Text of RI H 7577 (2024)

2024 -- H 7577 ======== LC004704 ======== S T A T E O F R H O D E I S L A N D IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2024 ____________ A N A C T RELATING TO HEALTH AND SAFETY -- HEALTH CARE PROVIDER SHIELD BILL Introduced By: Representatives Edwards, Kislak, Ajello, McNamara, Kazarian, Knight, Donovan, Craven, McEntee, and Felix Date Introduced: February 09, 2024 Referred To: House Judiciary It is enacted by the General Assembly as follows: SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby 1 amended by adding thereto the following chapter: 2 CHAPTER 100 3 HEALTH CARE PROVIDER SHIELD BILL 4 23-100-1. Definitions. 5 As used in this chapter, the following terms shall mean: 6 (1) "Aggrieved person" means: 7 (i) A person against whom hostile litigation is filed or their legal representative; 8 (ii) A person in the state that receives a subpoena in connection with hostile litigation, as 9 defined in this section, from any court, state or federal, in the United States or any of its territories, 10 that seeks information concerning legally protected health care activity, as defined in this section, 11 or aiding and assisting with legally protected health care activity, as defined in this section; or 12 (iii) A person or entity that employs a person against whom hostile litigation has been filed, 13 if the action is based on the employee's legally protected health care activity or the aiding or 14 assisting with legally protected health care activities performed within the scope of their 15 employment. 16 (2) “Aid and assist legally protected health care activity” means: 17 (i) The undertaking of any act or omission to aid or effectuate, or attempt to aid or 18 effectuate, any person in the exercise and enjoyment, or attempted exercise and enjoyment, of the 19 LC004704 - Page 2 of 15 right to transgender health care services or reproductive health care services in this state, regardless 1 of the patient’s location or whether the health care provider is licensed in the state where the patient 2 is located at the time the service is rendered; or 3 (ii) The undertaking of any act or omission to aid or effectuate, or attempt to aid or 4 effectuate, any person in the provision of, or attempted provision of, transgender health care 5 services or reproductive health care services in this state, regardless of the patient’s location or 6 whether the health care provider is licensed in the state where the patient is located at the time the 7 service is rendered. 8 (iii) For the purposes of this chapter, "aiding and assisting legally protected health care 9 activity" shall include, but not be limited to, the provision or administration or attempted provision 10 or administration of insurance coverage for transgender health care services or reproductive health 11 care services, by any insurer, payor, or employer. 12 (3) “Hostile litigation” means litigation or other legal action to deter, prevent, sanction, or 13 punish any person engaging in legally protected health care activity or aiding and assisting legally 14 protected health care activity by: 15 (i) Filing or prosecuting any action in any other state where liability, in whole or part, 16 directly or indirectly, is based on engaging in legally protected health care activity or aiding and 17 assisting legally protected health care activity that occurred in this state, including any action in 18 which liability is based on any theory of vicarious, joint, or several liability derived therefrom; or 19 (ii) Attempting to enforce any order or judgment issued in connection with any such action 20 by any party to the action, or any person acting on behalf of a party to the action. 21 (iii) Any action shall be considered to be based on conduct that occurred in this state if any 22 part of any act or omission involved in the course of conduct that forms the basis for liability in the 23 action occurs or is initiated in this state, whether or not such act or omission is alleged or included 24 in any pleading or other filing in the action. 25 (4) “Law enforcement agency” means any state, municipal, college or university police 26 department, sheriff’s department, correctional facility, prosecutorial office, court, probation office, 27 or a program of more than one of any such entity, or any other non-federal entity in the state charged 28 with the enforcement of laws or the custody of detained persons. 29 (5) “Legally protected health care activity” means: 30 (i) The exercise and enjoyment, or attempted exercise and enjoyment, by any person of the 31 right to transgender health care services or reproductive health care services in this state; and 32 (ii) The provision, or attempted provision, of transgender health care services or 33 reproductive health care services permitted under the laws and regulations of this state by a person 34 LC004704 - Page 3 of 15 duly licensed under the laws of this state and physically present in this state, regardless of the 1 patient’s location or whether the health care provider is licensed in the state where the patient is 2 located at the time the service is rendered. 3 (iii) “Legally protected health care activity” shall not include any service rendered below 4 the applicable professional standard of care of this state. 5 (iv) The protections available for engaging in “legally protected health care activity” shall 6 not apply to a lawsuit, judgment, or civil, criminal, or administrative action that is based on conduct 7 for which an action would exist under the laws of this state if the course of conduct that forms the 8 basis for liability had occurred entirely in this state. 9 (6) “Reproductive health care services” means all supplies, care, and services of a medical, 10 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, 11 rehabilitative, or supportive nature, including medication, relating to pregnancy, contraception, 12 assisted reproduction, pregnancy loss management, or the termination of a pregnancy provided in 13 accordance with the accepted standard of care as defined by major medical professional 14 organizations and agencies with expertise in the relevant field. 15 (7) “Transgender health care services” means all supplies, care, and services of a medical, 16 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, 17 rehabilitative, or supportive nature, including medication, relating to the treatment of gender 18 dysphoria and gender incongruence as provided in accordance with the accepted standard of care 19 as defined by major medical professional organizations and agencies with expertise in the field 20 including in the World Professional Association for Transgender Health Care Standards of Care 21 for the Health of Transgender and Gender Diverse People, 8th edition, or its successor in function. 22 “transgender health care services” does not include conversion therapy as defined by § 23-94-2. 23 23-100-2. Declaration of policy. 24 The general assembly finds and therefore declares that: 25 (1) Access to transgender health care services as defined by § 23-100-1 and access to 26 reproductive health care services as defined by § 23-100-1 is a legal right in this state. 27 (2) Interference with legally protected health care activity, as defined by § 23-100-1, or the 28 aiding and assisting of legally protected health care activity, as defined by § 23-100-1, whether or 29 not under the color of law, is against the public policy of this state. 30 (3) Any public act of a foreign jurisdiction that prohibits, criminalizes, sanctions, or 31 authorizes a person to bring a civil action against or otherwise interferes with a person, provider, 32 payer, or other entity in this state that engages in legally protected health care activity or aids and 33 assists legally protected health care activity shall be an interference with the exercise and enjoyment 34 LC004704 - Page 4 of 15 of the rights secured by this state and shall be a violation of the public policy of this state. 1 23-100-3. Tortious interference with legally protected health care activity. 2 (a) If a person, whether or not acting under color of law, engages or attempts to engage in 3 hostile litigation as defined in § 23-100-1, any aggrieved person may initiate a civil action against 4 that person for injunctive, monetary, or other appropriate relief within three (3) years after the cause 5 of action accrues. 6 (b) If the court finds for the petitioner in an action authorized by this section, recovery may 7 include damages for the amount of any judgment issued in connection with any hostile litigation, 8 and any and all other expenses, costs, and reasonable attorneys' fees incurred in connection with 9 the hostile litigation and with the tortious interference action. 10 (c) A court of this state may exercise jurisdiction over a person in an action authorized by 11 this section if: 12 (1) Personal jurisdiction is found; 13 (2) The person has commenced any action in any court in this state and, during the 14 pendency of that action or any appeal therefrom, a summons and complaint is served on the person, 15 authorized representative, or the attorney appearing on the person’s behalf in that action or as 16 otherwise permitted by law; or 17 (3) The exercise of jurisdiction is permitted under the constitution of the United States. 18 (d) Hostile litigation does not include a lawsuit or judgment entered in another state that is 19 based on conduct for which a cause of action would exist under the laws of this state if the course 20 of conduct that forms the basis for liability had occurred entirely in this state, including any 21 contract, tort, common law, or statutory claims. 22 23-100-4. Foreign judgments. 23 (a) In any action filed to enforce a foreign judgment issued in connection with hostile 24 litigation, a court of this state shall not give any force or effect to any judgment issued without 25 jurisdiction or due process or to any judgment that is penal in nature. 26 (b) Foreign judgments issued in connection with hostile litigation shall be brought by filing 27 a new and independent action on the judgment within five (5) years after the rendition of the 28 judgment, and not after. 29 23-100-5. Testimony, documents, and subpoenas. 30 (a) Notwithstanding any other provision in this chapter or court rule to the contrary, except 31 as required by federal law, a court shall not order a person who is domiciled or found within this 32 state to give testimony or a statement or produce documents or other things with any proceeding in 33 a tribunal outside this state concerning hostile litigation. 