I
106TH CONGRESS
2D SESSION
H. R. 5122
To amend the Health Care Quality Improvement Act of 1986 to provide
for the availability to the public of information reported to the National
Practitioner Data Bank under such Act, to establish additional reporting
requirements, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 7, 2000
Mr. BLILEY introduced the following bill; which was referred to the Committee
on Commerce
A BILL
To amend the Health Care Quality Improvement Act of
1986 to provide for the availability to the public of
information reported to the National Practitioner Data
Bank under such Act, to establish additional reporting
requirements, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Patient Protection Act
of 2000’’.
TITLE I—PUBLIC AVAILABILITY
OF PHYSICIAN INFORMATION
IN NATIONAL PRACTITIONER
DATA BANK
SEC. 101. PUBLIC AVAILABILITY OF PHYSICIAN INFORMA-
TION.
(a) IN GENERAL.—Part B of the Health Care Qual-
ity Improvement Act of 1986 (42 U.S.C. 11131 et seq.)
is amended by inserting after section 427 the following
section:
‘‘SEC. 428. PUBLIC AVAILABILITY OF PHYSICIAN INFORMA-
TION.
‘‘(a) IN GENERAL.—Not later than January 31,
2001, the Secretary, notwithstanding any other provision
of this part, shall in accordance with this section promul-
gate regulations under which the public may, through the
method described in subsection (c), obtain information re-
ported under this part on physicians.
‘‘(b) LIMITATIONS.—The following information on a
physician may not under subsection (a) be made available
to the public:
‘‘(1) Information disclosing the identity of any
patient involved in the incidents involved.
‘‘(2) The home address of the physician.
‘‘(3) The social security account number of the
physician.
‘‘(4) The date of birth of the physician.
‘‘(5) The number assigned to the physician by
the Drug Enforcement Administration.
‘‘(6) The name, title, and telephone number of
the official with responsibility for submitting the re-
port on behalf of the entity.
‘‘(c) USE OF INTERNET.—For purposes of subsection
(a), the method described in this subsection is to make
the information involved available to the public, without
charge, through the telecommunications medium known as
the World Wide Web of the Internet. The Secretary, act-
ing through the Administrator of the Health Resources
and Services Administration, shall provide for the estab-
lishment of a site on such medium, and shall update the
information maintained through such medium not less fre-
quently than monthly.
‘‘(d) STATEMENT OF PHYSICIAN.—Regulations under
subsection (a) shall require that each disclosure under
such subsection include any statement that was submitted
under section 426(b) by the physician involved.
‘‘(e) CONTEXT
OF DISCLOSED INFORMATION
ON
MEDICAL MALPRACTICE PAYMENTS.—With respect to in-
formation reported under section 421 on a physician, reg-
ulations under subsection (a) shall require that a disclo-
sure of a report under such section be accompanied by
supplemental information in accordance with the fol-
lowing:
‘‘(1) For each State for which such a report is
made on the physician:
‘‘(A) The information under section 421
shall be presented in context by comparing the
physician involved to the experiences of other
physicians in the same specialty in the same
State.
‘‘(B) In disclosing the amount of the pay-
ment reported under section 421(b)(2):
‘‘(i) The amount shall be presented in
context by categorizing the amount in a
manner that indicates the level of signifi-
cance of the payment in relation to
amounts reported under such section for
other physicians in the same specialty in
the same State. For such purposes, there
shall be a minimum of three graduated
categories.
‘‘(ii) The disclosure shall state wheth-
er the amount was made in settlement (or
partial settlement) of, or in satisfaction of
a judgment in, a medical malpractice ac-
tion or claim.)
‘‘(2) A statement providing that a payment
made pursuant to a medical malpractice action or
claim may occur for a variety of reasons which do
not necessarily reflect negatively on the professional
competence or conduct of the physician.
‘‘(3) A statement providing that a payment
made pursuant to a medical malpractice action or
claim should not be construed as creating a pre-
sumption that medical malpractice has occurred.
‘‘(4) A statement providing that some physi-
cians work primarily with high risk patients, and
such physicians may have numbers of medical mal-
practice actions or claims that are higher than aver-
age for their specialties because they specialize in
cases or patients who are at very high risk for med-
ical problems.
‘‘(5) A statement providing that—
‘‘(A) malpractice histories tend to vary by
specialty, and some specialties are more likely
than others to be the subject of litigation, and
‘‘(B) the disclosure and accompanying in-
formation compare physicians only to the mem-
bers of their specialty, not to all physicians, in
order to make an individual physician’s history
more meaningful.
