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Last Updated July 02, 2009 CMA's Legislative Hot List provides a summary and current status of CMA-sponsored bills, as well as the progress of other significant legislation followed by CMA's Center for Government Relations. The hot list represents only a small sampling of the hundreds bills CMA is following this year. For the current status or more information on a specific bill, please contact the appropriate lobbyist identified at the end of each bill summary by e-mail or by calling CMA's Center for Government Relations at 916/444-5532. If you'd like to be notified when the latest hot list is available online, subscribe now. CMA-Sponsored
Legislation The items in red have had a status change or have an upcoming hearing. To download the PDF version of this week's Hot List, click here.
CMA-Sponsored Legislation
Status: Senate Health Committee and Senate Judiciary Committee. Staff: Teresa Kline AB 120 (Hayashi) PEER REVIEW Nearly all peer review done in California is done efficiently, timely, and in a manner that protects patients from quality of care deficiencies. However, the current peer review system can be strengthened. For example, improper or biased review can be utilized to remove physicians for non-quality of care concerns. In rare circumstances peer review can be delayed to the point that patients are placed in danger by the inability to promptly remove a physician that is providing substandard care. AB 120 improves and already robust system to make it even more effective in ensuring high quality care in CA hospitals.Status: Senate Business and Professions Committee; 07/06/09. Staff: Brett Michelin AB 497 (Block) HIGH OCCUPANCY VEHICLE LANE ACCESS FOR PHYSICIANS This bill would allow physicians to use the high occupancy vehicle (carpool) lanes on the freeway when responding to an emergency. This bill would expand current law which allows physicians, with the appropriate decal on their car, to exceed speed limits in rural areas when responding to an emergency.Status: Failed in Senate Transportation and Housing Committee, 3-4. Reconsideration granted. Staff: Alma Hernandez AB 526 (Fuentes) PUBLIC PROTECTION AND PHYSICIAN HEALTH PROGRAM ACT OF 2009 This bill will create the Patient Protection and Physician Health Program in California. The bill will allow physicians with mental health or addiction problems to seek help leading to appropriate treatment and monitoring prior to harming a patient. With the closure of the Medical Board Diversion Program there is not a sufficient program available for physicians seeking help. This is a reintroduction of AB 214 of last year.Status: Senate Business and Professions Committee; 07/06/09. Staff: Brett Michelin AB 583 (Hayashi) HEALTH CARE PRACTITIONERS: DISCLOSURE OF EDUCATION CMA is co-sponsoring this bill with the California Society of Plastic Surgeons. It is becoming increasingly difficult for the public to identify the license, education, and training of health care professionals who practice in the state and many are unable to distinguish between physicians and non-physicians. To protect the public's health and safety, this "truth in advertising" legislation will require a health care professional to disclose information in various health care settings to help patients understand who will be helping them with their health care, such as information about their license, education, and recognized board certification.Status: Senate Business & Professions Committee, 8-2. Staff: Jodi Hicks AB 1201 (M. Perez) ADEQUATE REIMBURSEMENT FOR VACCINES CMA is co-sponsoring this bill with the American Academy of Pediatrics and the California Academy of Family Physicians. The bill requires plans/insurers to adequately reimburse for both the acquisition and administrative costs of giving shots, such as purchasing the vaccine, storage, inventory, staff time, supplies, etc. This bill also prohibits plans from applying co-pays, deductibles and other cost-sharing mechanisms to immunizations.Status: Held on Assembly Appropriations Committee Suspense File. Staff: Teresa Kline SB 606 (Ducheny) STEVEN M. THOMPSON LOAN REPAYMENT PROGRAM: OSTEOPATHIC PHYSICIANS CMA will co-sponsor this bill with the Osteopathic Physicians and Surgeons of California to allow Osteopathic Physicians (DOs) to access the Steve Thompson Loan Repayment Program (STLRTP). The STLRP is currently available to MDs, but not to DOs, who tend to focus on primary care and would be good candidates for the program. This legislation would make DOs eligible for the STLRP and require them to pay an additional $25 fee toward the program, as MDs are now required to do.Status: Assembly Business & Professions Committee; 07/07/09. Staff: Alma Hernandez CMA-Opposed LegislationAB 646 (Swanson) PHYSICIANS AND SURGEONS: EMPLOYMENT This bill would authorize a health care district that is located in a rural area, or a public or nonprofit hospital or clinic located in a health care district serving medically underserved urban populations and communities, to