HB 226 — An Act providing for the protection of patients and medical personnel from health care facility retaliation, for prohibitions, for rebuttable presumptions, for discriminatory treatment, for evidence, for civil penalties and remedies, for criminal penalty, for restitution and damages, for injunctive relief, for peer review activity and for exemption.

PRINTER'S NO.    179

                   THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        HOUSE BILL
                        No. 226
                                              Session of
                                                2025

     INTRODUCED BY CIRESI, SANCHEZ, HADDOCK, GUENST, PIELLI, GIRAL,
        KINKEAD, PROKOPIAK, CEPEDA-FREYTIZ, FREEMAN, DONAHUE, HILL-
        EVANS, CERRATO AND GREEN, JANUARY 22, 2025

     REFERRED TO COMMITTEE ON JUDICIARY, JANUARY 22, 2025


                                   AN ACT
 1   Providing for the protection of patients and medical personnel
 2      from health care facility retaliation, for prohibitions, for
 3      rebuttable presumptions, for discriminatory treatment, for
 4      evidence, for civil penalties and remedies, for criminal
 5      penalty, for restitution and damages, for injunctive relief,
 6      for peer review activity and for exemption.
 7      The General Assembly of the Commonwealth of Pennsylvania
 8   hereby enacts as follows:
 9   Section 1.   Short title.
10      This act shall be known and may be cited as the Protection of
11   Patients and Medical Personnel from Health Care Facility
12   Retaliation Act.
13   Section 2.   Definitions.
14      The following words and phrases when used in this act shall
15   have the meanings given to them in this section unless the
16   context clearly indicates otherwise:
17      "County correctional institution."   As defined in 61 Pa.C.S.
18   § 102 (relating to definitions).
19      "Health care facility."   As defined in section 802.1 of the
 1   act of July 19, 1979 (P.L.130, No.48), known as the Health Care
 2   Facilities Act. The term includes the facility's administrative
 3   personnel, employees, boards and committees of the board and
 4   medical staff.
 5      "Medical personnel."        An employee, member of the medical
 6   staff or another health care worker of a health care facility.
 7      "State correctional institution."        As defined in 61 Pa.C.S. §
 8   102.
 9   Section 3.     Prohibitions.
10      (a)   Health care facilities.--A health care facility may not
11   discriminate or retaliate against a patient or medical personnel
12   because the patient or medical personnel has done either of the
13   following:
14            (1)   Presented a grievance, complaint or report to the
15      facility, to an entity or agency responsible for accrediting
16      or evaluating the facility, to the medical staff of the
17      facility or to another governmental entity.
18            (2)   Initiated, participated or cooperated in an
19      investigation or administrative proceeding related to the
20      quality of care, services or conditions at the facility that
21      is carried out by an entity or agency responsible for
22      accrediting or evaluating the facility or its medical staff
23      or governmental entity.
24      (b)   Entities.--An entity that owns or operates a health care
25   facility or another health care facility may not discriminate or
26   retaliate against a person because the person took action under
27   this act.
28   Section 4.     Rebuttable presumption relating to patients.
29      Any type of discriminatory treatment of a patient by whom, or
30   upon whose behalf, a grievance or complaint has been submitted

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 1   to a governmental entity or received by a health care facility
 2   administrator within 180 days of the filing of the grievance or
 3   complaint shall raise a rebuttable presumption that the action
 4   was taken by the health care facility in retaliation for the
 5   filing of the grievance or complaint.
 6   Section 5.   Rebuttable presumption relating to medical
 7                personnel.
 8      There shall be a rebuttable presumption that discriminatory
 9   action was taken by the health care facility, or by the entity
10   that owns or operates that health care facility, or that owns or
11   operates any other health care facility, in retaliation against
12   medical personnel if responsible staff at the facility or the
13   entity that owns or operates the facility:
14          (1)   Had knowledge of the actions.
15          (2)   Participated or cooperated with the medical
16      personnel responsible for acts described in section 3.
17          (3)   Commits a discriminatory act within 120 days of the
18      filing of the grievance or complaint by the medical
19      personnel.
20   Section 6.   Discriminatory treatment.
21      For purposes of this act, discriminatory treatment of medical
22   personnel includes discharge, demotion, suspension or any
23   unfavorable changes in, or breach of, the terms or conditions of
24   a contract, employment or privileges of the medical personnel or
25   the threat of any of the actions.
26   Section 7.   Evidence.
27      The presumptions in sections 4 and 5 shall be presumptions
28   affecting the burden of producing evidence as provided in 42
29   Pa.C.S. Ch. 61 (relating to rules of evidence).
30   Section 8.   Civil penalties and remedies.