34 LC004704 - Page 5 of 15 (b) An aggrieved person may move to modify or quash any subpoena issued to a person in 1 this state in connection with such hostile litigation on any grounds provided by court rule, statute, 2 or on the grounds that the subpoena is inconsistent with the public policy of this state. 3 (c) State court shall issue a summons in a case, except as required by federal law, where 4 prosecution is pending concerning legally protected health care activity, as defined in § 23-100-1, 5 or aiding and assisting legally protected health care activity, as defined in § 23-100-1, or where a 6 grand jury investigation concerning legally protected health care activity or aiding and assisting 7 legally protected health care activity has commenced or is about to commence for a criminal 8 violation of a law of such other state unless the acts forming the basis of the prosecution or 9 investigation would also constitute an offense if occurring entirely in this state. 10 (d) A judge, clerk, or official may not issue a subpoena if the subpoena is sought to be 11 issued in connection with hostile litigation. 12 (e) A business entity that is incorporated, or has its principal place of business, in this state 13 may not: 14 (1)(i) Knowingly provide records, information, facilities, or assistance in response to a 15 subpoena, warrant, court order, or other civil or criminal legal process that relates to an 16 investigation into, or the enforcement of, another state’s law that asserts criminal or civil liability 17 for legally protected health care activity or aiding and assisting legally protected health care; or 18 (ii) Comply with a subpoena, warrant, court order, or other civil or criminal legal process 19 for records, information, facilities, or assistance related to legally protected health care activity or 20 aiding and assisting legally protected health care unless the subpoena, warrant, court order, or other 21 civil or criminal legal process includes, or is accompanied by, an attestation, made under penalty 22 of perjury, stating that the subpoena, warrant, court order, or other civil or criminal legal process 23 does not seek documents, information, or testimony relating to an investigation into, or the 24 enforcement of, another state's law that asserts criminal or civil liability for legally protected health 25 care activity or aiding and assisting legally protected health care activity. Any false attestation 26 submitted under this section is subject to a statutory penalty of ten thousand dollars ($10,000) per 27 violation. Submission of such attestation subjects the attester to the jurisdiction of the courts of this 28 state for any suit, penalty, or damages arising out of a false attestation under this section. 29 (2) Any business entity described in subsection (e)(1) of this section that is served with a 30 subpoena, warrant, court order, or other civil or criminal legal process described in subsection (e)(1) 31 of this section is entitled to rely on the representations made in an attestation described in subsection 32 (e)(1) of this section in determining whether the subpoena, warrant, court order, or other civil or 33 criminal legal process relates to an investigation into, or the enforcement of, another state's law that 34 LC004704 - Page 6 of 15 asserts criminal or civil liability for legally protected health care activity or aiding and assisting 1 legally protected health care activity. 2 23-100-6. Orders authorizing the interception of wire, oral, or electronic 3 communications or search warrants. 4 (a) A court in this state shall not issue an ex parte order for wiretapping or eavesdropping 5 to obtain any wire, oral, or electronic communication that relates to an investigation into a legally 6 protected health care activity as defined in § 23-100-1 or aiding and assisting with legally protected 7 health care activity, as defined by § 23-100-1. 8 (b) A court in this state shall not issue a search warrant or an order for the interception of 9 any communication or conversation for the purpose of investigating or recovering evidence that 10 related to legally protected health care activity as defined in § 23-100-1 or aiding and assisting 11 legally protected health care activity, as defined by § 23-100-1. 12 23-100-7. Choice of law. 13 Notwithstanding any general or special law or common law conflict of law rule to the 14 contrary, the laws of this state shall govern in any case or controversy heard in this state related to 15 legally protected health care activity or aiding and assisting legally protected health care activity, 16 except as may be required by federal law. 17 23-100-8. Noncooperation. 18 (a) No public agency, including a state or local law enforcement agency, or state or local 19 employee, appointee, officer or official, or any other person acting on behalf of a public agency 20 may knowingly provide any information or expend or use time, money, facilities, property, 21 equipment, personnel, or other resources in furtherance of any interstate investigation or proceeding 22 seeking to impose civil or criminal liability upon a person or entity for: 23 (1) Legally protected health care activity; or 24 (2) Aiding and assisting legally protected health care activity. 25 (b) Notwithstanding any general or special law to the contrary and except as required by 26 federal law, no officer or employee of a law enforcement agency of this state, while acting under 27 color of law, shall provide information or assistance to a federal law enforcement agency or any 28 other state’s law enforcement agency or any private citizen or quasi-law enforcement agent in 29 relation to an investigation or inquiry into services constituting legally protected health care 30 activity, as defined in § 23-100-1, or aiding and assisting legally protected health care activity, as 31 defined by § 23-100-1, if such services would be lawful as provided if they occurred entirely in this 32 state. 33 (c) Notwithstanding any other law or provision of this chapter to the contrary, arrest of a 34 LC004704 - Page 7 of 15 person is prohibited if the arrest is related to criminal liability that is based on legally protected 1 health care activity as defined in § 23-100-1 or aiding and assisting legally protected health care 2 activity as defined in § 23-100-1. 3 (d) This section shall not apply to: 4 (1) Any investigation or proceeding where the conduct subject to potential liability under 5 the investigation or proceeding would be subject to liability under the laws of this state if committed 6 in this state; or 7 (2) A public agency or employee, appointee, officer or official who, in the course of normal 8 business, is responding to a warrant or extradition demand on the good faith belief that the warrant 9 or demand is valid in this state. 10 SECTION 2. Chapter 12-9 of the General Laws entitled "Extradition" is hereby amended 11 by adding thereto the following section: 12 12-9-36. Legally protected health care activity exception to extradition. 13 Notwithstanding any other provision in this chapter to the contrary, except as required by 14 federal law, the governor shall not surrender a person charged in another state as a result of 15 engaging in legally protected health care activity as defined in § 23-100-1 or aiding and assisting 16 legally protected health care activity as defined in § 23-100-1 unless the executive authority of the 17 demanding state alleges in writing that the accused was physically present in the demanding state 18 at the time of the commission of the alleged offense and that thereafter the accused fled from the 19 demanding state. 20 SECTION 3. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" 21 is hereby amended by adding thereto the following chapter: 22 CHAPTER 37.8 23 PROTECTIONS FOR PROVIDERS ACT 24 5-37.8-1. License protections for providers of legally protected health care activity. 25 (a) No health care provider who is certified, registered, or licensed in Rhode Island shall 26 be subject to professional disciplinary action by a board or the director, including the revocation, 27 suspension or cancellation of the certificate of registration, or reprimanded, censured or monetarily 28 fined nor shall a board or the director refuse to issue, renew, or take adverse action on an application 29 for certification, registration, or licensure of a qualified health care practitioner based solely on: 30 (1) The health care provider engaging in legally protected health care or aiding and 31 assisting with legally protected health care activity; 32 (2) A criminal, civil, or disciplinary action, including license suspension or revocation, in 33 another state against the health care practitioner that is based on the practitioner engaging in legally 34 LC004704 - Page 8 of 15 protected health care activity or aiding and assisting with legally protected health care activity; or 1 (3) A criminal, civil, or disciplinary action, including license suspension or revocation, in 2 another state against the health care practitioner that is based solely on the practitioner violating 3 another state’s law prohibiting legally protected health care activity or aiding and assisting with 4 legally protected health care activity. 5 (b) No board or the director shall make available for public dissemination on a health care 6 provider’s individual profile the record of any criminal conviction or charge for a felony or serious 7 misdemeanor, final disciplinary action by a licensing board in another state or a medical 8 malpractice court judgment, arbitration award or settlement that resulted from legally protected 9 health care activity, aiding and assisting legally protected health care activity, or for any judgment, 10 discipline or other sanction arising from such health care services if the services as provided was 11 consistent with the applicable professional standard of care and did not otherwise violate Rhode 12 Island law. 13 (c) As used in this section: 14 (1) Health care provider has the same meaning as set forth in 5-37.3-3 and also includes, 15 but is not limited to, the licensed professionals as forth in § 5-32-1 ("electrologists"), chapter 40.1 16 of title 5 ("occupational therapists"), § 5-37-1 ("osteopathic physicians"), chapter 39.1 of title 5 17 ("social workers"), chapter 63.2 of title 5 ("mental health counselors and marriage and family 18 therapists"), chapter 54 of title 5 ("physician assistants"), chapter 36.1 of title 5 ("naturopathic 19 health care providers"), chapter 48 of title 5 (speech-language pathologists), and chapter 30 of title 20 5 ("chiropractic physicians"). 