N.Y. Public Health Law § 2995-a: Physician profiles

§ 2995-a. Physician profiles. 1. The department shall collect the

following information and create individual profiles on licensees

subject to the authority of the office of professional medical conduct,

in a format that shall be available for dissemination to the public:

(a) a statement of any criminal convictions (as defined by section

1.20 of the criminal procedure law) within the most recent ten years,

under the laws of New York state or any other jurisdiction, for offenses

specified by regulations of the department;

(b) a statement of any action (other than an action that remains

confidential) taken against the licensee pursuant to section two hundred

thirty of this chapter or any similar action taken by any other state or

licensing entity, within the most recent ten years;

(c) a statement of any current limitation of the licensee to a

specified area, type, scope or condition of practice;

(d) a statement of any loss or involuntary restriction of hospital

privileges or a failure to renew professional privileges at hospitals

within the last ten years, for reasons related to the quality of patient

care delivered or to be delivered by the physician where procedural due

process has been afforded, exhausted, or waived, or the resignation from

or removal of medical staff membership or restriction of privileges at a

hospital taken in lieu of a pending disciplinary case related to the

quality of patient care delivered or to be delivered by the physician

(notwithstanding paragraph (a) of subdivision three of section

twenty-eight hundred three-e of this chapter, as added by chapter eight

hundred sixty-six of the laws of nineteen hundred eighty);

(e) (i) a statement indicating the number of medical malpractice court

judgments and arbitration awards within the most recent ten years in

which a payment is awarded to a complaining party (notwithstanding

subsection (f) of section three hundred fifteen of the insurance law);

and

(ii) a statement indicating all malpractice settlements within the

most recent ten years in which payment is awarded to a complaining party

(notwithstanding subsection (f) of section three hundred fifteen of the

insurance law),

(A) if the total number of settlements exceeds two; or

(B) if the commissioner determines any such settlement could be

relevant to patient decisionmaking concerning health care quality. The

statement shall include the following: "Settlement payments will appear

in this profile only if the total number of settlements made within the

past ten years exceeds two, or if the commissioner of health determines

a settlement to be relevant to patient decisionmaking. Settlement of a

claim may occur for a variety of reasons, which do not necessarily

reflect negatively on the professional competence or conduct of the

physician. A payment in settlement of a medical malpractice action or

claim does not necessarily mean that a medical malpractice has

occurred." The commissioner may supplement such statement as may be

appropriate.

(iii) judgments, awards and settlements shall be reported in graduated

categories indicating the level of significance, date and place of the

judgment, award or settlement. Information concerning medical

malpractice judgments, awards and settlements shall be put in context by

comparing an individual licensee's medical malpractice settlements to

the experience of other physicians in New York state within the same

board specialty. Pending malpractice claims shall not be disclosed to

the public under this section. Nothing herein shall be construed to

prevent the board from investigating or disciplining a licensee on the

basis of medical malpractice claims that are pending;

(f) name of medical schools attended and date of graduations;

(g) graduate medical education;

(h) current specialty board certification and date of certification;

(i) dates admitted to practice in New York state;

(j) names of hospitals where the licensee has practice privileges;

(k) appointments to medical school faculties and indication as to

whether a licensee has had a responsibility for graduate medical

education within the most recent ten years;

(l) information regarding publications in peer reviewed medical

literature within the most recent ten years;

(m) information regarding professional or community service activities

or awards;

(n) (i) the location of the licensee's primary practice setting

identified as such; and

(ii) the names of any licensed physicians with whom the licensee

shares a group practice, as defined in subdivision five of section two

hundred thirty-eight of this chapter;

(o) the identification of any translating services that may be

available at the licensee's primary practice location;

(p) whether the licensee participates in the medicaid or medicare

program or any other state or federally financed health insurance

program; and

(q) health care plans with which the licensee has contracts,

employment, or other affiliation; provided that the reporting of such

information shall not be the responsibility of the physician, but shall

be included and updated by the department utilizing provider network

participation information, or other reliable sources of information

submitted by health care plans.

