Enrolled HB 500: Including the Joint Commission on Accreditation of Healthcare Organizations under the definition of medical review organizations.

00Enrolled HB 500 01 Including the Joint Commission on Accreditation of Healthcare Organizations under the 02 definition of medical review organizations. 03 _______________ 04 * Section 1. AS 18.23.070(5) is amended to read: 05 (5) "review organization" means 06 (A) a hospital governing body or a committee whose 07 membership is limited to health care providers and administrative staff, except 08 where otherwise provided for by state or federal law, and that is established by 09 a hospital, by a clinic, by one or more state or local associations of health care 10 providers, by an organization of health care providers from a particular area or 11 medical institution, or by a professional standards review organization 12 established under 42 U.S.C. 1320c-1, to gather and review information relating 13 to the care and treatment of patients for the purposes of 14 (i) evaluating and improving the quality of health care

01 rendered in the area or medical institution; 02 (ii) reducing morbidity or mortality; 03 (iii) obtaining and disseminating statistics and 04 information relative to the treatment and prevention of diseases, illness, 05 and injuries; 06 (iv) developing and publishing guidelines showing the 07 norms of health care in the area or medical institution; 08 (v) developing and publishing guidelines designed to 09 keep the cost of health care within reasonable bounds; 10 (vi) reviewing the quality or cost of health care services 11 provided to enrollees of health maintenance organizations; 12 (vii) acting as a professional standards review 13 organization under 42 U.S.C. 1320c; 14 (viii) reviewing, ruling on, or advising on controversies, 15 disputes, or questions between a health insurance carrier or health 16 maintenance organization and one or more of its insured or enrollees; 17 between a professional licensing board, acting under its powers of 18 discipline or license revocation or suspension, and a health care 19 provider licensed by it when the matter is referred to a review 20 organization by the professional licensing board; between a health care 21 provider and the provider's patients concerning diagnosis, treatment, or 22 care, or a charge or fee; between a health care provider and a health 23 insurance carrier or health maintenance organization concerning a 24 charge or fee for health care services provided to an insured or enrollee; 25 or between a health care provider or the provider's patients and the 26 federal or a state or local government, or an agency of the federal or a 27 state or local government; 28 (ix) acting on the recommendation of a credential 29 review committee or a grievance committee; 30 (B) the State Medical Board established by AS 08.64.010; 31 (C) a committee established by the commissioner of health and

01 social services and approved by the State Medical Board to review public 02 health issues regarding morbidity or mortality; at least 75 percent of the 03 committee members must be health care providers; 04 (D) the Joint Commission on Accreditation of Healthcare 05 Organizations (JCAHO).