I 

108TH CONGRESS 

2D SESSION H. R. 4211 

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

the National Practitioner Data Bank. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 22, 2004 

Mr. PALLONE introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

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 licensing 

3 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 Medical 

13 Examiners’’ and inserting ‘‘State licensing board’’; 

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

15 striking ‘‘subsection (a)(1)’’ and inserting ‘‘para16 graphs (1) and (2) of subsection (a) and subsection 

17 (b)’’; 

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

19 the paragraph heading, by striking ‘‘Board of Med20 ical Examiners’’ and inserting ‘‘State licensing 

21 board’’; 

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

23 subsection heading, by striking ‘‘Board of Medical 

24 Examiners’’ and inserting ‘‘State licensing board’’; 

25 and 
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1 (9) by adding at the end the following: 

2 ‘‘(f) CIVIL PENALTIES.— 

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

4 for the imposition of no more than $50,000 per vio5 lation for health care entities that fail to comply 

6 with this section. 

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

8 shall provide for civil penalties in addition to the 

9 amount listed in paragraph (1) for health care enti10 ties that establish patterns of repeated violations of 

11 this section.’’. 

12 SEC. 4. CIVIL PENALTIES. 

13 Section 425 of the Health Care Quality Improvement 

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

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

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

17 each place it appears and inserting ‘‘health care en18 tity or agency employing a physician or other li19 censed health care practitioner’’; 

20 (2) in subsection (a)— 

21 (A) in the matter preceding paragraph 

22 (1)— 

23 (i) by striking ‘‘each hospital’’ and in24 serting ‘‘each health care entity and agen-
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1 cy employing a physician or other licensed 

2 health care practitioner’’; and 

3 (ii) by inserting ‘‘and from the appro4 priate State licensing board,’’ after ‘‘(or 

5 the agency designated under section 

6 424(b)),’’; 

7 (B) in paragraph (1), by inserting ‘‘or em8 ployment’’ after ‘‘clinical privileges’’; and 

9 (C) in paragraph (2), by inserting ‘‘or em10 ployed’’ after ‘‘clinical privileges’’; 

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

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

13 and 

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

15 ‘‘(d) CIVIL PENALTIES.— 

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

17 for the imposition of no more than $50,000 per vio18 lation for a health care entity or agency employing 

19 a physician or other licensed health care practitioner 

20 that fails to comply with this section. 

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

22 shall provide for civil penalties in addition to the 

23 amount listed in paragraph (1) for a health care en24 tity or agency employing a physician or other li-
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1 censed health care practitioner that establishes pat2 terns of repeated violations of this section.’’. 

3 SEC. 5. PROFESSIONAL REVIEW. 

4 Section 411 of the Health Care Quality Improvement 

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

6 the end the following: 

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

8 ENTITIES.— 

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

10 discloses information about a former or current em11 ployee pursuant to section 423 is immune from civil 

12 liability for such disclosure and its consequences un13 less it is demonstrated that the employer— 

14 ‘‘(A) knowingly disclosed false information; 

15 or 

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

17 current employee that is protected under Fed18 eral or State laws. 

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

20 any employee, agent, or other representative of the 

21 current or former employer who is authorized to pro22 vide and who provides information in accordance 

23 with section 423. 

24 ‘‘(e) PROTECTION OF HEALTH CARE PRACTI25 TIONERS.—A health care entity shall not penalize, dis-
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1 criminate, or retaliate in any manner with respect to em2 ployment, including discharge, promotion, compensation, 

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

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

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

6 laws governing licensed health care professional practice 

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

8 review organization, or employer.’’. 

9 SEC. 6. HEALTH CARE ENTITY; SKILLED NURSING FACIL10 ITY. 

11 Section 431 of the Health Care Quality Improvement 

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

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

14 nursing facility’’ after ‘‘hospital’’; 

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

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

17 (3) by inserting after paragraph (12) the fol18 lowing: 

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

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

21 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 ‘‘Against’’; 

8 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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