1-a. Each physician licensed and registered to practice in this state

shall within thirty days of the transmittal of an initial profile survey

and upon entering or updating his or her profile information:

(a) register and maintain an account with the department's health

provider network and any successor electronic system established to

facilitate communications between the department and licensed health

care providers; or

(b) provide an e-mail address to the department which shall be used by

the department to communicate with the physician. Licensees shall

provide notice to the department of changed e-mail addresses within

thirty days of the change. Licensee e-mail addresses shall be

confidential and shall not be published as part of the licensee's

profile. The e-mail addresses may be used for department purposes only.

2. Nothing in this section shall limit the department's authority to

collect, require reporting of, publish or otherwise disseminate

information about licensees.

3. Each physician who is self-insured for professional medical

malpractice shall periodically report to the department on forms and in

the time and manner required by the commissioner the information

specified in paragraph (e) of subdivision one of this section, except

that the physician shall report the dollar amount (to the extent of the

physician's information and belief) for each judgment, award and

settlement and not a level of significance or context.

4. Each physician shall periodically report to the department on forms

and in the time and manner required by the commissioner any other

information as is required by the department for the development of

profiles under this section which is not otherwise reasonably

obtainable. In addition to such periodic reports and providing the same

information, each physician shall update his or her profile information

within the six months prior to the submission of the re-registration

application, as a condition of registration renewal under article one

hundred thirty-one of the education law. Except for optional information

provided, physicians shall notify the department of any change in the

profile information within thirty days of such change.

5. The department shall provide each licensee with a copy of his or

her profile prior to dissemination to the public. In the manner and time

required by the commissioner, a licensee shall be provided the

opportunity to correct factual inaccuracies that appear in the profile.

The physician shall be permitted to file a concise statement concerning

information contained in the profile, which shall be disseminated

therewith.

6. A physician may elect to have his or her profile omit certain

information provided pursuant to paragraphs (l), (m) and (n) of

subdivision one of this section. In collecting information for such

profiles and disseminating the same, the department shall inform

physicians that they may choose not to provide such information required

pursuant to paragraphs (l), (m) and (n) of subdivision one of this

section.

7. A physician who knowingly provides materially inaccurate

information under this section shall be guilty of professional

misconduct pursuant to section sixty-five hundred thirty of the

education law.

7-a. For purposes of this section, a physician may authorize a

designee to register, transmit, enter or update information on his or

her behalf, provided that:

(a) the designee so authorized is employed by the physician or the

same professional practice or is under contract with such practice;

(b) the physician takes reasonable steps to ensure that such designee

is sufficiently competent in the profile requirements; and

(c) the physician remains responsible for ensuring the accuracy of the

information provided and for any failure to provide accurate

information.

The commissioner shall establish in regulation reasonable parameters

with regard to a physician's ability to authorize designees pursuant to

this section, which shall include processes necessary to allow the

department to: (i) grant access to the profile in a reasonably prompt

manner to designees authorized by physicians; (ii) require that

physicians notify the department upon terminating the authorization of

any designee; and (iii) establish a mechanism to prevent such terminated

designees from accessing the profile in a reasonably prompt manner

following such notification.

8. The department shall establish a toll-free telephone number through

which it shall answer inquiries about and accept orders for hard copy

physician profiles established pursuant to this section and accept

consumer complaints about suspected professional misconduct. The

department may charge a nominal fee for producing and mailing a hard

copy physician profile.

9. The department shall, in addition to hard copy physician profiles,

provide for electronic access to and copying of physician profiles

developed pursuant to this section through the system commonly known as

the Internet. The department shall update a physician's online profile

within thirty days of receipt of a completed physician profile survey or

any change in profile information.

10. The commissioner shall require that:

(a) Practitioner organizations that are representative of the target

group for profiling, and health care consumer organizations, be provided

the opportunity to review and comment on the profiling methodology,

including collection methods, analysis, formatting, and methods and

means for release and dissemination.

(b) Comparisons of practitioner profiles shall be organized according

to practitioner areas of practice.

11. The commissioner shall evaluate the utility and practicability of

including in the profile a comparison of malpractice data by geographic

area. However, the implementation of the profile shall not be delayed

pending such evaluation.

