II

103D CONGRESS

2D SESSION S. 2323

To amend title 38, United States Code, to clarify the coverage and protection

provided to medical quality assurance records by section 5705 of that title.

IN THE SENATE OF THE UNITED STATES

JULY 26 (legislative day, JULY 20), 1994

Mr. ROCKEFELLER (by request) introduced the following bill; which was read

twice and referred to the Committee on Veterans’ Affairs

A BILL

To amend title 38, United States Code, to clarify the coverage and protection provided to medical quality assurance records by section 5705 of that title.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. BAN ON DISCLOSURE OF MEDICAL QUALITY AS4 SURANCE INFORMATION.

5 Subsection (a) of section 5705 of title 38, United

6 States Code, is amended—

7 (1) by inserting ‘‘(1)’’ after ‘‘(a)’’; and

8 (2) by adding at the end the following:

9 ‘‘(2)(A) Except as provided in subsection (b), no part

10 of any medical quality assurance record or document de-
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1 scribed in subsection (a)(1) may be subject to discovery

2 or admitted into evidence in any judicial or administrative

3 proceeding.

4 ‘‘(B) An individual who reviews or creates medical

5 quality assurance records or documents for the Depart6 ment or who participates in any proceeding that reviews

7 or creates such records or documents may not be per8 mitted or required to testify in any judicial or administra9 tive proceeding with respect to such records or documents

10 or with respect to any finding, recommendation, evalua11 tion, opinion, or action taken by such person in connection

12 with such records or documents except as provided in this

13 section.’’.

14 SEC. 2. DISCLOSURE AUTHORITY.

15 (a) CLARIFICATION OF COVERAGE.—Subsection

16 (b)(1) of section 5705 of title 38, United States Code, is

17 amended by striking out ‘‘or document’’ in the matter

18 above subparagraph (A) and inserting in lieu thereof ‘‘,

19 document, or testimony’’.

20 (b) DISCLOSURE FOR PROFESSIONAL USE.—Such

21 subsection is further amended by adding at the end the

22 following:

23 ‘‘(E) In an administrative or judicial proceeding

24 commenced by a criminal or civil law enforcement

25 agency or instrumentality referred to in subpara-
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1 graph (C), but only concerning the subject of such

2 proceeding.

3 ‘‘(F) To a governmental board or agency or to

4 a professional health care society or organization, if

5 such record or document is needed by the board,

6 agency, society, or organization to issue a profes7 sional license or credential to or to monitor the com8 pliance with professional standards of any health

9 care provider who is or was an employee of the De10 partment.

11 ‘‘(G) To a hospital, medical center, or other in12 stitution that provides health care services, if such

13 record or document is needed by the institution to

14 assess the professional qualifications of any health

15 care provider who is or was an employee of the De16 partment and who has applied for or been granted

17 authority or employment to provide health care serv18 ices in or on behalf of such institution.

19 ‘‘(H) To an administrative or judicial proceed20 ing commenced by a present or former Department

21 health care provider concerning the termination, sus22 pension or limitation of the clinical privileges of such

23 health care provider, or concerning any adverse ac24 tion involving such health care provider, but only to

25 the extent that such records or documents relate to
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1 the clinical conduct or performance of the individual

2 who has commenced the action.’’.

3 (c) REMOVAL OF IDENTITIES.—Subsection (b)(2) of

4 such section is amended by striking out ‘‘if disclosure’’

5 and all that follows through ‘‘personal privacy’’ and insert6 ing in lieu thereof ‘‘subparagraphs (1)(A) and (1)(B) of

7 this subsection’’.

8 SEC. 3. LIMITATION ON DISCLOSURE.

9 Paragraph (3) of section 5705(b) of title 38, United

10 States Code, is amended to read as follows:

11 ‘‘(3) A person or entity having possession of, or ac12 cess to, information, records, or documents, or testimony

13 relating thereto, that is subject to the provisions of this

14 section may not disclose such information, records, or doc15 uments, or any testimony relating thereto, in any manner

16 or for any purpose except for a purpose as provided in

17 this subsection. No person or entity to whom a record or

18 document has been disclosed under this subsection shall

19 make further disclosure of such record or document except

20 for a purpose provided in this subsection.’’.

21 SEC. 4. ACCESS TO RECORDS.

22 Subsection (b) of section 5705 of title 38, United

23 States Code, is amended by adding at the end the follow24 ing:
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1 ‘‘(7) Medical quality assurance records and docu2 ments described in subsection (a) which are subject to sec3 tion 552a of title 5 may not be disclosed in accordance

4 with that section except to the extent that such disclosure

5 is also authorized under this section.

6 ‘‘(8) Medical quality assurance records or documents

7 described in subsection (a) which are also subject to sec8 tion 552a of title 5—

9 ‘‘(A) shall not be subject to the access provi10 sions of such section 552a to the extent that such

11 access would reveal the identities of participants in

12 the quality assurance process which generated the

13 records or documents; and

14 ‘‘(B) are not subject to the amendment provi15 sions of such section 552a.

16 ‘‘(9) Medical quality assurance records and docu17 ments described in subsection (a) may not be made avail18 able to any person under section 552 of title 5.’’.

19 SEC. 5. REGULATIONS.

20 Subsection (d)(2) of section 5705 of title 38, United

21 States Code, is amended by striking out ‘‘specified in’’ and

22 inserting in lieu thereof ‘‘accomplished in accordance

23 with’’.

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