Medical Ethics Defense Act.

23LSO-0612
2023
STATE OF WYOMING
23LSO-0612
Numbered
2.0

HOUSE BILL NO. HB0234

Medical Ethics Defense Act.

Sponsored by: Representative(s) Ottman, Jennings, Pendergraft, Penn and Smith

A BILL

for

AN ACT relating to public health and safety; allowing health care providers, health care institutions and health care payers the right to refuse to participate in or pay for health care services as specified; prohibiting discrimination; providing immunity; providing definitions; specifying applicability; requiring rulemaking; and providing for effective dates.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S. 35
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33
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101 through 35
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33
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106 are created to read:

CHAPTER 33
MEDICAL ETHICS DEFENSE ACT

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101.

Short title.

This chapter shall be known and may be cited as the "Medical Ethics Defense Act."

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102.

Definitions.

(a)

As used in this act:

(i)

"Conscience" means the ethical, moral or religious beliefs or principles held by any health care provider, health care institution or health care payer. Conscience with respect to health care institutions and health care payers shall be determined by reference to the health care institution's or health care payer's governing documents, including any published ethical, moral or religious guidelines or directives, mission statements, constitutions, articles of incorporation, bylaws, policies or regulations;

(ii)

"Discrimination" means any person taking adverse action against or communicating a threat of adverse action to any health care provider, health care institution or health care payer as a result of a decision by the health care provider, health care institution or health care payer to decline to participate in or pay for any health care service on the basis of the conscience of the health care provider, health care institution or health care payer. The term does not include a person declining to use or purchase health care services from a specific health care provider, health care institution or health care payer if that health care provider, health care institution or health care payer exercises the right to refuse to participate in or pay for health care services based on its conscience;

(iii)

"Health care institution" means as defined in W.S. 35
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22
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402(a)(x);

(iv)

"Health care payer" means any employer, health plan, health maintenance organization, insurance company or management services organization or any other entity that pays for or arranges for the payment of any health care service provided to any patient whether the payment is made in whole or in part;

(v)

"Health care provider" means any person or individual who may be or is asked to participate in any health care service including but not limited to doctors, nurse practitioners, physician assistants, nurses, nurse aides, allied health professionals, medical assistants, hospital employees, clinic employees, nursing home employees, pharmacists, pharmacy technicians and employees, medical school faculty and students, nursing school faculty and students, psychology and counseling faculty and students, medical researchers, laboratory technicians, psychologists, psychiatrists, counselors, mental health professionals, social workers or any other person who facilitates or participates in a health care service;

(vi)

"Health care service" means medical care provided to any patient at any time over the entire course of treatment or medical research including but not limited to testing, diagnosis, referral, dispensing or administering any drug, medication or device, psychological therapy or counseling, research, prognosis, therapy, record making procedures, notes relating to treatment, set up of performance of a surgery or procedure or any other medical care or services provided by any health care provider;

(vii)

"Participate" in a health care service means to provide, perform, assist with, facilitate, refer for, counsel for, advise with regard to, admit for the purposes of providing or take part in any way in providing any health care service or any form of such health care service;

(viii)

"This act" means W.S. 35
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33
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101 through 35
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106.

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103.

Rights of conscience of health care providers, health care institutions and health care payers.

(a)

Each health care provider, health care institution and health care payer shall have the right to refuse to participate in or pay for any health care service that violates the health care provider's, health care institution's or health care payer's conscience. The exercise of the right to refuse to participate in or pay for any health care service as provided in this subsection is limited to conscience
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based objections to a particular health care service.

(b)

Notwithstanding any other provision of this act, a religious health care provider, health care institution or health care payer that holds itself out to the public as religious, states in its governing documents that it has a religious purpose or mission and has internal operating policies and procedures that implement its religious beliefs shall have the right to make employment, staffing, contracting and admitting privilege decisions consistent with its religious beliefs.

(c)

A health care provider may not be scheduled for, assigned or requested to directly or indirectly perform, facilitate, refer for or participate in any abortion unless the practitioner first affirmatively consents in writing to perform, facilitate, refer for or participate in the abortion.

(d)

Each health care institution shall adopt internal policies, programs, plans or procedures for each health care provider employed, contracted or granted admitting privileges by the health care institution, to exercise his right to refuse to participate in a health care service based on his conscience under subsection (a) of this section.