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 1      (a)   Secretary of Health.--Upon a determination by hearing
 2   that this act was violated, the Secretary of Health may pursue
 3   one or more of the following courses of action:
 4            (1)   Issue an order requiring the person in violation to
 5      cease and desist from engaging in the violation.
 6            (2)   Suspend or revoke or refuse to issue or renew the
 7      certificate or license of the person in violation.
 8            (3)   Impose a civil penalty of not more than $25,000 for
 9      each violation.
10            (4)   Impose another appropriate remedy.
11      (b)   Other remedies.--The enforcement remedies imposed under
12   this section are in addition to other remedies or penalties that
13   may be imposed by this act or any other law.
14   Section 9.     Criminal penalty.
15      In addition to another penalty assessed under this act or any
16   other law, a person who willfully violates this section commits
17   a misdemeanor punishable by a fine of not more than $20,000.
18   Section 10.    Restitution and damages.
19      (a)   Employee.--An employee who has been discriminated
20   against in employment under this act shall be entitled to:
21            (1)   reinstatement, reimbursement for lost wages and work
22      benefits caused by the acts of the employer and the legal
23      costs associated with pursuing the case; or
24            (2)   a remedy deemed warranted by a court of competent
25      jurisdiction.
26      (b)   Health care worker.--A health care worker who has been
27   discriminated against under this act shall be entitled to:
28            (1)   reimbursement for lost income and the legal costs
29      associated with pursuing the case; or
30            (2)   a remedy deemed warranted by a court of competent

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 1      jurisdiction.
 2      (c)     Medical staff.--A member of a medical staff who has been
 3   discriminated against under this act shall be entitled to
 4   reinstatement, reimbursement for lost income resulting from a
 5   change in the terms or conditions of the privileges caused by
 6   the acts of the health care facility or the entity that owns or
 7   operates a health care facility or another health care facility
 8   that is owned or operated by that entity, and the legal costs
 9   associated with pursuing the case, or to a remedy deemed
10   warranted by a court of competent jurisdiction.
11   Section 11.    Injunctive relief relating to peer review.
12      (a)     Right to petition.--The medical staff of a health care
13   facility may petition a court for an injunction to protect a
14   peer review committee from being required to comply with
15   evidentiary demands on a pending peer review hearing from the
16   member of the medical staff who has filed an action under this
17   section, if the evidentiary demands from the complainant would
18   impede the peer review process or endanger the health and safety
19   of patients of the health care facility during the peer review
20   process.
21      (b)     In camera review.--Prior to granting an injunction, the
22   court shall conduct an in camera review of the evidence sought
23   to be discovered to determine if a peer review hearing, as
24   authorized by law, would be impeded. If it is determined that
25   the peer review hearing will be impeded, the injunction shall be
26   granted until the peer review hearing is completed.
27      (c)     Irreparable harm.--Nothing in this section shall be
28   construed to preclude the court, on motion of its own or by a
29   party, from issuing an injunction or other order under this act
30   in the interest of justice for the duration of the peer review

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 1   process to protect the person from irreparable harm.
 2   Section 12.   Peer review activity.
 3      This act may not be construed to limit the ability of the
 4   medical staff to carry out its legitimate peer review activities
 5   in accordance with 35 Pa.C.S. Ch. 81 (relating to emergency
 6   medical services system) or any other law.
 7   Section 13.   Exemption.
 8      This act does not apply to an inmate of a State correctional
 9   institution or juvenile facility owned or operated by the State
10   or local government or to an inmate housed in a local detention
11   facility, including a county correctional institution or a
12   juvenile hall, juvenile camp or other juvenile detention
13   facility.
14   Section 14.   Effective date.
15      This act shall take effect in 60 days.




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