21 (2) Legally protected health care activity has the same meaning as set forth in § 23-100-1. 22 (3) Aiding and assisting with legally protected health care activity has the same meaning 23 as set forth in § 23-100-1. 24 5-37.8-2. Insurance protections for providers of legally protected health care activity. 25 (a) An insurer that issues malpractice insurance for a health care provider who is certified, 26 registered, or licensed in Rhode Island shall not take a prohibited action against an applicant for or 27 the named insured under a malpractice policy in this state because the applicant or insured has 28 engaged in a legally protected health care activity as defined in § 23-100-1 or aiding and assisting 29 with legally protected health care activity as defined in § 23-100-1 in this state, so long as the care 30 provided by the applicant or insured was consistent with the applicable professional standard of 31 care and did not violate Rhode Island law. 32 (b) As used in this section, “prohibited action” means: 33 (1) Refusing to issue a malpractice policy; 34 LC004704 - Page 9 of 15 (2) Charging higher rates for a malpractice policy, including malpractice policies that 1 include coverage for cross-border care; 2 (3) Canceling or terminating a malpractice policy; 3 (4) Refusing to renew a malpractice policy; or 4 (5) Imposing any sanctions, fines, penalties, or rate increases. 5 (c) A carrier shall not refuse to credential an applicant, or terminate a participating health 6 care provider’s participation, in a provider network based solely on the applicant’s or participating 7 health care provider’s engaging in legally protected health care activity, as defined in § 23-100-1, 8 or aiding and assisting with legally protected health care activity, as defined § 23-100-1. 9 (d) A carrier shall not take adverse action against a health care provider or subject the health 10 care provider to financial disincentives based solely on the provider engaging in legally protected 11 health care activity, as defined in § 23-100-1, or aiding and assisting with legally protected health 12 care activity, as defined § 23-100-1 so long as the care provided did not violate the law of this state. 13 Adverse action in this section means refusing or failing to pay a provider for otherwise covered 14 services as defined in the applicable health benefit plan. 15 (e) As used in this section: 16 (1) “Health care provider” has the same meaning as set forth in § 5-37.3-3 and also 17 includes, but is not limited to, the licensed professionals as forth in § 5-32-1 ("electrologists"), 18 chapter 40.1 of title 5 ("occupational therapists"), § 5-37-1("osteopathic physicians"), chapter 39.1 19 of title 5 ("social workers"), chapter 63.2 of title 5 ("mental health counselors and marriage and 20 family therapists"), chapter 54 of title 5 ("physician assistants"), chapter 36.1 of title 5 21 ("naturopathic health care providers"), chapter 48 of title 5 ("speech-language pathologists"), § 5- 22 92-3 ("genetic counselors"), and chapter 30 of title 5 ("chiropractic physicians"). 23 (2) “Legally protected health care activity” has the same meaning as set forth in § 23-100- 24 1. 25 (3) “Aiding and assisting with legally protected health care activity” has the same meaning 26 as set forth in § 23-100-1. 27 SECTION 4. Chapter 23-17 of the General Laws entitled "Licensing of Healthcare 28 Facilities" is hereby amended by adding thereto the following section: 29 23-17-67. Protection of health care provider’s clinical privileges. 30 A health care facility shall not take any adverse action including, but not limited to, 31 restricting or terminating any health care provider’s clinical privileges as a result of an adverse 32 action against a health care provider’s license or clinical privileges or other disciplinary action by 33 another state or health care institution that resulted from the health care provider’s engaging in 34 LC004704 - Page 10 of 15 legally protected health care activity, as defined in § 23-100-1, or aiding and assisting with legally 1 protected health care activity, as defined § 23-100-1 if the adverse action was based solely on a 2 violation of the other state's law prohibiting such legally protected health care activity and related 3 services, if that legally protected health care activity is consistent with the applicable professional 4 standard of care and did not violate Rhode Island law. 5 As used in this section, “health care provider” has the same meaning as set forth in § 5- 6 37.3-3 and also includes, but is not limited to, the licensed professionals as forth in § 5-32-1 7 ("electrologists"), chapter 40.1 of title 5 ("occupational therapists"), § 5-37-1("osteopathic 8 physicians"), chapter 39.1 of title 5 ("social workers"), chapter 63.2 of title 5 ("mental health 9 counselors and marriage and family therapists"), chapter 54 of title 5 ("physician assistants"), 10 chapter 36.1 of title 5 ("naturopathic health care providers"), chapter 48 of title 5 ("speech-language 11 pathologists"), § 5-92-3 ("genetic counselors"), and chapter 30 of title 5 ("chiropractic physicians"). 12 SECTION 5. Section 5-37-9.2 of the General Laws in Chapter 5-37 entitled "Board of 13 Medical Licensure and Discipline" is hereby amended to read as follows: 14 5-37-9.2. Physician profiles — Public access to data. 15 (a)(1) The board shall compile the information listed in this section to create individual 16 profiles on licensed physicians, in a format created by the board, consistent with the provisions of 17 this section and any regulations promulgated under this section, that are available for dissemination 18 to the public and that include a conspicuous statement that: “This profile contains certain 19 information that may be used as a starting point in evaluating the physician. This profile should not 20 be your sole basis for selecting a physician.” 21 (2) The following information shall be compiled by the board in accordance with state laws 22 and board regulations and procedures and shall be included in physician profiles, subject to the 23 limitations and requirements set forth below: 24 (i) Names of medical schools and dates of graduation; 25 (ii) Graduate medical education; 26 (iii) A description of any final board disciplinary actions within the most recent ten (10) 27 years; 28 (iv) A description of any final disciplinary actions by licensing boards in other states within 29 the most recent ten (10) years; 30 (v) A description of any criminal convictions for felonies within the most recent ten (10) 31 years. For the purposes of this subsection, a person is deemed to be convicted of a crime if he or 32 she pleaded guilty or if he or she was found or adjudged guilty by a court of competent jurisdiction, 33 or was convicted of a felony by the entry of a plea of nolo contendere; 34 LC004704 - Page 11 of 15 (vi) A description of revocation or restriction of hospital privileges for reasons related to 1 competence taken by the hospital’s governing body or any other official of the hospital after 2 procedural due process has been afforded, or the resignation from or nonrenewal of medical staff 3 membership or the restriction of privileges at a hospital. Only cases that have occurred within the 4 most recent ten (10) years, shall be disclosed by the board to the public; and 5 (vii) All medical malpractice court judgments and all medical malpractice arbitration 6 awards in which a payment is awarded to a complaining party since September 1, 1988, or during 7 the most recent ten (10) years, and all settlements of medical malpractice claims in which a payment 8 is made to a complaining party since September 1, 1988, or within the most recent ten (10) years. 9 Dispositions of paid claims shall be reported in a minimum of three (3) graduated categories 10 indicating the level of significance of the award or settlement. Information concerning paid medical 11 malpractice claims shall be put in context by comparing an individual physician’s medical 12 malpractice judgments, awards, and settlements to the experience of other physicians licensed in 13 Rhode Island who perform procedures and treat patients with a similar degree of risk. All judgment, 14 award, and settlement information reported shall be limited to amounts actually paid by or on behalf 15 of the physician. 16 (3) Comparisons of malpractice payment data shall be accompanied by: 17 (i) An explanation of the fact that physicians treating certain patients and performing 18 certain procedures are more likely to be the subject of litigation than others and that the comparison 19 given is for physicians who perform procedures and treat patients with a similar degree of risk; 20 (ii) A statement that the report reflects data since September 1, 1988, or for the last ten (10) 21 years and the recipient should take into account the number of years the physician has been in 22 practice when considering the data; 23 (iii) An explanation that an incident, giving rise to a malpractice claim, may have occurred 24 years before any payment was made due to the time lawsuits take to move through the legal system; 25 (iv) An explanation of the effect of treating high-risk patients on a physician’s malpractice 26 history; and 27 (v) An explanation that malpractice cases may be settled for reasons other than liability 28 and that settlements are sometimes made by the insurer without the physician’s consent. 29 (4) Information concerning all settlements shall be accompanied by the following 30 statement: “Settlement of a claim may occur for a variety of reasons that do not necessarily reflect 31 negatively on the professional competence or conduct of the physician. A payment in settlement of 32 a medical malpractice action or claim should not be construed as creating a presumption that 33 medical malpractice has occurred.” Nothing in this section shall be construed to limit or prevent 34 LC004704 - Page 12 of 15 the board from providing further explanatory information regarding the significance of categories 1 in which settlements are reported. 