12. The commissioner shall develop and distribute a notice suitable

for posting that informs consumers of the availability of physician

profiles and the telephone numbers and Internet addresses for accessing

them.

13. Further study of physician profiles. After the initial

dissemination of the data identified in subdivision one of this section,

the department shall conduct a further study of physician profiles as

follows:

(a) Data sources. The department shall identify the types of physician

data to which the public has access, including all information available

from federal, state or local agencies which is useful for making

determinations concerning health care quality determinations. The

department shall study all physician data reporting requirements and

develop recommendations to consolidate data collection and eliminate

duplicate and unnecessary reporting requirements, or to supplement

existing reporting requirements in order to satisfy the requirements of

this section. The department shall study the feasibility of

incorporating health plan reporting requirements, without imposing any

extra burden on the physician, regarding network participation into this

section to ensure this information is available, accurate, up-to-date

and accessible to consumers.

(b) Supplemental information adjustment and security safeguards. The

department shall develop a methodology for application to collected

physician data that accounts for factors such as frequency, severity and

geographic area which shall be used to provide context to reported data.

Any such methodology shall not diminish the information reported

pursuant to subdivision one of this section. In developing such

methodology, the department may consult with physicians, including

representatives of appropriate specialty societies. The department may

also consult with organizations representing consumers, other health

care providers, and health care plans. Any such methodology shall

include adequate and appropriate safeguards to ensure the security,

accuracy and integrity of health information created, received,

maintained, used or transmitted in connection with the statewide health

information system. Such safeguards shall be sufficient to meet any

minimum standards set by state and federal laws and regulations.

(c) Public review. The department shall provide organizations which

are representative of consumers, physicians, including representatives

of appropriate specialty societies, other health care providers and

health care plans the opportunity to review and comment on its

determinations and recommendations. The department shall consider such

comments, and may amend its determinations and recommendations to

reflect them.

(d) Report. The department shall provide a report of its

determinations and recommendations under this subdivision to the

governor and legislature, and make such report publicly available, on or

before January first, two thousand sixteen. The department shall report

annually thereafter to the legislature on the status of the physician

profiles and any recommendations for additions, consolidations or other

changes deemed appropriate.

14. The physician data so disseminated shall be updated at regular

intervals to be determined by the department.

15. (a) All physician data disseminated shall include the following

statements: "THE DATA COLLECTED BY THE DEPARTMENT IS ACCURATE TO THE

BEST OF THE KNOWLEDGE OF THE DEPARTMENT, BASED ON THE INFORMATION

SUPPLIED BY THE PHYSICIAN WHO IS THE SUBJECT OF THE DATA. WHILE THE

DEPARTMENT UTILIZES A VARIETY OF SOURCES OF INFORMATION IN CHECKING THE

ACCURACY OF THE DATA REPORTED, WE CANNOT BE SURE THAT ALL OF THE

INFORMATION ON THIS WEBSITE IS RIGHT, COMPLETE, OR UP-TO-DATE, AND

CANNOT BE RESPONSIBLE FOR ANY INFORMATION THAT IS WRONG OR HAS BEEN LEFT

OUT. CONSUMERS ARE ENCOURAGED TO CONSULT OTHER SOURCES TO VERIFY OR

OBTAIN ADDITIONAL INFORMATION ABOUT A PHYSICIAN. PENDING LEGAL ACTIONS

DO NOT IN ANY WAY INDICATE PARTIES' GUILT, LIABILITY OR CULPABILITY.

CASES MAY BE DISMISSED, WITHDRAWN, OR SETTLED WITHOUT PAYMENTS TO

PLAINTIFFS. ANY DISPOSITION TO A CASE MAY BE SUBJECT TO APPEAL." The

commissioner shall ensure that the full text of the statements appear on

each web page of the physician profile in a manner that does not require

the user of the site to click on a separate link in order to view the

statements.

(b) The department shall provide on the physician profiles an active

link to the website maintained by the unified court system containing

information on active and disposed cases in the local and state courts

in the state.

16. If, after initial dissemination of the physician data required by

this section, the department determines that any such data is not useful

for making quality determinations, the department shall recommend to the

legislature the necessary statutory changes.