Three New Laws With Immediate Impact

The 2013 meeting of the Arkansas Legislature will be remembered most for adopting the “private option,” an innovative and game-changing alternative to expanding the Arkansas Medicaid program to persons making up to 138 percent of poverty. AMS played a major role in helping pass the private option, but behind the front page headlines, the AMS was busy gaining passage of several other pieces of legislation designed to help physicians. A full report will appear in the next issue of the Journal of the Arkansas Medical Society, but three are worth mentioning here:

Act 587 – Office-Based Surgery Regulation

Many physicians were surprised last year upon learning that if they performed surgery in their office under general or IV anesthesia their clinic fell under the definition of an “outpatient surgery center,” which under Arkansas statutes requires a facility license from the Arkansas Department of Health. The licensure rules are cumbersome and designed for freestanding facilities rather than a physician’s office. That has now been corrected with the passage of Act 587, sponsored by Rep. Steve Magie, MD. This new law clarifies that the definition of outpatient surgery center does not include a medical office owned and operated by a physician(s) if the medical office does not bill facility fees to a third party payer. The new law places the regulation of office-based surgery (using general or IV anesthesia) under the Arkansas State Medical Board and provides an 18 month window during which the Board will adopt regulations that physicians should follow if performing office-based surgery.

Act 441 – Peer Review by Medical Practices

As more and more attention is being focused on quality of care, many medical practices have approached AMS about conducting peer review activities within their clinics. A major obstacle has been the concern that the records and testimony that would be needed could be subject to discovery in civil actions. Current law protects these documents and testimony only for “hospital” peer review committee activities. Act 441, sponsored by Senator Cecile Bledsoe, extends these same protections to medical offices conducting peer review under “a written plan or policy,” which simply means it must be a formal, purposeful process designed to improve quality of care.

Act 887 – Peer Review Fairness

This act, also sponsored by Sen. Bledsoe, strengthens the hospital peer review process by ensuring due process and avoidance of conflicts of interest. Among other things, the law requires that a physician be given notice as soon as he/she has been referred for an investigation; insures the physician has the right to be represented by legal counsel and have counsel present at any proceedings where counsel is present for the hospital or peer review committee; gives the physician the right to discuss the case with the peer review body BEFORE it makes a decision; if a hearing officer is used, the hearing officer cannot be the hospital’s attorney or employee. The bill also contains language protecting the physicians and other individuals conducting peer review activities from civil damages and encourages medical staffs to obtain independent counsel to review medical staff bylaws (or changes).

For complete copies of these and other AMS supported Acts passed during the recent General Assembly, visit the AMS Legislative webpage.