2 (5) Pending malpractice claims and actual amounts paid by or on behalf of a physician in 3 connection with a malpractice judgment, award, or settlement shall not be disclosed by the board 4 to the public. Nothing in this section shall be construed to prevent the board from investigating and 5 disciplining a licensee on the basis of medical malpractice claims that are pending. 6 (6) The following information shall be reported to the board by the physician and shall be 7 included in physician profiles, subject to the limitations and requirements specified in this 8 subdivision: 9 (i) Specialty board certification; 10 (ii) Number of years in practice; 11 (iii) Names of the hospitals where the physician has privileges; 12 (iv) Appointments to medical school faculties and indication as to whether a physician has 13 a responsibility for graduate medical education within the most recent ten (10) years; 14 (v) Information regarding publications in peer-reviewed medical literature within the most 15 recent ten (10) years; 16 (vi) Information regarding professional or community service activities and awards; 17 (vii) The location of the physician’s primary practice setting; and 18 (viii) The identification of any language translating services that may be available at the 19 physician’s primary practice location; provided, that a statement is included in the profile indicating 20 that these services may be temporary and that the physician’s office should first be contacted to 21 confirm the present availability of language translation. 22 (b) A physician may elect to have his or her profile omit certain information provided 23 pursuant to subsections (a)(6)(iv) — (a)(6)(vi) of this section, concerning academic appointments 24 and teaching responsibilities, publication in peer-reviewed journals, and professional and 25 community service awards. In collecting information for these profiles and disseminating it, the 26 board shall inform physicians that they may choose not to provide any information required 27 pursuant to subsections (a)(6)(iv) — (a)(6)(vi) of this section. 28 (c) A physician profile shall not include the personal residence address, telephone number, 29 email address, or other personal contact information of the physician. 30 (d)(1) The board shall provide individual physicians with a copy of their profiles prior to 31 initial release to the public and each time a physician’s profile is modified or amended based on 32 information not personally supplied to the board by the physician or not generated by the board 33 itself. 34 LC004704 - Page 13 of 15 (2) Prior to initial release to the public and upon each modification or amendment requiring 1 physician review as provided in this subsection, a physician shall be provided not less than twenty- 2 one (21) calendar days to correct factual inaccuracies that appear in his or her profile. 3 (3) If a dispute arises between a physician and the board regarding the accuracy of factual 4 information in the physician’s profile, the physician shall notify the board, in writing, of this 5 dispute. 6 (4) If a physician does not notify the board of a dispute during the twenty-one-day (21) 7 review period, the profile shall be released to the public and the physician will be deemed to have 8 approved the profile and all information contained in the profile. 9 (5) If a physician notifies the board of a dispute in accordance with this subsection, the 10 physician’s profile shall be released to the public without the disputed information, but with a 11 statement to the effect that information in the identified category is currently the subject of a dispute 12 and is not available at this time. 13 (6) Within ten (10) calendar days after the board’s receipt of notice of a dispute, the 14 physician and the board or its authorized representative shall in good faith enter into discussions, 15 which may continue for up to thirty (30) days, to resolve the dispute. If the dispute is not resolved 16 within thirty (30) days, the disputed information shall be included in the profile with a statement 17 that this information is disputed by the physician. 18 (d)(e) Each profile shall contain a statement specifying the date of its last modification, 19 amendment, or update. If a physician has reviewed and approved or been deemed to have approved 20 his or her profile in accordance with this subsection, the physician is responsible for the accuracy 21 of the information contained in it. If a profile is released to the public without physician review as 22 required by this subsection, then notwithstanding any immunity from liability granted by § 5-37- 23 1.5 or § 23-1-32, the board or any state agency supplying physician information to the board is 24 solely responsible for the accuracy of the information it generates or supplies and that is contained 25 in physician profiles released to the public. 26 (e)(f) In order to protect against the unauthorized use or disclosure of provider profiles by 27 department of health employees with access to the data, the department of health shall apply its 28 existing safeguards and procedures for protecting confidential information to physician profile 29 information. 30 (f)(g) For each profile provided to the public by the board, the board may charge no more 31 than fifty cents ($.50) per page or three dollars ($3.00) per profile, whichever is greater. 32 LC004704 - Page 14 of 15 SECTION 6. This act shall take effect upon passage. 1 ======== LC004704 ======== LC004704 - Page 15 of 15 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO HEALTH AND SAFETY -- HEALTH CARE PROVIDER SHIELD BILL *** This act would enact the Health Care Provider Shield Bill, precluding any individual from 1 interfering with another’s access to transgender health care services and reproductive health care 2 services. 3 This act would take effect upon passage. 4 ======== LC004704 ========

2024 -- H 7577 SUBSTITUTE A ======== LC004704/SUB A ======== S T A T E O F R H O D E I S L A N D IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2024 ____________ A N A C T RELATING TO HEALTH AND SAFETY -- HEALTHCARE PROVIDER SHIELD BILL Introduced By: Representatives Edwards, Kislak, Ajello, McNamara, Kazarian, Knight, Donovan, Craven, McEntee, and Felix Date Introduced: February 09, 2024 Referred To: House Judiciary It is enacted by the General Assembly as follows: SECTION 1. This act shall be known and may be cited as the “Healthcare Provider Shield 1 Act.” 2 SECTION 2. Findings of fact. 3 The general assembly finds and therefore declares that: 4 (1) Access to gender-affirming health care services as defined by § 23-100-2 and access to 5 reproductive health care services as defined by § 23-100-2, as authorized under the laws of this 6 state, is a legal right. 7 (2) Interference with legally protected health care activity, as defined by § 23-100-2, or the 8 aiding and assisting of legally protected health care activity, as defined by § 23-100-2, whether or 9 not under the color of law, is against the public policy of this state. 10 (3) Any public act of another state that prohibits, criminalizes, sanctions, or authorizes a 11 person to bring a civil action against or otherwise interferes with a person, provider, payer or other 12 entity in this state that engages in legally protected health care activity or aids and assists legally 13 protected health care activity shall be an interference with the exercise and enjoyment of the rights 14 secured by this state and is against the public policy of this state. 15 SECTION 3. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby 16 amended by adding thereto the following chapter: 17 CHAPTER 100 18 HEALTHCARE PROVIDER SHIELD 19 LC004704/SUB A - Page 2 of 18 23-100-1. Short title. 1 This chapter shall be known and may be cited as the "Healthcare Provider Shield." 2 23-100-2. Definitions. 3 As used in this chapter, the followings words shall have the following meanings unless the 4 context clearly indicates otherwise: 5 (1) "Aid and assist legally protected health care activity" and "aiding and assisting legally 6 protected health care activity" mean: 7 (i) Any act or omission of a person aiding or effectuating or attempting to aid or effectuate 8 any other person in legally protected health care activity; or 9 (ii) The provision or administration of, or attempted provision or administration of, 10 insurance coverage for gender-affirming health care services or reproductive health care services 11 to a beneficiary or a dependent of a beneficiary by any insurer, payor or employer. 12 (iii) "Aiding and assisting legally protected health care activity" does not include any 13 conduct that violates Rhode Island law or deviates from the applicable standard of care or that could 14 form the basis of a civil, criminal or administrative action under the laws of this state had the course 15 of conduct that forms the basis for liability occurred entirely within this state. 16 (2) "Aggrieved person" means: 17 (i) A person against whom hostile litigation is filed or prosecuted or the legal representative 18 of a person against whom hostile litigation is filed or prosecuted; or 19 (ii) The employer of a person against whom hostile litigation is filed or prosecuted if the 20 legally protected health care activity or aiding and assisting legally protected health care activity of 21 the person that forms the basis of the hostile litigation was performed within the scope of the 22 person's employment. 23 (3) "Foreign judgment" means any judgment or decree of a court of another state. 24 (4) "Gender-affirming health care services" means all supplies, care and services of a 25 medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive, 26 rehabilitative or supportive nature, including medication, relating to the treatment of gender 27 dysphoria and gender incongruence in accordance with the accepted standard of care as defined by 28 major medical professional organizations and agencies with expertise in the field of gender- 29 affirming health care, including the Standards of Care for the Health of Transgender and Gender 30 Diverse People, Version 8, or subsequent version, published by the World Professional Association 31 for Transgender Health. "Gender-affirming health care services" does not include conversion 32 therapy as defined by §23-94-2. 