‘‘(6) A statement providing that—
‘‘(A) malpractice histories tend to vary by
State, and due to variations in State laws, phy-
sicians in some States are more likely than
those in other States to be the subject of litiga-
tion, and
‘‘(B) the disclosure and accompanying in-
formation compare physicians only to other
physicians within a given State, not to all physi-
cians, in order to make an individual physi-
cian’s history more meaningful.
‘‘(f) CONTEXT
OF DISCLOSED INFORMATION RE-
GARDING CRIMINAL ACTS.—With respect to information
that under section 422(c) or 424A is reported on a physi-
cian, regulations under subsection (a) shall require that
a disclosure of a report under such a section be accom-
panied by a statement providing that the disclosure may
fail to provide all crime-related information on the physi-
cian because the availability of such information depends
in part on State laws and in part on self-reporting by phy-
sicians.’’.
(b) DISCLOSURE.—Section 427(b)(1) of the Health
Care Quality Improvement Act of 1986 (42 U.S.C.
11137(b)(1)) is amended by striking ‘‘Information re-
ported’’ and inserting ‘‘Except for the disclosure of infor-
mation authorized by this title, information reported’’.
(c) FEES.—Section 427(b) of the Health Care Qual-
ity Improvement Act of 1986 (42 U.S.C. 11137(b)) is
amended by striking paragraph (4).
TITLE II—REPORTING REQUIRE-
MENTS 
REGARDING 
NA-
TIONAL PRACTITIONER DATA
BANK
SEC. 
201. 
REQUIRING 
REPORTS 
ON 
MEDICAL 
MAL-
PRACTICE PAYMENTS.
Section 421(b) of the Health Care Quality Improve-
ment Act of 1986 (42 U.S.C. 11131(b)) is amended—
(1) by redesignating paragraph (5) as para-
graph (6);
(2) in paragraph (4), by striking ‘‘and’’ after
the comma at the end; and
(3) by inserting after paragraph (4) the fol-
lowing paragraph:
‘‘(5) in the case of a physician—
‘‘(A) the medical field of the physician, in-
cluding the medical specialty,
‘‘(B) the date on which the physician was
first licensed in the medical field and specialty,
and the number of years the physician has been
practicing in such field and specialty, and
‘‘(C) the professional license number of the
physician, and the name of the State in which
the license is held, and’’.
SEC. 202. REPORTING OF SANCTIONS TAKEN BY BOARDS
OF MEDICAL EXAMINERS.
(a) IN GENERAL.—Section 422(a) of the Health Care
Quality Improvement Act of 1986 (42 U.S.C. 11132(a))
is amended—
(1) in paragraph (1)(A), by striking ‘‘which re-
vokes or suspends’’ and inserting ‘‘which denies, re-
vokes, or suspends’’; and
(2) in paragraph (2)—
(A) in subparagraph (B), by striking ‘‘(if
known)’’ and all that follows and inserting ‘‘for
the action described in paragraph (1)(A) that
was taken with respect to the physician or, if
known, for the surrender of the license,’’;
(B) by redesignating subparagraph (C) as
subparagraph (F);
(C) by inserting after subparagraph (B)
the following subparagraphs:
‘‘(C) the medical field of the physician, in-
cluding the medical specialty,
‘‘(D) the date on which the physician was
first licensed in the medical field and specialty,
and the number of years the physician has been
practicing in such field and specialty, and
‘‘(E) the professional license number of the
physician, and the name of the State in which
the license is held, and’’.
(b) CRIMINAL ACTS OF PHYSICIANS.—Section 422 of
the Health Care Quality Improvement Act of 1986 (42
U.S.C. 11132) is amended by adding at the end the fol-
lowing subsection:
‘‘(c) CRIMINAL ACTS OF PHYSICIANS.—
‘‘(1) IN GENERAL.—Each Board of Medical Ex-
aminers shall report, in accordance with section 424,
the information described in paragraph (2), to the
extent that the information is collected by such
Board.
‘‘(2) INFORMATION
TO
BE
REPORTED.—With
respect to the Board of Medical Examiners of a
State, the information to be reported under para-
graph (1) is as follows:
‘‘(A) A description of felony convictions of
physicians in courts of the State or other
States.
‘‘(B) A description of such misdemeanor
convictions of physicians in such courts as in
the Secretary’s discretion may reflect on quality
health matters.
