AN ACT
Relating to community clinics that utilize retired physicians to provide
primary care to low-income persons without compensation; adding new sections to
chapter 43.70 RCW; and creating a new section.
BE IT ENACTED BY THE LEGISLATURE
OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. There
are a number of retired physicians who wish to provide, or are providing,
health care services to low-income patients without compensation. However, the
cost of obtaining malpractice insurance is a burden that is deterring them from
donating their time and services in treating the health problems of the poor.
The necessity of maintaining malpractice insurance for those in practice is a significant
reality in today's litigious society.
A
program to alleviate the onerous costs of malpractice insurance for retired
physicians providing uncompensated health care services to low-income patients
will encourage philanthropy and augment state resources in providing for the
health care needs of those who have no access to basic health care services.
An
estimated sixteen percent of the nonelderly population do not have health
insurance and lack access to even basic health care services. This is especially
problematic for low-income persons who are young and who are either unemployed
or have entry-level jobs without health care benefits. The majority of the
uninsured, however, are working adults, and some twenty-nine percent are
children.
The
legislature declares that this act will increase the availability of primary
care to low-income persons and is in the interest of the public health and
safety.
NEW
SECTION. Sec. 2. A new
section is added to chapter 43.70 RCW to read as follows:
(1)
The department may establish a program to purchase and maintain liability
malpractice insurance for retired physicians who provide primary health care
services at community clinics. The following conditions apply to the program:
(a) Primary
health care services shall be provided at community clinics that are public or
private tax-exempt corporations;
(b)
Primary health care services provided at the clinics shall be offered to
low-income patients based on their ability to pay;
(c) Retired
physicians providing health care services shall not receive compensation for
their services; and
(d)
The department shall contract only with a liability insurer authorized to offer
liability malpractice insurance in the state.
(2)
This section and section 3 of this act shall not be interpreted to require a
liability insurer to provide coverage to a physician should the insurer
determine that coverage should not be offered to a physician because of past
claims experience or for other appropriate reasons.
(3)
The state and its employees who operate the program shall be immune from any
civil or criminal action involving claims against clinics or physicians that
provided health care services under this section and section 3 of this act.
This protection of immunity shall not extend to any clinic or physician
participating in the program.
(4)
The department may monitor the claims experience of retired physicians covered
by liability insurers contracting with the department.
(5)
The department may provide liability insurance under this act only to the
extent funds are provided for this purpose by the legislature.
NEW
SECTION. Sec. 3. A new
section is added to chapter 43.70 RCW to read as follows:
The
department may establish by rule the conditions of participation in the
liability insurance program by retired physicians at clinics utilizing retired
physicians for the purposes of this section and section 2 of this act. These
conditions shall include, but not be limited to, the following:
(1)
The participating physician associated with the clinic shall hold a valid
license to practice medicine and surgery in this state and otherwise be in
conformity with current requirements for licensure as a retired physician,
including continuing education requirements;
(2)
The participating physician shall limit the scope of practice in the clinic to
primary care. Primary care shall be limited to noninvasive procedures and
shall not include obstetrical care, or any specialized care and treatment.
Noninvasive procedures include injections, suturing of minor lacerations, and
incisions of boils or superficial abscesses;
(3)
The provision of liability insurance coverage shall not extend to acts outside
the scope of rendering medical services pursuant to this section and section 2
of this act;
(4)
The participating physician shall limit the provision of health care services
to low-income persons provided that clinics may, but are not required to,
provide means tests for eligibility as a condition for obtaining health care
services;
(5)
The participating physician shall not accept compensation for providing health
care services from patients served pursuant to this section and section 2 of
this act, nor from clinics serving these patients. "Compensation"
shall mean any remuneration of value to the participating physician for
services provided by the physician, but shall not be construed to include any
nominal copayments charged by the clinic, nor reimbursement of related expenses
of a participating physician authorized by the clinic in advance of being
incurred; and
(6)
The use of mediation or arbitration for resolving questions of potential
liability may be used, however any mediation or arbitration agreement format
shall be expressed in terms clear enough for a person with a sixth grade level
of education to understand, and on a form no longer than one page in length.