33 (5) “Health care provider” means and shall apply to the following: 34 LC004704/SUB A - Page 3 of 18 (i) A qualified physician licensed pursuant to chapters 37 and 37.3 of title 5; 1 (ii) A qualified osteopathic physician licensed pursuant to chapter 37 of title 5; 2 (iii) A qualified physician assistant licensed pursuant to chapter 54 of title 5; 3 (iv) A genetic counselor licensed pursuant to chapter 92 of title 5; 4 (v) A qualified psychologist licensed pursuant to chapter 44 of title 5; 5 (vi) A qualified social worker licensed pursuant to chapter 39.1 of title 5; 6 (vii) An advanced practice registered nurse, and a certified nurse practitioner, licensed 7 pursuant to chapter 34 of title 5, and a certified registered nurse anesthetist licensed pursuant to 8 chapters 34 and 34.2 of title 5; 9 (viii) A certified nurse midwife licensed pursuant to chapter 13 of title 23; 10 (ix) A licensed clinical mental health counselor or associate, and a licensed marriage and 11 family therapist or associate, licensed pursuant to chapter 63.2 of title 5; 12 (x) An electrologist licensed pursuant to chapter 32 of title 5; 13 (xi) A speech-language pathologist licensed pursuant to chapter 48 of title 5; 14 (xii) An occupational therapist licensed pursuant to chapter 40.1 of title 5; 15 (xiii) A chiropractic physician licensed pursuant to chapter 30 of title 5; and 16 (xiv) A pharmacist engaging in the practice of pharmacy and licensed pursuant to chapter 17 19.1 of title 5. 18 (6) “Hostile litigation" means any litigation or other legal action, including civil, criminal 19 or administrative action, to deter, prevent, sanction or punish any person engaging in legally 20 protected health care activity or aiding and assisting legally protected health care activity by: 21 (i) Filing or prosecuting any litigation or other legal action in any other state where liability 22 is based on legally protected health care activity or aiding and assisting legally protected health 23 care activity that occurred in this state, including any action in which liability is based on any theory 24 of vicarious, joint or several liability; or 25 (ii) Attempting to enforce any order or judgment issued in connection with any litigation 26 or other legal action under subsection (6)(i) of this section by any party to the action or by any 27 person acting on behalf of any party to the action. 28 (iii) For purposes of this chapter, litigation or other legal action is based on legally protected 29 health care activity or aiding and assisting legally protected health care activity that occurred in this 30 state if any part of any act or omission involved in the course of conduct that forms the basis for 31 liability in the action occurs or is initiated in this state, whether or not the act or omission is alleged 32 or included in any pleading or other filing in the lawsuit. 33 (7) "Law enforcement agency" means any police department in any city or town or the state 34 LC004704/SUB A - Page 4 of 18 police as defined in the general laws. For purposes of this act, a law enforcement agency may 1 include any other non-federal entity in the state charged with the enforcement of laws relating to 2 the custody of detained persons. 3 (8) "Legally protected health care activity" means: 4 (i) The exercise and enjoyment or attempted exercise and enjoyment by any person of the 5 right secured by this state to gender-affirming health care services or reproductive health care 6 services; and 7 (ii) The provision or attempted provision of gender-affirming health care services or 8 reproductive health care services that are permitted under the laws and regulations of this state and 9 that are provided in accordance with the applicable standard of care by a person properly licensed 10 under the laws of this state and physically present in this state, regardless of whether the patient is 11 located in this state or whether the person is licensed in the state where the patient is located at the 12 time the services are rendered. 13 (iii) “Legally protected health care activity" does not include any conduct that could form 14 the basis of a civil, criminal or administrative action under the laws of this state had the course of 15 conduct that forms the basis for liability occurred entirely within this state and/or in violation of 16 Rhode Island law. 17 (9) "Reproductive health care services" means all supplies, care and services of a medical, 18 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive, 19 rehabilitative or supportive nature, including medication, relating to pregnancy, contraception, 20 assisted reproduction, pregnancy loss management or the termination of a pregnancy in accordance 21 with the applicable standard of care as defined by major medical professional organizations and 22 agencies with expertise in the field of reproductive health care. 23 (10) "State" means a state of the United States, the District of Columbia, Puerto Rico, the 24 United States Virgin Islands or any territory or insular possession subject to the jurisdiction of the 25 United States. The term “this state” refers to the state of Rhode Island. 26 23-100-3. Tortious interference with legally protected health care activity. 27 (a) If a person, whether or not acting under color of law, engages or attempts to engage in 28 hostile litigation, any aggrieved person may initiate a civil action against that person for injunctive, 29 monetary, or other appropriate relief within three (3) years after the cause of action accrues. 30 (b) If the court finds for the aggrieved person/petitioner in an action authorized by this 31 section, recovery may include damages for the amount of any judgment issued in connection with 32 any hostile litigation, and any and all other expenses, costs, and reasonable attorney’s fees incurred 33 in connection with the hostile litigation and with the tortious interference action. 34 LC004704/SUB A - Page 5 of 18 (c) A court of this state may exercise jurisdiction over a person in an action authorized by 1 this section if: 2 (1) Personal jurisdiction is found; 3 (2) The person who engages or attempts to engage in hostile litigation has commenced any 4 action in any court in this state and, during the pendency of that action or any appeal therefrom, a 5 summons and complaint is served on the person, authorized representative, or the attorney 6 appearing on the person’s behalf in that action or as otherwise permitted by law; or 7 (3) The exercise of jurisdiction is permitted under the Constitution of the United States. 8 23-100-4. Foreign judgments issued in connection with hostile litigation. 9 (a) Jurisdiction and due process required. A court of this state may not give any force or 10 effect to any foreign judgment in connection with hostile litigation if the court that issued the 11 foreign judgment did not: 12 (1) Have personal jurisdiction over the defendant; 13 (2) Have jurisdiction over the subject matter; or 14 (3) Provide due process of law. 15 (b) Limitations period. Notwithstanding any provision of law to the contrary, an action on 16 a foreign judgment in connection with hostile litigation must be commenced by filing a new and 17 independent action on the judgment within five (5) years of the foreign judgment. 18 23-100-5. Testimony, documents, and subpoenas. 19 (a) Notwithstanding any other provision in this chapter or court rule to the contrary, except 20 as required by federal law, a court may not order a person who is domiciled or found within this 21 state to give testimony or a statement or produce documents or other things with any proceeding in 22 a tribunal outside this state concerning hostile litigation. 23 (b) Any person in this state upon whom a subpoena seeking information concerning legally 24 protected healthcare activity is served by any state or federal court in connection with hostile 25 litigation, may move to modify or quash such subpoena on any grounds provided by court rule, 26 statute, or on the grounds that the subpoena is inconsistent with the public policy as set out in this 27 act. 28 (c) Except as required by federal law, a judicial officer may not issue a summons in a case 29 where prosecution is pending concerning legally protected health care activity, or aiding and 30 assisting legally protected healthcare activity, or where a grand jury investigation concerning 31 legally protected healthcare activity or aiding and assisting legally protected healthcare activity has 32 commenced or is about to commence for a criminal violation of a law of such other state unless the 33 acts forming the basis of the prosecution or investigation would also constitute an offense if 34 LC004704/SUB A - Page 6 of 18 occurring entirely in this state. 1 (d) A judge, clerk, or official may not issue a subpoena if the subpoena is sought to be 2 issued in connection with hostile litigation. 3 (e) A business entity that is incorporated, or has its principal place of business, in this state 4 may not: 5 (1) Knowingly provide records, information, facilities, or assistance in response to an out 6 of state subpoena, warrant, court order, or other civil or criminal legal process that the business 7 entity has reason to believe relates to an investigation into, or the enforcement of, another state’s 8 law that asserts criminal or civil liability for legally protected healthcare activity or aiding and 9 assisting legally protected healthcare; or 10 (2) Comply with an out of state subpoena, warrant, court order, or other civil or criminal 11 legal process for records, information, facilities, or assistance that the business entity has reason to 12 believe relates to legally protected healthcare activity or aiding and assisting legally protected 13 healthcare. 14 (3) Any business entity described in subsection (e)(1) or (e)(2) of this section that is served 15 with a an out of state subpoena, warrant, court order, or other civil or criminal legal process 16 described in subsection (e)(1) or (e)(2) of this section is entitled to request an attestation, made 17 under penalty of perjury, stating that the subpoena, warrant, court order, or other civil or criminal 18 legal process does not seek documents, information, or testimony relating to an investigation into, 19 or the enforcement of, another state's law that asserts criminal or civil liability for legally protected 20 healthcare activity or aiding and assisting legally protected healthcare activity, before providing 21 records, information, facilities or assistance. 