II 

108TH CONGRESS 

2D SESSION S. 2341

To amend the Health Care Quality Improvement Act of 1986 to expand 

the National Practitioner Data Bank. 

IN THE SENATE OF THE UNITED STATES 

APRIL 22, 2004

Mr. CORZINE (for himself, Mr. LAUTENBERG, and Mr. DURBIN) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL

To amend the Health Care Quality Improvement Act of 

1986 to expand the National Practitioner Data Bank.

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Safe Health Care Re5 porting Act of 2004’’. 

6 SEC. 2. REPORTING OF SANCTIONS. 

7 Section 422 of the Health Care Quality Improvement 

8 Act of 1986 (42 U.S.C. 11132) is amended— 
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1 (1) in the section heading by striking ‘‘BOARDS

2 OF MEDICAL EXAMINERS’’ and inserting ‘‘STATE LI3 CENSING BOARDS’’; 

4 (2) in paragraphs (1) and (2) of subsection 

5 (a)— 

6 (A) by striking ‘‘physician’s’’ each place it 

7 appears and inserting ‘‘physician’s or other 

8 health care practitioner’s’’; and 

9 (B) by striking ‘‘physician’’ each place it 

10 appears and inserting ‘‘physician or other 

11 health care practitioner’’; and 

12 (3) in subsections (a) and (b), by striking 

13 ‘‘Board of Medical Examiners’’ each place it appears 

14 and inserting ‘‘State licensing board’’. 

15 SEC. 3. REPORTING OF CERTAIN PROFESSIONAL REVIEW 

16 ACTIONS. 

17 Section 423 of the Health Care Quality Improvement 

18 Act of 1986 (42 U.S.C. 11133) is amended— 

19 (1) by striking ‘‘Board of Medical Examiners’’ 

20 each place it appears and inserting ‘‘State licensing 

21 board’’; 

22 (2) in subsection (a)— 

23 (A) by striking paragraph (2) and insert24 ing the following: 
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1 ‘‘(2) MANDATORY REPORTING ON OTHER LI2 CENSED HEALTH CARE PRACTITIONERS.—A health 

3 care entity shall report to the appropriate State li4 censing boards and to the agency designated under 

5 section 424(b), the information described in para6 graph (3) in the case of a licensed health care prac7 titioner who is not a physician, if the entity would 

8 be required to report such information under para9 graph (1) with respect to the practitioner if the 

10 practitioner were a physician.’’; 

11 (B) by redesignating paragraph (3)(C) as 

12 paragraph (3)(D); and 

13 (C) by striking paragraph (3)(B) and in14 serting the following: 

15 ‘‘(B) a description of any adverse action, 

16 including dismissal and review action, taken by 

17 a hospital or other health care entity against a 

18 health care practitioner who is employed by, has 

19 privileges at, is under contract with, or other20 wise works at the health care entity for conduct 

21 that may be construed to violate any Federal or 

22 State law, including laws governing licensed 

23 health care professional practice standards, 

24 ‘‘(C) information on a health care practi25 tioner who voluntarily resigns during, or as a 
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1 result of, a pending dismissal or review action, 

2 and’’; 

3 (3) by redesignating subsections (b), (c), and 

4 (d) as subsections (c), (d), and (e), respectively; 

5 (4) by inserting after subsection (a), the fol6 lowing: 

7 ‘‘(b) STANDARD FOR REPORTING OF ADVERSE AC8 TIONS.—Adverse actions reported under subsection (a)(2) 

9 shall be made in accordance with the rights and proce10 dures afforded to physicians under section 412.’’; 

11 (5) in subsection (c) (as so redesignated), in the 

12 subsection heading, by striking ‘‘BOARD OF MED13 ICAL EXAMINERS’’ and inserting ‘‘STATE LICENSING

14 BOARD’’; 

15 (6) in subsection (d)(1) (as so redesignated), by 

16 striking ‘‘subsection (a)(1)’’ and inserting ‘‘para17 graphs (1) and (2) of subsection (a) and subsection 

18 (b)’’; 

19 (7) in subsection (d)(2) (as so redesignated), in 

20 the paragraph heading, by striking ‘‘BOARD OF

21 MEDICAL EXAMINERS’’ and inserting ‘‘STATE LI22 CENSING BOARD’’; 

23 (8) in subsection (e) (as so redesignated), in the 

24 subsection heading, by striking ‘‘BOARD OF MED-
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1 ICAL EXAMINERS’’ and inserting ‘‘STATE LICENSING

2 BOARD’’; and 

3 (9) by adding at the end the following: 

4 ‘‘(f) CIVIL PENALTIES.—

5 ‘‘(1) IN GENERAL.—The Secretary shall provide 

6 for the imposition of no more than $50,000 per vio7 lation for health care entities that fail to comply 

8 with this section. 

9 ‘‘(2) REPEATED VIOLATIONS.—The Secretary 

10 shall provide for civil penalties in addition to the 

11 amount listed in paragraph (1) for health care enti12 ties that establish patterns of repeated violations of 

13 this section.’’. 

