07 LC 33
1669
Senate
Bill 93
By:
Senators Smith of the 52nd, Thomas of the 54th, Hill of the 32nd and Unterman of
the 45th
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Title 31 of the Official Code of Georgia Annotated, relating to health, so
as to enact the "Patient Disclosure for Eye Surgery Act"; to provide for the
delegation of postoperative eye care for a patient who has undergone eye
surgery; to provide for definitions; to provide for comanagement agreements; to
provide for requirements for delegation; to provide for an affirmative defense;
to provide for related matters; to repeal conflicting laws; and for other
purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Title
31 of the Official Code of Georgia Annotated, relating to health, is amended by
adding after Chapter 9A a new Chapter 9B to read as follows:
"CHAPTER
9B
31-9B-1.
This
chapter shall be known and may be referred to as the 'Patient Disclosure for Eye
Surgery Act.'
31-9B-2.
As
used in this chapter, the term:
(1)
'Board' means the Composite State Board of Medical Examiners.
(2)
'Operating physician' means a physician who performs eye surgery.
(3)
'Optometrist' means a person who is licensed and registered to practice
optometry in this state pursuant to Chapter 30 of Title 43.
(4)
'Physician' means a person who is licensed to practice medicine in this state
pursuant to Chapter 34 of Title 43.
31-9B-3.
(a)
Except as otherwise provided in this subsection, an operating physician in this
state shall be physically available to a patient for postoperative care in the
community in which the operation was performed for at least 48 hours after the
surgery is completed. Such operating physician may delegate the responsibility
for the first 48 hours of postoperative care for a patient for whom the
physician performed eye surgery in this state only by entering into a
comanagement agreement with another physician or an optometrist to provide such
postoperative care under the provisions of this Code section. Such delegation
may only be made through a comanagement agreement that meets the requirements of
this Code section and if the person to whom the responsibility is delegated
is:
(1)
An optometrist; or
(2)
A physician.
(b)
A comanagement agreement for postoperative eye care of a patient must meet the
following requirements:
(1)
The agreement may be entered into only when:
(A)
The distance the patient would have to travel to the regular office of the
operating physician would result in an unreasonable hardship for the patient, as
determined by the patient;
(B)
The operating physician will not be available for postoperative eye care of the
patient as a result of the operating physician´s personal travel, illness,
travel to a rural area of the state for occasional practice of medicine, or
travel to an area of the state designated as a physician shortage area by the
board; or
(C)
Other justifiable circumstances exist, as provided under regulations of the
board;
(2)
The agreement may not provide a fee to the person to whom the care is delegated
that does not reflect the fair market value of the services provided by such
person;
(3)
The agreement may be entered into only if the operating physician confirms that
the person to whom the care is delegated is qualified to treat the patient
during the postoperative period and is licensed or certified to provide the care
if licensing or certification is required by law;
(4)
The agreement may not take effect unless there is a written statement in the
operating physician´s file and in the files of the person to whom
postoperative eye care is being delegated that is signed by the patient in which
the patient states the patient´s consent to the comanagement agreement and
in which the patient acknowledges that the details of the comanagement agreement
have been explained to the extent required under paragraph (5) of this
subsection; and
(5)
The details of the agreement shall be disclosed to the patient in writing before
surgery is performed. The disclosure required under this paragraph shall
include:
(A)
The reason for the delegation;
(B)
The qualifications, including licensure or certification, of the person to whom
the care is delegated;
(C)
The financial details about how the surgical fee will be divided between the
operating physician and the person who provides the postoperative eye care;
(D)
A notice that, notwithstanding the delegation of care, the patient may receive
postoperative eye care from the operating physician at the patient´s
request without the payment of additional fees;
(E)
A statement that the operating physician will be ultimately responsible for the
patient´s care until the patient is postoperatively stable;
(F)
A statement that there is no fixed date on which the patient will be required to
return to the referring physician or optometrist; and
(G)
A description of special risks to the patient that may result from the
comanagement agreement.
(c)
An operating physician may not enter into a comanagement agreement governed by
this Code section:
(1)
Under which two or more physicians or optometrists agree to comanage patients of
the operating physician as a matter of routine policy rather than on a
case-by-case basis;
(2)
That is not clinically appropriate for the patient;
(3)
That is made with the intent to induce surgical referrals; or
(4)
That is based on economic considerations affecting the operating
physician.
(d)
A physician or optometrist may not require as a condition of making referrals to
an operating physician that the operating physician must enter into a
comanagement agreement with the physician or optometrist for the postoperative
eye care of the patient who is referred.
(e)
A physician or optometrist to whom postoperative eye care is delegated under a
comanagement agreement governed by this Code section may not delegate the care
to another person, regardless of whether such person is under the supervision of
the physician or optometrist.
(f)
It shall be an affirmative defense to a prosecution under this Code section or
in a disciplinary proceeding for violation of this Code section that the
operating physician delegated postoperative eye care of a patient because of
unanticipated circumstances that were not reasonably foreseeable by such
physician before the surgery was performed."
SECTION
2.
All
laws and parts of laws in conflict with this Act are repealed.