22 (f) Any false attestation submitted under this section is subject to a statutory penalty of ten 23 thousand dollars ($10,000) per violation. Submission of such attestation subjects the attester to the 24 jurisdiction of the courts of this state for any suit, penalty, or damages arising out of a false 25 attestation under this section. The business entity is entitled to rely on the representations made in 26 an attestation described in subsection (e)(3) of this section in determining whether the out of state 27 subpoena, warrant, court order, or other civil or criminal legal process relates to an investigation 28 into, or the enforcement of, another state's law that asserts criminal or civil liability for legally 29 protected healthcare activity or aiding and assisting legally protected healthcare activity. 30 23-100-6. Prohibition on expenditure of public resources. 31 (a) Notwithstanding any provision of state law to the contrary and except as required by 32 federal law, a public agency, including a law enforcement agency, and an employee, appointee, 33 officer or official or any other person acting on behalf of a public agency may not provide any 34 LC004704/SUB A - Page 7 of 18 information or expend or use time, money, facilities, property, equipment, personnel or other 1 resources in furtherance of any interstate investigation or proceeding seeking to impose civil, 2 administrative or criminal liability upon a person or entity for: 3 (1) Legally protected health care activity; or 4 (2) Aiding and assisting legally protected health care activity. 5 23-100-7. Noncooperation. 6 (a) Except as required by federal law, an officer or employee of a law enforcement agency, 7 while acting under color of law, may not provide information or assistance to a federal law 8 enforcement agency, to any law enforcement agency in another state or political subdivision of 9 another state, or to any private citizen in relation to an investigation or inquiry into services 10 constituting legally protected health care activity or aiding and assisting legally protected health 11 care activity, if such services would be lawful as provided if they occurred entirely in this state. 12 (b) No arrest. Notwithstanding any provision of state law to the contrary and except as 13 required by federal law, arrest of a person in this state is prohibited if at the time of the arrest the 14 arresting official has information or knowledge that the arrest is related to criminal liability that is 15 based on legally protected health care activity or aiding and assisting legally protected health care 16 activity and the services would be lawful if they occurred entirely in this state. 17 (c) Exceptions. This section does not apply to a public agency, including a law enforcement 18 agency, or an employee, appointee, officer or official or any other person acting on behalf of a 19 public agency: 20 (1) When responding to a warrant or extradition demand on the good faith belief that the 21 warrant or demand is valid in this state; or 22 (2) When exigent circumstances make compliance with this section impossible. For the 23 purposes of this subsection, "exigent circumstances" means circumstances in which there is an 24 insufficient time to comply with this section and there is a compelling need for action due to the 25 presence of an imminent danger to public safety, there is a potential where evidence faces imminent 26 destruction, or any other circumstances where “exigent circumstances” as defined by common law 27 exists. 28 23-100-8. Choice of law. 29 Notwithstanding any general or special law or common law conflict of law rule to the 30 contrary, the laws of this state govern in any case or controversy heard in this state involving legally 31 protected health care activity or aiding and assisting legally protected health care activity. 32 23-100-9. Professions covered. 33 (a) The protections afforded by the provisions of this chapter for providing gender- 34 LC004704/SUB A - Page 8 of 18 affirming health care services, legally-protected health care activity, and reproductive health care 1 services, shall apply to the following healthcare providers: 2 (1) A qualified physician licensed pursuant to chapters 37 and 37.3 of title 5; 3 (2) A qualified osteopathic physician licensed pursuant to chapter 37 of title 5; 4 (3) A qualified physician assistant licensed pursuant to chapter 54 of title 5; 5 (4) A genetic counselor licensed pursuant to chapter 92 of title 5; 6 (5) A qualified psychologist licensed pursuant to chapter 44 of title 5; 7 (6) A qualified social worker licensed pursuant to chapter 39.1 of title 5; 8 (7) An advanced practice registered nurse, and a certified nurse practitioner, licensed 9 pursuant to chapter 34 of title 5, and a certified registered nurse anesthetist licensed pursuant to 10 chapters 34 and 34.2 of title 5; 11 (8) A certified nurse midwife licensed pursuant to chapter 13 of title 23; 12 (9) A licensed clinical mental health counselor or associate, and a licensed marriage and 13 family therapist or associate, licensed pursuant to chapter 63.2 of title 5; 14 (10) An electrologist licensed pursuant to chapter 32 of title 5; 15 (11) A speech-language pathologist licensed pursuant to chapter 48 of title 5; 16 (12) An occupational therapist licensed pursuant to chapter 40.1 of title 5; 17 (13) A chiropractic physician licensed pursuant to chapter 30 of title 5; and 18 (14) A pharmacist engaging in the practice of pharmacy and licensed pursuant to chapter 19 19.1 of title 5. 20 SECTION 4. Chapter 12-9 of the General Laws entitled "Extradition" is hereby amended 21 by adding thereto the following section: 22 12-9-36. Interstate extradition. 23 Notwithstanding any other provision in this chapter to the contrary, except as required by 24 federal law, the governor may not comply with any request received from the executive authority 25 of any other state to issue a warrant for the arrest or surrender of any person charged with a criminal 26 violation of a law of that other state where the violation alleged involves legally protected health 27 care activity, as defined in § 23-100-2, or aiding and assisting legally protected health care activity, 28 as defined in § 23-100-2. Consistent with the requirements of the United States Constitution, this 29 limitation does not apply in the circumstance where the person who is the subject of the request for 30 arrest or surrender was physically present in the requesting state at the time of the commission of 31 the alleged offense and thereafter fled from that state. 32 SECTION 5. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" 33 is hereby amended by adding thereto the following chapter: 34 LC004704/SUB A - Page 9 of 18 CHAPTER 37.8 1 PROTECTIONS FOR HEALTHCARE PROVIDERS ACT 2 5-37.8-1. License protections for providers of legally protected healthcare activity. 3 (a) As used in this chapter: 4 (1) Aiding and assisting with legally protected healthcare activity has the same meaning as 5 set forth in § 23-100-2. 6 (2) “Healthcare provider” means: 7 (i) A qualified physician licensed pursuant to chapters 37 and 37.3 of title 5; 8 (ii) A qualified osteopathic physician licensed pursuant to chapter 37 of title 5; 9 (iii) A qualified physician assistant licensed pursuant to chapter 54 of title 5; 10 (iv) A genetic counselor licensed pursuant to chapter 92 of title 5; 11 (v) A qualified psychologist licensed pursuant to chapter 44 of title 5; 12 (vi) A qualified social worker licensed pursuant to chapter 39.1 of title 5; 13 (vii) An advanced practice registered nurse, and a certified nurse practitioner, licensed 14 pursuant to chapter 34 of title 5, and a certified registered nurse anesthetist licensed pursuant to 15 chapters 34 and 34.2 of title 5; 16 (viii) A certified nurse midwife licensed pursuant to chapter 13 of title 23; 17 (ix) A licensed clinical mental health counselor or associate, and a licensed marriage and 18 family therapist or associate, licensed pursuant to chapter 63.2 of title 5; 19 (x) An electrologist licensed pursuant to chapter 32 of title 5; 20 (xi) A speech-language pathologist licensed pursuant to chapter 48 of title 5; 21 (xii) An occupational therapist licensed pursuant to chapter 40.1 of title 5; 22 (xiii) A chiropractic physician licensed pursuant to chapter 30 of title 5; and 23 (xiv) A pharmacist engaging in the practice of pharmacy and licensed pursuant to chapter 24 19.1 of title 5. 25 (3) Legally protected healthcare activity has the same meaning as set forth in § 23-100-2. 26 (4) "Prohibited action" means: 27 (i) Refusing to issue a malpractice policy; 28 (ii) Charging higher rates for a malpractice policy, including malpractice policies that 29 include coverage for cross-border care; 30 (iii) Canceling or terminating a malpractice policy; 31 (iv) Refusing to renew a malpractice policy; or 32 (v) Imposing any sanctions, fines, penalties, or rate increases. 33 (b) No healthcare provider who is certified, registered, or licensed in Rhode Island shall be 34 LC004704/SUB A - Page 10 of 18 subject to professional disciplinary action by a board or the director, including the revocation, 1 suspension or cancellation of the certificate, or registration or reprimand, censure or monetary fine 2 nor shall a board or the director refuse to issue, renew, or take adverse action on an application for 3 certification, registration, or licensure of a qualified healthcare provider based solely on: 4 (1) The healthcare provider engaging in legally protected healthcare or aiding and assisting 5 with legally protected healthcare activity; 6 (2) A criminal, civil, or disciplinary action, including license suspension or revocation, in 7 another state against the healthcare provider that is based on the provider engaging in legally 8 protected healthcare activity or aiding and assisting with legally protected healthcare activity; or 9 (3) A criminal, civil, or disciplinary action, including license suspension or revocation, in 10 another state against the healthcare provider that is based solely on the provider violating another 11 state’s law prohibiting legally protected healthcare activity or aiding and assisting with legally 12 protected healthcare activity. 13 (c)(1) Notwithstanding any general or special law to the contrary, no person may be subject 14 to discipline by a board or director, including the revocation, suspension or cancellation of the 15 certificate of registration or reprimand, censure or monetary fine, for providing or assisting in the 16 provision of reproductive health care services or gender-affirming health care services, as those 17 terms are defined in chapter 100 of title 23 (“healthcare provider shield act”), or for any judgment, 18 discipline or other sanction arising solely from such health care services if the services as provided 19 would have been lawful and consistent with the applicable professional standard of care if they 20 occurred entirely in the state. 