employ physicians. Status: Failed Senate Business & Professions Committee, 5-3. Reconsideration granted, 07/08/09. Staff: Brett Michelin AB 648 (Chesbro) RURAL HOSPITALS: PHYSICIAN SERVICES This bill will allow rural general acute care hospitals to employ an unlimited number of physicians and surgeons. The bill requires an employed physician and surgeon to sign a contract to exercise independent medical judgment and to notify the Medical Board of any action or event that compromises that independent medical judgment. Status: Failed Senate Business & Professions Committee, 4-4. Reconsideration granted; 07/08/09. Staff: Brett Michelin AB 721 (Nava) PHYSICAL THERAPY DIRECT ACCESS This bill would substantially expand the scope of practice for physical therapists in California by allowing them to evaluate and treat patients without a previous diagnosis or referral from a licensed physician. Current law does not specifically address physical therapy treatment without referral, but the law does prohibit therapists from making medical diagnoses. Status: Failed Assembly Business & Professions Committee, 3-1. Reconsideration denied. Staff: Jodi Hicks AB 1126 (Hernandez) THE PUBLIC EMPLOYEES’ HEALTH CARE ACT: BILLING DISPUTES This bill would prohibit a health care provider giving emergency services and care from seeking reimbursement or attempting to obtain payment for any covered services provided to an employee or annuitant enrolled under the Public Employees' Health Care Act (PEMHCA). This bill specifically notes that the affected emergency services providers include but are not limited to hospitals and hospital-based physicians such as radiologists, pathologists, anesthesiologists, and on-call specialists. Status: Assembly Public Employees, Retirement and Social Security Committee. Staff: Jodi Hicks AB 1218 (Jones) HEALTH INSURANCE RATE REGULATION This bill would require the Department of Managed Health Care (DMHC) and Department of Insurance (DOI) to approve any increase in the amount of the premium, copayment, coinsurance obligation, deductible, and other charges under the health care service plan or health insurance policy. CMA opposed similar legislation in 2005 (SB 26) and 2006 (SB 425) because of concern that such rate regulation could lead to rate regulation of provider reimbursement. Status: Failed Assembly Health Committee, 7-6. Reconsideration granted. Staff: Alma Hernandez AB 1478 (Ammiano) WRITTEN ACKNOWLEDGEMENT: MEDICAL NUTRITION THERAPY This bill would require that a physician, prior to providing care for diabetes or heart disease, must inform the patient or the patient's legal representative of the option of “medical nutrition therapy” treatment for diabetes or heart disease, including a description of the potential risks, consequences, and benefits; and obtain written acknowledgment from the patient or the patient' s legal representative confirming that the patient received this information. The failure of a physician and surgeon to comply with this requirement would constitute unprofessional conduct. Status: Referred to Assembly Business & Professions Committee. 2-year Bill. Staff: Teresa Kline AB 1458 (Ammiano) DRUGS: ADVERSE EFFECTS REPORTING This bill would require health care professionals to report “suspected serious adverse drug events that are spontaneously discovered or observed” to MedWatch, a drug safety and adverse event reporting system operated by the federal FDA. This bill would place an unnecessary mandate on the practice of medicine. Status: Held on Assembly Appropriations Committee Suspense File. Staff: Alma Hernandez
SB 700 (Negrete McLeod) PEER REVIEW As amended April 13th, this bill will require an 805 report to be filed with the MBC prior to the 809 hearing process. The bill would circumvent the fair hearing process and not allow a physician to test the validity of charges prior to an 805 report being filed. Further it will require peer review at individual physician offices even though many are covered by medical staff membership, participation with groups of 25 or more physicians, or through contracts with insurers. The bill also calls for more 805 reports for alleged misconduct. The bill will continue to change through the legislative process as peer review is reformed. Status: Placed on Senate Inactive File. Staff: Brett Michelin SB 810 (Leno) SINGLE PAYER HEALTH CARE This bill is a reintroduction of SB 840 (Kuehl) from last session. The bill would create a single-payer system of health care in California. Specifically, SB 810 creates a single payer purchasing pool and would prohibit most private health insurance from being sold.Status: Held on Senate Appropriations Committee Suspense File. Staff: David Ford