‘‘(C) A description of any criminal charges
in such courts to which the physician pled nolo
contendere.’’.
(c) CONTEXTUAL INFORMATION REGARDING DIS-
CLOSURES OF PHYSICIAN INFORMATION.—Section 422 of
the Health Care Quality Improvement Act of 1986, as
amended by subsection (b) of this section, is amended by
adding at the end the following subsection:
‘‘(d) CONTEXTUAL INFORMATION REGARDING DIS-
CLOSURES OF PHYSICIAN INFORMATION.—Each Board of
Medical Examiners shall, in accordance with section 424,
report to the Secretary such information as the Secretary
may request from the Board for purposes of assisting the
Secretary in making disclosures in accordance with section
428(e), to the extent that such information is collected by
such Board.’’.
(d) CONFORMING
AMENDMENT.—Subsections (a)
and (b) of section 424 of the Health Care Quality Im-
provement Act of 1986 (42 U.S.C. 11134) are each
amended by striking ‘‘section 422(a)’’ and inserting ‘‘sec-
tion 422’’.
SEC. 203. REPORTING OF CERTAIN PROFESSIONAL REVIEW
ACTIONS TAKEN BY HEALTH CARE ENTITIES.
(a) IN GENERAL.—Section 423(a)(3) of the Health
Care Quality Improvement Act of 1986 (42 U.S.C.
11133(a)(3)) is amended—
(1) in subparagraph (B), by striking ‘‘and’’
after ‘‘surrender,’’;
(2) by redesignating subparagraph (C) as sub-
paragraph (D); and
(3) by inserting after subparagraph (B) the fol-
lowing subparagraph:
‘‘(C) in the case of a physician—
‘‘(i) the medical field of the physician,
including the medical specialty,
‘‘(ii) the date on which the physician
was first licensed in the medical field and
specialty, and the number of years the
physician has been practicing in such field
and specialty, and
‘‘(iii) the professional license number
of the physician, and the name of the State
in which the license is held, and’’.
(b) APPLICABILITY OF REQUIREMENTS TO FEDERAL
ENTITIES.—
(1) IN GENERAL.—Section 423 of the Health
Care Quality Improvement Act of 1986 (42 U.S.C.
11133) is amended by adding at the end the fol-
lowing subsection:
‘‘(e) APPLICABILITY TO FEDERAL FACILITIES AND
PHYSICIANS.—
‘‘(1) IN GENERAL.—Subsection (a) applies to
Federal health facilities (including hospitals) and ac-
tions by such facilities regarding the competence or
professional conduct of Federal physicians to the
same extent and in the same manner as such sub-
section applies to health care entities and profes-
sional review actions.
‘‘(2) RELEVANT
BOARD
OF
MEDICAL
EXAM-
INERS.—For purposes of paragraph (1), the Board
of Medical Examiners to which a Federal health fa-
cility is to report is the Board of Medical Examiners
of the State within which the facility is located.’’.
(2) CONFORMING
AMENDMENT.—Section 432
of the Health Care Quality Improvement Act of
1986 (42 U.S.C. 11152) is amended—
(A) by striking subsection (b); and
(B) by redesignating subsection (c) as sub-
section (b).
SEC. 204. PHYSICIAN SELF-REPORTING REGARDING FEL-
ONY CONVICTIONS.
Part B of the Health Care Quality Improvement Act
of 1986 (42 U.S.C. 11131 et seq.) is amended by inserting
after section 424 the following section:
‘‘SEC. 424A. PHYSICIAN SELF-REPORTING REGARDING FEL-
ONY CONVICTIONS.
‘‘(a) IN GENERAL.—Each physician shall report, in
accordance with subsection (b), each felony conviction of
the physician.
‘‘(b) FORM OF REPORTING.—The information re-
quired to be reported under subsection (a) shall—
‘‘(1) be reported regularly (but not less often
than monthly) and in such form and manner as the
Secretary prescribes, and
‘‘(2) be reported to the Secretary, or, in the
Secretary’s discretion, to the agency described in
section 424(b).
‘‘(c) SANCTIONS FOR FAILURE TO REPORT.—Any
physician who fails to report information on a felony con-
viction required to be reported under this section shall be
subject to a civil money penalty of not more than $10,000
for each such failure to report. Such penalty shall be im-
posed and collected in the same manner as civil money
penalties under subsection (a) of section 1128A of the So-
cial Security Act are imposed and collected under that sec-
tion.’’.