21 (2) Except as authorized by state or federal law, the board or director may not make 22 available for public dissemination on a healthcare provider’s individual profile the record of any 23 criminal conviction or charge for a felony or serious misdemeanor, final disciplinary action by a 24 licensing board in another state, or arbitration award or settlement that resulted solely from 25 providing or assisting in the provision of reproductive health care services or gender-affirming 26 health care services or for any judgment, discipline or other sanction arising solely from such 27 legally protected health care services if the services as provided would have been lawful and 28 consistent with the applicable professional standard of care if they occurred entirely in the state. 29 The board or director may not take adverse action on an application for registration of a qualified 30 healthcare provider based on a criminal or civil action, disciplinary action by a licensing board of 31 another state or a medical malpractice claim in another state arising solely from the provision of 32 reproductive health care services or gender-affirming health care services that, as provided, would 33 have been lawful and consistent with the applicable professional standard of care if they occurred 34 LC004704/SUB A - Page 11 of 18 entirely in the state. 1 (3) Nothing in this section shall be construed to regulate the practice of medicine in any 2 other state. 3 5-37.8-2. Insurance protections for providers of legally protected healthcare activity. 4 (a) An insurer that issues malpractice insurance for a healthcare provider who is certified, 5 registered, or licensed in Rhode Island may not take a prohibited action against an applicant for or 6 the named insured under a malpractice policy in this state because the applicant or insured engaged 7 in a legally protected healthcare activity or aiding and assisting with legally protected healthcare 8 activity in this state, as long as the care provided by the applicant or insured was consistent with 9 the applicable professional standard of care and/or did not violate Rhode Island law. 10 (b) A carrier may not refuse to credential an applicant, or terminate a participating 11 healthcare provider’s participation, in a provider network based solely on the applicant’s or 12 participating healthcare provider’s engagement in legally protected healthcare activity, or aiding 13 and assisting with legally protected health care activity, provided that the care provided by the 14 applicant or insured was consistent with the applicable professional standard of care and/or did not 15 violate Rhode Island law. 16 (c) A carrier may not take adverse action against a healthcare provider or subject the 17 healthcare provider to financial disincentives based solely on the provider engaging in legally 18 protected healthcare activity, or aiding and assisting with legally protected healthcare activity, as 19 long as the care provided was consistent with the applicable professional standard of care and/or 20 did not violate the law of this state. Adverse action in this section means refusing or failing to pay 21 a provider for otherwise covered services as defined in the applicable health benefit plan. 22 (d) No medical malpractice insurer may discriminate against a provider or adjust or 23 otherwise calculate a provider’s risk classification or premium charges because, applying the 24 definitions set forth in chapter 100 of title 23 (“healthcare provider shield”): 25 (1) The health care provider offers reproductive health care services or gender-affirming 26 health care services that are unlawful in another state; 27 (2) Another state’s laws create potential or actual liability for those services; or 28 (3) Hostile litigation against a healthcare provider concerning reproductive health care 29 services or gender-affirming health care services resulted in a judgment against the healthcare 30 provider, if such health care services would be lawful and consistent with the applicable 31 professional standard of care as provided if they occurred entirely in this state. 32 5-37.8-3. Employment Protections for providers of legally protected health care 33 activity. 34 LC004704/SUB A - Page 12 of 18 An employer, agency, or institution shall not take any adverse action, including but not 1 limited to, restricting or terminating any health care provider’s employment or ability to practice 2 as a result of an adverse action against the health care provider’s license or other disciplinary action 3 by another state or institution that resulted from the health care provider’s engagement in legally 4 protected healthcare activity, as defined in § 23-100-2, or aiding and assisting with legally protected 5 health care activity, as defined in § 23-100-2, if the adverse action was based solely on a violation 6 of the other state’s law prohibiting such legally protected health care activity and related services, 7 if that legally protected health care activity is consistent with the applicable professional standard 8 of care and did not violate Rhode Island law. 9 10 SECTION 6. Section 23-17-53 of the General Laws in Chapter 23-17 entitled "Licensing 11 of Healthcare Facilities" is hereby amended to read as follows: 12 23-17-53. Physician contracts. 13 (a) A hospital, by contract or otherwise, may not refuse or fail to grant or renew medical 14 staff membership or staff privileges, or condition or otherwise limit or restrict medical staff 15 membership or staff privileges, based in whole or in part on the fact that the physician or a partner, 16 associate, or employee of the physician is providing medical or healthcare services at a different 17 hospital, hospital system, or on behalf of a health plan. Notwithstanding the previous sentence, a 18 hospital may condition or otherwise limit or restrict staff privileges for reasons related to the 19 availability of limited resources as determined in advance by the hospital’s governing body. Nor 20 shall a hospital by contract, or otherwise, limit a physician’s participation or staff privileges or the 21 participation or staff privileges of a partner, associate, or employee of the physician at a different 22 hospital, hospital system or health plan. 23 (b) This section does not prevent a hospital from entering into contracts with physicians to 24 ensure physician availability and coverage at the hospital or to comply with regulatory requirements 25 or quality of care standards established by the governing body of the hospital, if contracts, 26 requirements or standards do not require that a physician join, participate in or contract with a 27 physician-hospital organization or similar organization as a condition of the grant or continuation 28 of medical staff membership or staff privileges at the hospital. 29 (c) This section does not prevent the governing body of a hospital from limiting the number 30 of physicians granted medical staff membership or privileges at the hospital based on a medical 31 staff development plan that is unrelated to a physician or a partner, associate, or employee of a 32 physician having medical staff membership or privileges at another hospital or hospital system. 33 (d) A contract provision that violates this section shall be void and of no force and effect. 34 LC004704/SUB A - Page 13 of 18 (e) Hospitals shall allow patients of their medical staff to be evaluated and educated by the 1 various appropriate departments of the hospital upon referral by their treating physician, regardless 2 of the physician affiliation, as long as the physician has unrestricted privileges in their field of 3 practice. 4 (f) A hospital may not take any adverse action, including, but not limited to, refusing or 5 failing to grant or renew medical staff membership or staff privileges, or condition or otherwise 6 limit or restrict medical staff membership or staff privileges, based on a result of an adverse action 7 against a healthcare provider’s license or clinical privileges or other disciplinary action by another 8 state or healthcare institution that resulted from the healthcare provider’s engagement in legally 9 protected healthcare activity, as defined in § 23-100-2, or aiding and assisting with legally protected 10 healthcare activity, as defined § 23-100-2, if the adverse action was based solely on a violation of 11 the other state's law prohibiting such legally protected healthcare activity and related services, if 12 that legally protected healthcare activity is consistent with the applicable professional standard of 13 care and/or did not violate Rhode Island law. 14 SECTION 7. Section 5-37-9.2 of the General Laws in Chapter 5-37 entitled "Board of 15 Medical Licensure and Discipline" is hereby amended to read as follows: 16 5-37-9.2. Physician profiles — Public access to data. 17 (a)(1) The board shall compile the information listed in this section to create individual 18 profiles on licensed physicians, in a format created by the board, consistent with the provisions of 19 this section and any regulations promulgated under this section, that are available for dissemination 20 to the public and that include a conspicuous statement that: “This profile contains certain 21 information that may be used as a starting point in evaluating the physician. This profile should not 22 be your sole basis for selecting a physician.” 