Other Significant LegislationAB 542 (Feuer) NON-PAYMENT FOR ADVERSE EVENTS (Watch) In the face of strong CMA opposition, this bill was dramatically narrowed by the author before its first committee hearing. The bill now applies only to hospitals and merely requires the state to adopt regulations establishing uniform policies and practices governing the nonpayment to and reporting by hospitals of substantiated adverse events by public and private payers, consistent with those developed by the federal Centers for Medicare and Medicaid Services (CMS). The original problematic language creating a state Patient Safety Committee that would substantiate a broader list of adverse events and determine nonpayment policies for all providers was removed. CMA will continue to provide suggestions to further improve this bill and will stay engaged in the discussion. Status: Senate Health Committee; 2-year bill. Staff: Teresa Kline AB 613 (Beall) MEDI-CAL TAR REFORM (Support) This bill will require the Department of Health Care Services (DHCS) to improve and streamline the treatment authorization request process by, among other things, performing a cost-benefit analysis for each TAR and reducing the number of TARs required, developing alternative approaches for fraud and abuse detection, developing an alternative to the requirement that a patient obtain a TAR for each individual day of his or her stay in the hospital and consider adopting a single TAR for the entire length of a patient's hospital stay, and make publicly available the rules and criteria for determining medical necessity. Status: Sent to Assembly Appropriations Committee Suspense File. Staff: David Ford AB 832 (Jones) SURGICAL CLINIC LICENSING (Watch) Status: Held on Assembly Appropriations Committee Suspense File. Staff: Teresa Kline AB 834 (Solorio) PEER REVIEW This is a spot bill introduced at the request of the California Hospital Association. It is currently in “spot form” stating only legislative intent to reform the peer review process. Status: Referred to Assembly Business and Professions Committee. Staff: Brett Michelin AB 877 (Emmerson) SCOPE OF PRACTICE REVIEW COMMITTEE This bill would declare the intent of the Legislature to enact legislation that would authorize the Director of Consumer Affairs to appoint a committee to perform occupational analyses on various healing arts practices, including education, training, and experience, and to prepare a written report on any bill introduced in either house of the Legislature that seeks to expand the scope of a healing arts practice. The committee would be composed of seven members: two academics representing each side of the scope of practice issue, one practitioner representing each side of the scope of practice issue, and one public member. This bill is intended to respond to the frustration of legislators who are called upon to vote on scope of practice expansion measures every year without the benefit of an independent, expert review which considers the potential impacts on the public health, safety and welfare. Status: Sent to Assembly Appropriations Committee Suspense File. Staff: Jodi Hicks SB 58 (Aanestad) PEER REVIEW This bill has been amended to revise the peer review system in California. It mirrors some of the provisions included in AB 120 but adds provisions not supported by the CMA. It would demand external review for certain medical outcomes and errors that are adequately addressed in properly functioning peer review bodies. This bill is involved in ongoing negotiations regarding the peer review reforms. Status: Held on Senate Appropriations Committee Suspense File. Staff: Brett Michelin SB 196 (Corbett) HEALTH CARE COVERAGE: PROVIDER CONTRACTS AND DISCLOSURE The transparency provisions previously contained in the bill have been eliminated by amendments taken on 6/18/2009. The bill now requires a hospital to provide 180 days notice and hold public hearings prior to the elimination of emergency services. Status: Failed Assembly Health Committee, 9-5. Reconsideration granted; 07/07/09. Staff: Brett Michelin SB 294 (Negrete McLeod) NURSE PRACTITIONER SCOPE (Watch) This bill, within physician standardized protocols, would allow nurse practitioners to order durable medical equipment, certify disability and approve or modify a plan of treatment for patients receiving home health services. Status: Passed Assembly Business & Professions Committee, 10-0. Sent to Assembly Appropriations Committee. Staff: Jodi Hicks SB 726 (Ashburn) HOSPITALS: EMPLOYMENT OF PHYSICIANS AND SURGEONS (Support) This bill was substantially amended to authorize a limited pilot program to allow qualified district hospitals to employ up to two physicians with an affirmative vote of the medical staff. To qualify, the district must be in an underserved community and show that it was unsuccessful in recruiting a core physician for 12 months between July 1, 2008 and July 1, 2009. Core physicians are defined as family practice, internal medicine, general surgery, or ob/gyn. The district may apply to the MBC for an additional 3 physicians with a showing of clear need in the community following a public hearing and the concurrence of the medical staff. Status: Sent to Assembly Business & Professions Committee; 07/07/09, and Assembly Health Committee. Staff: Brett Michelin
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