(e)

The right to refuse to participate in a health care service based on conscience provided in subsection (a) of this section shall not be construed to waive or modify any duty of a health care provider or health care institution to provide other health care services or provide emergency medical treatment under 42 U.S.C. § 1395dd.

(f)

Each health care payer shall adopt internal policies, programs, plans or procedures for:

(i)

Each health care payer exercising its right to refuse to pay for a health care service based on its conscience under subsection (a) of this section; and

(ii)

The resolution of conflicts arising between a health care payer exercising its right to refuse to pay for a health care service based on its conscience and a health care institution or health care provider who provided the health care service to the patient.

(g)

A health care payer shall file its conscience policies annually with the state insurance department by including a comprehensive list by billing code of any products, services and procedures that the health care payer shall not pay or make payment based on its conscience. The annual filing shall be submitted annually to each beneficiary of the health care payer.

(h)

A health care payer shall not refuse or reduce payments based on its conscience to a health care provider, health care institution or beneficiary for any product, service or procedure that is not included in the annual filing required under subsection (g) of this section.

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104.

Discrimination prohibited.

(a)

No person or entity shall discriminate against any health care provider, health care institution or health care payer for exercising the right to refuse to participate in or pay for health care services based on its conscience under this act.

(b)

No person or entity shall discriminate against a health care provider or health care institution for:

(i)

Providing the health care provider's employer, the department of health or the attorney general of Wyoming, information relating to any violation of or any act or omission the health care provider or health care institution reasonably believes to be a violation of any provision of this act; or

(ii)

Testifying, assisting, participating or agreeing to testify, assist or participate in a proceeding concerning a violation of this section.

(c)

Unless the disclosure is specifically prohibited by law, no health care provider shall be subject to discrimination for disclosing any information that the health care provider reasonably believes violates:

(i)

Any federal or state law, rule or regulation;

(ii)

Any standard of care or other ethical guidelines for the provision of any health care service; or

(iii)

Gross mismanagement, a gross waste of funds, an abuse of authority, practice or methods of treatment that may place a patient's health at risk or a substantial and specific danger to public health or safety.

(d)

A board, certifying or licensing agency or the department of health may not reprimand, sanction or revoke or threaten to revoke a license, certificate, certification or registration of a health care provider for engaging in speech or expressive activity protected by the first amendment to the United States constitution unless the board, certifying or licensing agency or the department of health demonstrates beyond a reasonable doubt that the health care provider's speech was the direct cause of physical harm to a person that the health care provider had established a health care provider
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patient relationship within the past three (3) years before the incident of physical harm.

(e)

A board, certifying or licensing agency or the department of health shall provide a health care provider with a complaint to revoke the health care provider's license, certificate, certification or registration within fourteen (14) days after receipt of the complaint. A board, certifying or licensing agency or the department of health shall pay the health care provider an administrative penalty of five hundred dollars ($500.00) for each week the complaint is not provided to the health care provider after the fourteen (14) days as provided by this subsection.

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105.

Immunity.

(a)

No health care provider, health care institution or health care payer shall be subject to civil or criminal liability for exercising the right to refuse to participate in or pay for any health care service based on its conscience.

(b)

No health care institution shall be subject to civil or criminal liability for a health care provider employed, contracted or granted admitting privileges by the health care institution for the health care provider exercising his right to refuse to participate in a health care service based on his conscience.

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106.

Civil remedies.

A civil action for damages or injunctive relief, or both, may be brought by a health care provider, health care institution or health care payer in a court of competent jurisdiction for any alleged violation of any provision of this act.

Section 2.

This act shall not apply to health care services and payment obligations for which the obligation to provide health care services or payment arose before July 1, 2023.

Section 3.

The department of insurance shall promulgate all rules necessary to implement the provisions of this act.

Section 4.

Any provision of this act held to be invalid or unenforceable by its terms or as applied to any person or circumstances shall be construed to provide for the maximum effect permitted by law unless such holding shall be one of invalidity or unenforceability, in which event such provision shall be deemed severable and shall not affect the remainder of the provision or the application of such provision to other persons not similarly situated or to other dissimilar circumstances.

Section 5.

This act shall not be construed to supersede any law of the state that is equally as protective of the conscience or more protective of the conscience than this act.

Section 6.

(a)

Except as provided in subsection (b) of this section, this act is effective July 1, 2023.

(b)

Sections 3 and 6 of this act are effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

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HB0234