23 (2) The following information shall be compiled by the board in accordance with state laws 24 and board regulations and procedures and shall be included in physician profiles, subject to the 25 limitations and requirements set forth below: 26 (i) Names of medical schools and dates of graduation; 27 (ii) Graduate medical education; 28 (iii) A description of any final board disciplinary actions within the most recent ten (10) 29 years; 30 (iv) A description of any final disciplinary actions by licensing boards in other states within 31 the most recent ten (10) years; 32 (v) A description of any criminal convictions for felonies within the most recent ten (10) 33 years. For the purposes of this subsection, a person is deemed to be convicted of a crime if he or 34 LC004704/SUB A - Page 14 of 18 she pleaded guilty or if he or she was found or adjudged guilty by a court of competent jurisdiction, 1 or was convicted of a felony by the entry of a plea of nolo contendere; 2 (vi) A description of revocation or restriction of hospital privileges for reasons related to 3 competence taken by the hospital’s governing body or any other official of the hospital after 4 procedural due process has been afforded, or the resignation from or nonrenewal of medical staff 5 membership or the restriction of privileges at a hospital. Only cases that have occurred within the 6 most recent ten (10) years, shall be disclosed by the board to the public; and 7 (vii) All medical malpractice court judgments and all medical malpractice arbitration 8 awards in which a payment is awarded to a complaining party since September 1, 1988, or during 9 the most recent ten (10) years, and all settlements of medical malpractice claims in which a payment 10 is made to a complaining party since September 1, 1988, or within the most recent ten (10) years. 11 Dispositions of paid claims shall be reported in a minimum of three (3) graduated categories 12 indicating the level of significance of the award or settlement. Information concerning paid medical 13 malpractice claims shall be put in context by comparing an individual physician’s medical 14 malpractice judgments, awards, and settlements to the experience of other physicians licensed in 15 Rhode Island who perform procedures and treat patients with a similar degree of risk. All judgment, 16 award, and settlement information reported shall be limited to amounts actually paid by or on behalf 17 of the physician. 18 (3) Comparisons of malpractice payment data shall be accompanied by: 19 (i) An explanation of the fact that physicians treating certain patients and performing 20 certain procedures are more likely to be the subject of litigation than others and that the comparison 21 given is for physicians who perform procedures and treat patients with a similar degree of risk; 22 (ii) A statement that the report reflects data since September 1, 1988, or for the last ten (10) 23 years and the recipient should take into account the number of years the physician has been in 24 practice when considering the data; 25 (iii) An explanation that an incident, giving rise to a malpractice claim, may have occurred 26 years before any payment was made due to the time lawsuits take to move through the legal system; 27 (iv) An explanation of the effect of treating high-risk patients on a physician’s malpractice 28 history; and 29 (v) An explanation that malpractice cases may be settled for reasons other than liability 30 and that settlements are sometimes made by the insurer without the physician’s consent. 31 (4) Information concerning all settlements shall be accompanied by the following 32 statement: “Settlement of a claim may occur for a variety of reasons that do not necessarily reflect 33 negatively on the professional competence or conduct of the physician. A payment in settlement of 34 LC004704/SUB A - Page 15 of 18 a medical malpractice action or claim should not be construed as creating a presumption that 1 medical malpractice has occurred.” Nothing in this section shall be construed to limit or prevent 2 the board from providing further explanatory information regarding the significance of categories 3 in which settlements are reported. 4 (5) Pending malpractice claims and actual amounts paid by or on behalf of a physician in 5 connection with a malpractice judgment, award, or settlement shall not be disclosed by the board 6 to the public. Nothing in this section shall be construed to prevent the board from investigating and 7 disciplining a licensee on the basis of medical malpractice claims that are pending. 8 (6) The following information shall be reported to the board by the physician and shall be 9 included in physician profiles, subject to the limitations and requirements specified in this 10 subdivision: 11 (i) Specialty board certification; 12 (ii) Number of years in practice; 13 (iii) Names of the hospitals where the physician has privileges; 14 (iv) Appointments to medical school faculties and indication as to whether a physician has 15 a responsibility for graduate medical education within the most recent ten (10) years; 16 (v) Information regarding publications in peer-reviewed medical literature within the most 17 recent ten (10) years; 18 (vi) Information regarding professional or community service activities and awards; 19 (vii) The location of the physician’s primary practice setting; and 20 (viii) The identification of any language translating services that may be available at the 21 physician’s primary practice location; provided, that a statement is included in the profile indicating 22 that these services may be temporary and that the physician’s office should first be contacted to 23 confirm the present availability of language translation. 24 (b) A physician may elect to have his or her profile omit certain information provided 25 pursuant to subsections (a)(6)(iv) — (a)(6)(vi) of this section, concerning academic appointments 26 and teaching responsibilities, publication in peer-reviewed journals, and professional and 27 community service awards. In collecting information for these profiles and disseminating it, the 28 board shall inform physicians that they may choose not to provide any information required 29 pursuant to subsections (a)(6)(iv) — (a)(6)(vi) of this section. 30 (c) A physician profile shall not include the personal residence address, personal telephone 31 number, personal email address, or other personal contact information of the physician. 32 (d)(1) The board shall provide individual physicians with a copy of their profiles prior to 33 initial release to the public and each time a physician’s profile is modified or amended based on 34 LC004704/SUB A - Page 16 of 18 information not personally supplied to the board by the physician or not generated by the board 1 itself. 2 (2) Prior to initial release to the public and upon each modification or amendment requiring 3 physician review as provided in this subsection, a physician shall be provided not less than twenty- 4 one (21) calendar days to correct factual inaccuracies that appear in his or her profile. 5 (3) If a dispute arises between a physician and the board regarding the accuracy of factual 6 information in the physician’s profile, the physician shall notify the board, in writing, of this 7 dispute. 8 (4) If a physician does not notify the board of a dispute during the twenty-one-day (21) 9 review period, the profile shall be released to the public and the physician will be deemed to have 10 approved the profile and all information contained in the profile. 11 (5) If a physician notifies the board of a dispute in accordance with this subsection, the 12 physician’s profile shall be released to the public without the disputed information, but with a 13 statement to the effect that information in the identified category is currently the subject of a dispute 14 and is not available at this time. 15 (6) Within ten (10) calendar days after the board’s receipt of notice of a dispute, the 16 physician and the board or its authorized representative shall in good faith enter into discussions, 17 which may continue for up to thirty (30) days, to resolve the dispute. If the dispute is not resolved 18 within thirty (30) days, the disputed information shall be included in the profile with a statement 19 that this information is disputed by the physician. 20 (d)(e) Each profile shall contain a statement specifying the date of its last modification, 21 amendment, or update. If a physician has reviewed and approved or been deemed to have approved 22 his or her profile in accordance with this subsection, the physician is responsible for the accuracy 23 of the information contained in it. If a profile is released to the public without physician review as 24 required by this subsection, then notwithstanding any immunity from liability granted by § 5-37- 25 1.5 or § 23-1-32, the board or any state agency supplying physician information to the board is 26 solely responsible for the accuracy of the information it generates or supplies and that is contained 27 in physician profiles released to the public. 28 (e)(f) In order to protect against the unauthorized use or disclosure of provider profiles by 29 department of health employees with access to the data, the department of health shall apply its 30 existing safeguards and procedures for protecting confidential information to physician profile 31 information. 32 (f)(g) For each profile provided to the public by the board, the board may charge no more 33 than fifty cents ($.50) per page or three dollars ($3.00) per profile, whichever is greater. 34 LC004704/SUB A - Page 17 of 18 SECTION 8. Chapter 23-1 of the General Laws entitled "Department of Health" is hereby 1 amended by adding thereto the following section: 2 23-1-42.2. Professions and occupations licenses, certifications, and registration – 3 Confidentiality of personal information. 4 Notwithstanding the licensure, certification, or registration requirements specified in 5 statutes governing professions and occupations administered by the department of health, the 6 director of health shall not include the personal residence address, personal telephone number, 7 personal email address, or other personal contact information of licensed professionals on any and 8 all public provider profiles, registries, and any other lists of professionals and occupations 9 developed and maintained by the department. 10 SECTION 9. Severability. If any provision of this act or the application thereof to any 11 person or circumstances is held invalid, such invalidity shall not affect other provisions or 12 applications of this act, which can be given effect without the invalid provision or application, and 13 to this end the provisions of this act are declared to be severable. 14 SECTION 10. This act shall take effect upon passage. 15 ======== LC004704/SUB A ======== LC004704/SUB A - Page 18 of 18 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO HEALTH AND SAFETY -- HEALTHCARE PROVIDER SHIELD BILL *** This act would create a protective legal shield for healthcare providers, precluding any civil 1 or criminal action by other states or persons against healthcare providers involving persons seeking 2 access to gender-affirming health care services and reproductive healthcare services provided in 3 this state. 4 This act would take effect upon passage. 5 ======== LC004704/SUB A ========