To amend the Health Care Quality Improvement Act of 1986 to expand the National Practitioner Data Bank.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Safe Health Care Reporting Act of 
2004''.

SEC. 2. REPORTING OF SANCTIONS.

    Section 422 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11132) is amended--
            (1) in the section heading by striking ``Boards of medical 
        examiners'' and inserting ``State licensing boards'';
            (2) in paragraphs (1) and (2) of subsection (a)--
                    (A) by striking ``physician's'' each place it 
                appears and inserting ``physician's or other health 
                care practitioner's''; and
                    (B) by striking ``physician'' each place it appears 
                and inserting ``physician or other health care 
                practitioner''; and
            (3) in subsections (a) and (b), by striking ``Board of 
        Medical Examiners'' each place it appears and inserting ``State 
        licensing board''.

SEC. 3. REPORTING OF CERTAIN PROFESSIONAL REVIEW ACTIONS.

    Section 423 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11133) is amended--
            (1) by striking ``Board of Medical Examiners'' each place 
        it appears and inserting ``State licensing board'';
            (2) in subsection (a)--
                    (A) by striking paragraph (2) and inserting the 
                following:
            ``(2) Mandatory reporting on other licensed health care 
        practitioners.--A health care entity shall report to the 
        appropriate State licensing boards and to the agency designated 
        under section 424(b), the information described in paragraph 
        (3) in the case of a licensed health care practitioner who is 
        not a physician, if the entity would be required to report such 
        information under paragraph (1) with respect to the 
        practitioner if the practitioner were a physician.'';
                    (B) by redesignating paragraph (3)(C) as paragraph 
                (3)(D); and
                    (C) by striking paragraph (3)(B) and inserting the 
                following:
                    ``(B) a description of any adverse action, 
                including dismissal and review action, taken by a 
                hospital or other health care entity against a health 
                care practitioner who is employed by, has privileges 
                at, is under contract with, or otherwise works at the 
                health care entity for conduct that may be construed to 
                violate any Federal or State law, including laws 
                governing licensed health care professional practice 
                standards,
                    ``(C) information on a health care practitioner who 
                voluntarily resigns during, or as a result of, a 
                pending dismissal or review action, and'';
            (3) by redesignating subsections (b), (c), and (d) as 
        subsections (c), (d), and (e), respectively;
            (4) by inserting after subsection (a), the following:
    ``(b) Standard for Reporting of Adverse Actions.--Adverse actions 
reported under subsection (a)(2) shall be made in accordance with the 
rights and procedures afforded to physicians under section 412.'';
            (5) in subsection (c) (as so redesignated), in the 
        subsection heading, by striking ``Board of Medical Examiners'' 
        and inserting ``State licensing board'';
            (6) in subsection (d)(1) (as so redesignated), by striking 
        ``subsection (a)(1)'' and inserting ``paragraphs (1) and (2) of 
        subsection (a) and subsection (b)'';
            (7) in subsection (d)(2) (as so redesignated), in the 
        paragraph heading, by striking ``Board of Medical Examiners'' 
        and inserting ``State licensing board'';
            (8) in subsection (e) (as so redesignated), in the 
        subsection heading, by striking ``Board of Medical Examiners'' 
        and inserting ``State licensing board''; and
            (9) by adding at the end the following:
    ``(f) Civil Penalties.--
            ``(1) In general.--The Secretary shall provide for the 
        imposition of no more than $50,000 per violation for health 
        care entities that fail to comply with this section.
            ``(2) Repeated violations.--The Secretary shall provide for 
        civil penalties in addition to the amount listed in paragraph 
        (1) for health care entities that establish patterns of 
        repeated violations of this section.''.

SEC. 4. CIVIL PENALTIES.

    Section 425 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11135) is amended--
            (1) in paragraphs (1) and (2) of subsection (a), and 
        subsections (b) and (c), by striking ``hospital'' each place it 
        appears and inserting ``health care entity or agency employing 
        a physician or other licensed health care practitioner'';
            (2) in subsection (a)--
                    (A) in the matter preceding paragraph (1)--
                            (i) by striking ``each hospital'' and 
                        inserting ``each health care entity and agency 
                        employing a physician or other licensed health 
                        care practitioner''; and
                            (ii) by inserting ``and from the 
                        appropriate State licensing board,'' after 
                        ``(or the agency designated under section 
                        424(b)),'';
                    (B) in paragraph (1), by inserting ``or 
                employment'' after ``clinical privileges''; and
                    (C) in paragraph (2), by inserting ``or employed'' 
                after ``clinical privileges'';
            (3) in subsection (c), by striking ``hospital's'' and 
        inserting ``the health care entity's or agency's'' and
            (4) by adding at the end the following:
    ``(d) Civil Penalties.--
            ``(1) In general.--The Secretary shall provide for the 
        imposition of no more than $50,000 per violation for a health 
        care entity or agency employing a physician or other licensed 
        health care practitioner that fails to comply with this 
        section.
            ``(2) Repeated violations.--The Secretary shall provide for 
        civil penalties in addition to the amount listed in paragraph 
        (1) for a health care entity or agency employing a physician or 
        other licensed health care practitioner that establishes 
        patterns of repeated violations of this section.''.

