Kentucky
Senate Bill 90: Medical Ethics and Diversity Act (2020)
SECTION 1. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO READ AS FOLLOWS:
As used in Sections 1 to 4 of this Act:
(1)"Conscience" means the religious, moral, ethical, or philosophical beliefs or principles held by any medical practitioner, healthcare institution, or healthcare payer. Conscience with respect to institutional entities or corporate bodies, as opposed to individual persons, is determined by reference to that entity or body's governing documents, including but not limited to any published religious, moral, ethical, or philosophical guidelines or directives, mission statements, articles of incorporation, bylaws, policies, or regulations;
(2)"Disclosure" means a formal or informal communication or transmission, but does not include a communication or transmission concerning policy decisions that lawfully exercise discretionary authority, unless the medical practitioner providing the disclosure or transmission reasonably believes that the disclosure or transmission evinces:
(a)A violation of any law, rule, or regulation;
(b)A violation of any standard of care or other ethical guidelines for the provision of any healthcare service; or
c)Gross mismanagement, a gross waste of funds, an abuse of authority, or a substantial and specific danger to public health or safety;
(3)"Discrimination" means any adverse action taken against, or any threat of adverse action communicated to, any medical practitioner, healthcare institution, or healthcare payer as a result of his, her, or its decision to decline to participate in a healthcare service on the basis of conscience. Discrimination includes but is not limited to termination of employment; transfer from current position; demotion from current position; adverse administrative action; reassignment to a different shift or job title; increased administrative duties; refusal of staff privileges; refusal of board certification;loss of career specialty; reduction of wages, benefits, or privileges; refusal to award a grant, contract, or other program; refusal to provide residency training opportunities; denial, deprivation, or disqualification of licensure; withholding or disqualifying from financial aid and other assistance; reducing, excluding, terminating, materially altering the terms of conditions of, or
otherwise making unavailable or denying, any grant, contract, subcontract, cooperative agreement, guarantee, loan, or othersimilar program or benefit; impediments to creating any healthcare institution or payer or expanding or improving that healthcare institution or payer; impediments to acquiring, associating with, or merging with any other healthcare institution or payer; the threat thereof with regard to any of the preceding; or any other penalty, disciplinary, or retaliatory action, whether executed or threatened;
(4)"Healthcare service" means medical care provided to any patient at any time over the entire course of treatment. This includes but is not limited to initial examination; testing; diagnosis; referral; dispensing or administering any drug, medication, or device; psychological therapy or counseling; research; prognosis; therapy; any other care or necessary services performed or provided by any medical practitioner, including but not limited to allied health professionals, paraprofessionals, or employees of healthcare institutions;
(5)"Healthcare institution" means any public or private hospital, clinic, medical center, professional association, ambulatory surgical center, private physician's office, pharmacy, nursing home, medical school, nursing school, medical training facility, or any other entity or location in which healthcare services are performed on behalf of any person. Healthcare institutions may include but are not limited to organizations, corporations, partnerships, associations, agencies, networks, sole proprietorships, joint ventures, or any other entity that provides healthcare services;
(6)"Healthcare payer" means any employer, healthcare plan, health maintenance organization, insurance company, management services organization, or any other entity that pays for or arranges for the payment of any healthcare service provided to any patient, whether that payment is made in whole or in part;
(7)"Medical practitioner" means any person or individual who may be or is asked to 8participate in a healthcare service. This includes but is not limited to doctors, nurses, practitioners, physician's assistants, nurses, nurse's aides, allied health professionals, medical assistants, hospital employees, clinic employees, nursing home employees, pharmacists, pharmacy technicians and employees, medical school faculty and students, nursing home faculty and students,psychology and counseling faculty and students, medical researchers, laboratory technicians, counselors, social workers, or any other person who facilitates or participates in the provision of healthcare to any person;
(8)"Participate in a healthcare service" means to provide, perform, assist with, facilitate, refer for, counsel for, consult with regard to, admit for the purposes of providing, or take part in any way in providing, any healthcare service or any form of such a service; and
(9)"Pay" or "payment" means to pay for, contract for, arrange for the payment of (whether in whole or in part), reimburse, or remunerate.
SECTION 2. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO READ AS FOLLOWS:
(1)A medical practitioner, healthcare institution, or healthcare payer shall have the right not to participate in or pay for any healthcare service which violates his, her, or its conscience.
(2)A medical practitioner, healthcare institution, or healthcare payer shall not be 1liable civilly, criminally, or administratively for exercising his, her, or its right or conscience with respect to a healthcare service.
(3)No medical practitioner, healthcare institution, or healthcare payer shall be subject to discrimination in any manner as a result of his, her, or its decision to 5decline to participate in a healthcare service on the basis of conscience.
(4)Sections 1 to 4 of this Act shall not apply to a religious medical practitioner, healthcare institution, or healthcare payer that only hires individuals of a particular religion with respect to any employment-related decision, including but not limited to the decision whether or not to hire, terminate, or discipline an individual whose conduct or religious beliefs are inconsistent with those of the religious organization.
(5)Nothing in Sections 1 to 4 of this Act shall be construed to override the requirement to provide emergency medical treatment to all patients as set forth in 1442 U.S.C. sec. 1395dd or any other federal law governing emergency medical treatments.
SECTION 3. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO READ AS FOLLOWS:
(1)No medical practitioner shall be discriminated against because he or she:
(a)Provided, caused to be provided, or is about to provide to his or her employer, the Attorney General, any agency of the Commonwealth charged with protecting healthcare rights of conscience, the United States Department of Health and Human Services, Office for Civil Rights, or any other federal agency charged with protecting healthcare rights of conscience with information relating to any violation, act, or omission the medical practitioner reasonably believes to be a violation of any provision of Sections 1 to 4 of this Act;
(b)Testified or is about to testify in a proceeding concerning a violation; or
(c)Assisted, participated, or is about to assist or participate in related proceedings.
(2)Unless the disclosure is prohibited by law, no medical practitioner shall be discriminated against because he or she disclosed information that he or she reasonably believe evinces:
(a)A violation of a relevant law, rule, or regulation;
(b)A violation of a standard of care or other ethical guideline for the provision of healthcare services; or
(c)Gross mismanagement, gross waste of funds, abuse of authority, or substantial and specific danger to public health or safety.
SECTION 4. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO READ AS FOLLOWS:
Any person injured by a violation of Sections 1 to 4 of this Act shall have a civil cause of action in the Circuit Court of appropriate jurisdiction to enjoin further violations, to recover the actual damages sustained, and to recover the costs of the lawsuit and to provide any other appropriate relief, which may include reinstatement of a medical practitioner to his or her previous position, reinstatement of board certification, and relicensure of a healthcare institution or healthcare payer. If a violation is found to have occurred, the court's order or judgment shall include a reasonable fee for the plaintiff's attorney of record. Any additional burden or expense on another medical practitioner, healthcare institution, or healthcare payer arising from the exercise of the right of conscience shall not be a defense to any violation of Sections 1 to 4 of this Act.
Section 5.
Sections 1 to 4 of this Act may be cited as the Medical Ethics and Diversity Act