SEC. 205. NOTICE TO PRACTITIONERS; CORRECTION OF IN-
FORMATION.
Section 426 of the Health Care Quality Improvement
Act of 1986 (42 U.S.C. 11136) is amended—
(1) by inserting ‘‘(a) IN GENERAL.—’’ before
‘‘With respect to’’;
(2) in subsection (a) (as so designated), in
paragraph (1), by striking ‘‘, upon request,’’; and
(3) by adding at the end the following sub-
section:
‘‘(b) STATEMENT OF PRACTITIONER.—
‘‘(1) IN GENERAL.—With respect to informa-
tion reported under this part, if the physician or
other licensed health care practitioner involved sub-
mits to the Secretary a statement regarding the in-
formation so reported, the statement shall be made
a part of the report involved, subject to paragraph
(2). Such a statement may be made at any time, and
may be revised.
‘‘(2) LENGTH OF STATEMENT.—Paragraph (1)
applies to a statement by a physician or other li-
censed health care practitioner only if the statement
does not exceed 4,000 characters, including spaces
and punctuation.
‘‘(3) NOTICE.—In carrying out subsection
(a)(1), the Secretary shall inform the practitioner in-
volved that a statement under paragraph (1) may be
submitted, and that the statement is subject to the
limitation described in paragraph (2).’’.
TITLE III—DUTY TO OBTAIN
INFORMATION
SEC. 301. DUTY OF HOSPITALS TO OBTAIN INFORMATION.
Section 425 of the Health Care Quality Improvement
Act of 1986 (42 U.S.C. 11135) is amended by adding at
the end the following subsection:
‘‘(d) APPLICABILITY
TO FEDERAL HOSPITALS.—
This section applies to Federal hospitals to the same ex-
tent and in the same manner as such subsection applies
to other hospitals.’’.
SEC. 302. DUTY OF BOARDS OF MEDICAL EXAMINERS TO
OBTAIN INFORMATION.
Part B of the Health Care Quality Improvement Act
of 1986 (42 U.S.C. 11131 et seq.) is amended by inserting
after section 425 the following section:
‘‘SEC. 425A. DUTY OF BOARDS OF MEDICAL EXAMINERS TO
OBTAIN INFORMATION.
‘‘(a) IN GENERAL.—Effective six months after the
date of the enactment of the Patient Protection Act of
2000, it is the duty of each Board of Medical Examiners
to request from the Secretary (or the agency designated
under section 424(b)) information reported under this
part concerning a physician—
‘‘(1) at the time the physician submits the ini-
tial application for a physician’s license in the State
involved, and
‘‘(2) at each time the physician submits an ap-
plication to continue in effect the license.
A Board of Medical Examiners may request information
reported under this part concerning a physician at other
times.
‘‘(b) FAILURE TO OBTAIN INFORMATION.—With re-
spect to an action for mandamus or other cause of action
against a Board of Medical Examiners, a Board which
does not request information respecting a physician as re-
quired under subsection (a) is presumed to have knowl-
edge of any information reported under this part to the
Secretary with respect to the physician.
‘‘(c) RELIANCE ON INFORMATION PROVIDED.—With
respect to a cause of action against a Board of Medical
Examiners, each Board of Medical Examiners may rely
upon information provided to the Board under this title,
unless the Board has knowledge that the information pro-
vided was false.’’.
TITLE IV—GENERAL
PROVISIONS
SEC. 401. REQUEST OF BOARD OF MEDICAL EXAMINERS RE-
GARDING PHYSICIAN INFORMATION IN NA-
TIONAL PRACTITIONER DATA BANK.
Section 427(a) of the Health Care Quality Improve-
ment Act of 1986 (42 U.S.C. 11137(a)) is amended by
adding at the end the following: ‘‘The Secretary (or the
agency designated under section 424(b)) shall, upon re-
quest, provide the Board of Medical Examiners of a State
a summary of information reported under this part on
physicians who are licensed in that State. For each physi-
cian included in such a summary, the summary shall at
a minimum provide the name, address, total number of
reports of such information, and the number of reports
for each report type.’’.
SEC. 402. REGULATIONS; EFFECTIVE DATE.
The Secretary of Health and Human Services shall
promulgate a final rule to implement the amendments
made by this Act not later than January 31, 2001. Such
amendments take effect 30 days after the date on which
such final rule is promulgated.
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