Relating to protections for health care institutions, health care payors, and medical practitioners including those related to the exercise of a right of conscience, whistleblower activities, and free speech, and providing penalties

This bill relates to protections for health care institutions, health care payors, and medical practitioners involving a right of conscience, whistleblower activities, and free speech. The bill provides definitions used in the bill including for “conscience”, “health care institution”, “health care payor”, “health care service”, and “medical practitioner”. The bill provides that a health care institution or health care payor shall not be required to participate in or pay for a health care service that violates the health care institution’s or health care payor’s conscience. An insurer shall list any health care service the insurer refuses to pay for on the basis of the insurer’s conscience in the insurer’s policies, plans, contracts, or other agreements. A health care institution or health care payor that refuses to participate in or pay for a health care service is immune from liability for damages allegedly arising from the refusal, and such refusal shall not be the basis for any discrimination against the health care institution or health care payor, or any personnel, agent, or governing board of the health care institution or health care payor. The bill also provides that a medical practitioner has the right not to participate in a health care service that violates the medical practitioner’s conscience. A health care institution may require a medical practitioner who is employed, contracted, or granted admitting privileges by the health care institution and who is seeking to exercise their conscience by not participating in a health care service, to submit to the health care institution a written refusal signed by the medical practitioner. A health care institution is immune from liability for the exercise of conscience not to participate in a health care service by a medical practitioner. A medical practitioner who refuses to participate in a health care service due to exercise of conscience is immune from liability for damages allegedly arising from the refusal, and such refusal shall not be the basis for any discrimination against the medical practitioner. These provisions are not to be construed to relieve a health care institution of the requirement under federal law to provide emergency medical services to all individuals. The immunity provisions do not apply to a health care institution or health care payor owned or operated by the state or a political subdivision of the state. The bill provides that a medical practitioner, health care institution, or health care payor that holds itself out to the public as religion-based states in the entity’s governing documents that the entity has a religious purpose or mission, and that has internal operating policies or procedures that implement the entity’s religious beliefs, shall have the right to make employment, staffing, contracting, and admitting privilege decisions consistent with the entity’s religious beliefs. The bill provides that a medical practitioner’s, health care institution’s, or health care payor’s exercise of conscience not to participate in a health care service shall not be grounds for loss of any privileges, immunities, or public benefits under state law. The bill provides whistleblower protections by providing that a medical practitioner or health care institution shall not be discriminated against because the medical practitioner or health care institution: provides, causes to be provided, or intends to provide or cause to be provided information relating to a suspected violation of the bill to the medical practitioner or health care institution’s employer or various other entities specified in the bill; testifies or intends to testify in a proceeding concerning a violation of the bill; or assists or participates, or intends to assist or participate, in a proceeding under the bill. It is also unlawful under the bill to discriminate against a medical practitioner because the medical practitioner discloses information to appropriate government, regulation, or law enforcement entities that the medical practitioner reasonably believes evidences a violation of any law or rule; a violation of any standard of care or ethical guidelines for the provision of any health care service; or gross mismanagement, a gross waste of funds, an abuse of authority, practices, or methods of treatment that may put patient or client health at risk, or a substantial and specific danger to public health or safety. These provisions are not to be construed to exempt a person from the requirements of the federal Health Insurance Portability and Accountability Act. The bill also provides that the department of health and human services (HHS), a health professional licensing board, or any other licensing or certifying entity of a medical practitioner shall not reprimand, sanction, or revoke or threaten to revoke a license or certification of a medical practitioner for engaging in speech or expressive activity protected under the first amendment to the Constitution of the United States, unless HHS, a licensing board, or other licensing or certifying entity demonstrates beyond a reasonable doubt that the medical practitioner’s speech was the direct cause of physical harm to a person with whom the medical practitioner had a medical practitioner-patient or medical practitioner-client relationship within the three years immediately preceding the incident of physical harm. Within 14 days of receiving a complaint alleging a violation of speech or expressive activity protected under the bill that may result in revocation of a medical practitioner’s license, HHS, a licensing board, or other licensing or certifying entity shall provide the medical practitioner with a copy of the complaint. If HHS, a licensing board, or other licensing or certifying entity fails to provide the complaint within 14 days of receipt, HHS, the licensing board, or other certifying entity shall pay the medical practitioner an administrative penalty of $500 for each week of noncompliance. The bill provides that it is unlawful for a person to interfere or attempt to interfere with the exercise of conscience not to participate in a health care service or the whistleblower or free speech rights and protections authorized under the bill. A health care institution, health care payor, or medical practitioner injured by unlawful interference under the bill is entitled to bring a civil action that, if successful, may result in injunctive relief, monetary damages for injuries suffered, and reasonable costs and attorney fees. The provisions of the bill shall not be construed as modifying or limiting the rights and remedies provided under Code chapter 146 (abortions —— refusal to perform). The bill applies to a health care payor policy, contract, plan, or other agreement delivered, issued for delivery, continued, or renewed in the state on or after January 1, 2025. The bill includes a severability clause.