTS TO\nPLAINTIFFS. ANY DISPOSITION TO A CASE MAY BE SUBJECT TO APPEAL." The\ncommissioner shall ensure that the full text of the statements appear on\neach web page of the physician profile in a manner that does not require\nthe user of the site to click on a separate link in order to view the\nstatements.\n (b) The department shall provide on the physician profiles an active\nlink to the website maintained by the unified court system containing\ninformation on active and disposed cases in the local and state courts\nin the state.\n 16. If, after initial dissemination of the physician data required by\nthis section, the department determines that any such data is not useful\nfor making quality determinations, the department shall recommend to the\nlegislature the necessary statutory changes.\n