A.R.S. tit. 36 ch. 25 — Arizona Revised Statutes Title 36 Chapter 25 — Health Care Quality

36-2401. Definitions In this article, unless the context otherwise requires: 1. "Health care entity" means any of the following: (a) A licensed health care provider. (b) An entity that provides health care services through one or more licensed health care providers. (c) An entity that contracts to provide or pays for health care services. (d) A professional organization of licensed health care providers. (e) A utilization or quality control peer review organization. (f) A state health care provider. (g) A component of the statewide emergency medical services and trauma system. (h) A qualifying community health center as defined in section 36-2907.06. (i) A committee or other organizational structure of a health care entity. 2. "Licensed health care provider" means a person or institution that is licensed or certified by this state to provide health care, medical services, nursing services or other health-related services. 3. "Quality assurance activities" means activities or proceedings of a health care entity: (a) That are established for the purposes of reducing morbidity and mortality and for improving the quality of health care or encouraging proper utilization of health care services and facilities through the review of the qualifications, professional practices, training, experience, patient care, conduct, processes or data of licensed health care providers. (b) That follow a process adopted by the health care entity that includes written standards and criteria. 4. "Quality assurance information" means information in oral, written or digital form that is submitted to, prepared for or by or considered by a health care entity for or in the course of quality assurance activities, including the record of the health care entity's actions and proceedings. 5. "State health care provider" means a department, agency, board or commission of the state and its officers, agents and employees that is a health care provider to clients, wards, patients or other persons in the control or custody of a department, agency, board or commission of the state and a health care provider rendering health care services on behalf of the state that is covered by insurance or self-insurance pursuant to section 41-621, 41-622 or 41-623. 36-2402. Quality assurance activities; sharing of quality assurance information; immunity; confidentiality A. State health care providers, hospitals and outpatient surgical centers shall, and other health care entities may, conduct quality assurance activities. B. A health care entity may share quality assurance information with appropriate state licensing or certifying agencies and with licensed health care providers who are the subject of quality assurance activities. A hospital may share quality assurance information with other health care entities only with the approval of the hospital's medical executive committee or an equivalent committee. C. A health care entity may share quality assurance information with other health care entities only for the purpose of conducting quality assurance activities. D. A health care entity or person that provides or receives information, that participates, takes any action or makes any decision or recommendation in the course of quality assurance activities or that furnishes any records, information or assistance to a health care entity for or in the course of quality assurance activities is not subject to liability for civil damages or any legal action in consequence of such action except as provided in section 36-445.02. E. Quality assurance activities conducted by state, county or local medical, pharmacy and dental associations and societies on behalf of a health care entity are immune from civil liability to the same degree as the facility for which the review activities are conducted. F. Health care entities may jointly conduct quality assurance activities. G. This section does not relieve any health care entity from liability arising from the treatment of a patient or from negligent credentialing decisions. H. Long-term care incident reports: 1. Are a risk management tool to be used solely for internal investigations and quality improvement efforts. 2. Are confidential records of an unplanned event or occurrence that is inconsistent with routine care and that may impact a resident's safety, health or well-being. 3. Are used to support follow-up actions and identify opportunities for improvement and manage risk. 4. Are maintained separately from the resident's medical record. 36-2403. Confidentiality; protection from discovery proceedings and subpoena; exceptions A. Quality assurance information shall be confidential and is not subject to subpoena or order to produce except in proceedings before the appropriate state licensing or certifying agency, or in actions by a licensed health care provider against a health care entity arising from the discipline of the licensed health care provider or the refusal, termination, suspension or limitation of privileges. A health care entity or a person who provides or receives information or who participates in, takes any action in or makes any decision or recommendation for or in the course of quality assurance activities may not be subpoenaed to testify in any judicial or quasi-judicial proceeding relating to the subject matter of the quality assurance activities. B. This article shall not be construed to affect any patient's claim to privilege or privacy or to prevent the subpoena of a patient's health care records if they are otherwise subject to discovery. In any legal action brought pursuant to section 36-2402 in which it is alleged that quality assurance activities were inadequate or were negligently conducted, representatives of a health care entity are permitted to testify only as to whether there were quality assurance activities relating to the subject matter being litigated and the date or dates of the quality assurance activities. C. Sharing of information about quality assurance activities in accordance with section 36-2402 does not waive or otherwise impair the confidentiality of the information shared. Governing bodies and administrative and other personnel of a health care entity may participate in quality assurance activities without waiving confidentiality. All individuals or entities sharing or receiving quality assurance information shall maintain the information confidentially in accordance with this section. D. A state agency or the affected licensed health care provider receiving or reviewing quality assurance information pursuant to section 36-2402 shall maintain the information confidentially, and such entities and individuals are subject to the same provisions concerning discovery and use in legal actions as are health care entities. E. Except as otherwise provided in this subsection, information that is otherwise discoverable does not become confidential based solely on its submission to or consideration by a health care entity conducting confidential quality assurance activities. A health care entity conducting quality assurance activities may not produce such information if discovery of such information might reveal the deliberative process engaged in during such quality assurance activities. F. This section does not apply to information considered confidential under section 36-2917. 36-2411. Custom orthotic and custom prosthetic devices; requirements; definition A. Beginning January 1, 2018, a custom orthotic or custom prosthetic device furnished to an individual shall meet all of the following requirements: 1. Except for a custom orthotic or custom prosthetic device provided by a health care provider who is licensed pursuant to title 32, chapter 7, 13, 17, 19, 25 or 34, be provided by a fabricator or supplier that is accredited by an independent accreditation organization approved by the secretary of the United States department of health and human services pursuant to 42 United States Code section 1395m(a)(20)(B) and the regulations promulgated thereunder. 2. Be provided by a health care provider that is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F) or is licensed pursuant to title 32, chapter 7, 13, 17, 19, 25 or 34. 3. Be the subject of a valid prescription for the custom orthotic or custom prosthetic device. B. Except for a custom orthotic or custom prosthetic device provided by a health care provider who is licensed pursuant to title 32, chapter 7, 13, 17, 19, 25 or 34, a health care provider that does not receive insurance payment for a custom orthotic or custom prosthetic device because the custom orthotic or custom prosthetic device or the provider does not meet the requirements of subsection A of this section may not attempt to collect payment or reimbursement for the amount of the coverage denial for the custom orthotic or custom prosthetic device from the patient. This subsection applies only if the coverage denial is strictly based on the custom orthotic or custom prosthetic device or the provider not meeting the requirements of subsection A of this section. C. This section does not: 1. Require a health care provider to accept medicare patients. 2. Restrict the ability of a licensed health care provider to issue a valid prescription for a custom orthotic or custom prosthetic device pursuant to the applicable state law provided that the custom orthotic or custom prosthetic device is molded, fabricated and fitted by a provider pursuant to subsection A of this section. 3. Prevent a licensed health care provider, that does not meet the requirements in subsection A of this section, from engaging in the profession or occupation for which the health care provider is licensed, provided that the licensed health care provider does not bill or otherwise receive insurance payment or collect reimbursement from a patient for the custom orthotic or custom prosthetic device. D. For the purposes of this section, "custom orthotic or custom prosthetic device" means an orthotic or prosthetic device that is individually fabricated for a patient over a positive mold, a tracing or a scan of the patient. Custom orthotic or custom prosthetic device does not include shoes and shoe inserts, a dental device, a hearing-related device or the replacement of all or part of an internal body organ.