SEC. 5. PROFESSIONAL REVIEW.

    Section 411 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11111) is amended by adding at the end the following:
    ``(d) Civil Liability Immunity for Health Care Entities.--
            ``(1) In general.--A health care entity that discloses 
        information about a former or current employee pursuant to 
        section 423 is immune from civil liability for such disclosure 
        and its consequences unless it is demonstrated that the 
        employer--
                    ``(A) knowingly disclosed false information; or
                    ``(B) violated any right of the former or current 
                employee that is protected under Federal or State laws.
            ``(2) Application.--This subsection applies to any 
        employee, agent, or other representative of the current or 
        former employer who is authorized to provide and who provides 
        information in accordance with section 423.
    ``(e) Protection of Health Care Practitioners.--A health care 
entity shall not penalize, discriminate, or retaliate in any manner 
with respect to employment, including discharge, promotion, 
compensation, or terms, conditions, or privileges of employment, 
against an employee who, in good faith, reports conduct that may be 
construed to violate a Federal or State law, including laws governing 
licensed health care professional practice standards, to a State 
authority, licensing authority, peer review organization, or 
employer.''.

SEC. 6. HEALTH CARE ENTITY; SKILLED NURSING FACILITY.

    Section 431 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11151) is amended--
            (1) in paragraph (4)(i), by inserting ``or skilled nursing 
        facility'' after ``hospital'';
            (2) by redesignating paragraphs (13) and (14) as paragraphs 
        (14) and (15), respectively; and
            (3) by inserting after paragraph (12) the following:
            ``(13) The term `skilled nursing facility' means an entity 
        described in section 1819(a) of the Social Security Act (42 
        U.S.C. 1395i-3(a)).''.

SEC. 7. SANCTIONS AGAINST AND BACKGROUND CHECKS OF HEALTH CARE 
              PRACTITIONERS AND PROVIDERS.

    Section 1921 of the Social Security Act (42 U.S.C. 1396r-2) is 
amended--
            (1) in the section heading, by inserting ``and Criminal 
        Background Checks of'' after ``Against''; and
            (2) in subsection (a)--
                    (A) by redesignating paragraph (2) as paragraph 
                (3); and
                    (B) by inserting after paragraph (1) the following:
            ``(2) Information concerning criminal background of 
        licensed health care practitioners.--The State shall have in 
        effect a system of reporting criminal background information on 
        licensed health care practitioners to the agency designated 
        under section 424(b) of the Health Care Quality Improvement Act 
        of 1986 (42 U.S.C. 11134(b)).''.

SEC. 8. DATE OF IMPLEMENTATION.

    The Secretary of Health and Human Services shall, through the 
promulgation of appropriate regulations, implement the provisions of 
this Act within 1 year after the date of enactment of this Act.

Summary: Safe Health Care Reporting Act of 2004 - Amends the Health Care Quality Improvement Act of 1986 to require State licensing boards (currently, boards of medical examiners) to report to the National Practitioner Data Bank regarding: (1) any sanctions taken against a physician or health care practitioner (currently, against a physician); and (2) known instances of health care entities failing to report required information.

Requires (current law authorizes) health care entities to report specified information to State licensing boards and the Data Bank regarding any action that adversely affects the clinical privileges of a health care practitioner who is not a physician if the entity would be required to report such information if the practitioner were a physician.

Allows the Secretary to impose fines for violations of reporting requirements by health care entities.

Requires health care entities and other agencies that employ physicians or other licensed health care providers (currently, requires hospitals) to request from the Data Bank and the State licensing board reported information on licensed health care practitioners who apply to be on the medical staff or who apply for clinical privileges or employment.

Provides immunity from civil liability for health care entities that disclose information about employees pursuant to mandatory reporting requirements unless the employer knowingly disclosed false information or violated any legal right of the employee. Prohibits health care entities from retaliating against any employee who, in good faith, reports conduct that may be construed to violate a Federal or State law to a State authority, licensing authority, peer review organization, or employer.

Amends title XIX (Medicaid) of the Social Security Act to require States to implement a system to report criminal background information to the Data Bank.