14 SEC. 4. CIVIL PENALTIES. 

15 Section 425 of the Health Care Quality Improvement 

16 Act of 1986 (42 U.S.C. 11135) is amended—

17 (1) in paragraphs (1) and (2) of subsection (a), 

18 and subsections (b) and (c), by striking ‘‘hospital’’ 

19 each place it appears and inserting ‘‘health care en20 tity or agency employing a physician or other li21 censed health care practitioner’’; 

22 (2) in subsection (a)—

23 (A) in the matter preceding paragraph 

24 (1)—
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1 (i) by striking ‘‘each hospital’’ and in2 serting ‘‘each health care entity and agen3 cy employing a physician or other licensed 

4 health care practitioner’’; and 

5 (ii) by inserting ‘‘and from the appro6 priate State licensing board,’’ after ‘‘(or 

7 the agency designated under section 

8 424(b)),’’; 

9 (B) in paragraph (1), by inserting ‘‘or em10 ployment’’ after ‘‘clinical privileges’’; and 

11 (C) in paragraph (2), by inserting ‘‘or em12 ployed’’ after ‘‘clinical privileges’’; 

13 (3) in subsection (c), by striking ‘‘hospital’s’’ 

14 and inserting ‘‘the health care entity’s or agency’s’’ 

15 and 

16 (4) by adding at the end the following: 

17 ‘‘(d) CIVIL PENALTIES.—

18 ‘‘(1) IN GENERAL.—The Secretary shall provide 

19 for the imposition of no more than $50,000 per vio20 lation for a health care entity or agency employing 

21 a physician or other licensed health care practitioner 

22 that fails to comply with this section. 

23 ‘‘(2) REPEATED VIOLATIONS.—The Secretary 

24 shall provide for civil penalties in addition to the 

25 amount listed in paragraph (1) for a health care en-
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1 tity or agency employing a physician or other li2 censed health care practitioner that establishes pat3 terns of repeated violations of this section.’’. 

4 SEC. 5. PROFESSIONAL REVIEW. 

5 Section 411 of the Health Care Quality Improvement 

6 Act of 1986 (42 U.S.C. 11111) is amended by adding at 

7 the end the following: 

8 ‘‘(d) CIVIL LIABILITY IMMUNITY FOR HEALTH CARE

9 ENTITIES.— 

10 ‘‘(1) IN GENERAL.—A health care entity that 

11 discloses information about a former or current em12 ployee pursuant to section 423 is immune from civil 

13 liability for such disclosure and its consequences un14 less it is demonstrated that the employer— 

15 ‘‘(A) knowingly disclosed false information; 

16 or 

17 ‘‘(B) violated any right of the former or 

18 current employee that is protected under Fed19 eral or State laws. 

20 ‘‘(2) APPLICATION.—This subsection applies to 

21 any employee, agent, or other representative of the 

22 current or former employer who is authorized to pro23 vide and who provides information in accordance 

24 with section 423. 
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1 ‘‘(e) PROTECTION OF HEALTH CARE PRACTI2 TIONERS.—A health care entity shall not penalize, dis3 criminate, or retaliate in any manner with respect to em4 ployment, including discharge, promotion, compensation, 

5 or terms, conditions, or privileges of employment, against 

6 an employee who, in good faith, reports conduct that may 

7 be construed to violate a Federal or State law, including 

8 laws governing licensed health care professional practice 

9 standards, to a State authority, licensing authority, peer 

10 review organization, or employer.’’. 

11 SEC. 6. HEALTH CARE ENTITY; SKILLED NURSING FACIL12 ITY. 

13 Section 431 of the Health Care Quality Improvement 

14 Act of 1986 (42 U.S.C. 11151) is amended—

15 (1) in paragraph (4)(i), by inserting ‘‘or skilled 

16 nursing facility’’ after ‘‘hospital’’; 

17 (2) by redesignating paragraphs (13) and (14) 

18 as paragraphs (14) and (15), respectively; and 

19 (3) by inserting after paragraph (12) the fol20 lowing: 

21 ‘‘(13) The term ‘skilled nursing facility’ means 

22 an entity described in section 1819(a) of the Social 

23 Security Act (42 U.S.C. 1395i–3(a)).’’. 
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1 SEC. 7. SANCTIONS AGAINST AND BACKGROUND CHECKS 

2 OF HEALTH CARE PRACTITIONERS AND PRO3 VIDERS. 

4 Section 1921 of the Social Security Act (42 U.S.C. 

5 1396r–2) is amended—

6 (1) in the section heading, by inserting ‘‘AND

7 CRIMINAL BACKGROUND CHECKS OF’’ after 

8 ‘‘AGAINST’’; and 

9 (2) in subsection (a)—

10 (A) by redesignating paragraph (2) as 

11 paragraph (3); and 

12 (B) by inserting after paragraph (1) the 

13 following: 

14 ‘‘(2) INFORMATION CONCERNING CRIMINAL

15 BACKGROUND OF LICENSED HEALTH CARE PRACTI16 TIONERS.—The State shall have in effect a system 

17 of reporting criminal background information on li18 censed health care practitioners to the agency des19 ignated under section 424(b) of the Health Care 

20 Quality Improvement Act of 1986 (42 U.S.C. 

21 11134(b)).’’. 

22 SEC. 8. DATE OF IMPLEMENTATION. 

23 The Secretary of Health and Human Services shall, 

24 through the promulgation of appropriate regulations, im-
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1 plement the provisions of this Act within 1 year after the 

2 date of enactment of this Act.

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