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, send us an e-mail.
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
AB 214 (Fuentes) - Physician Health Program
This bill will institute the Public Protection and Physician Health Program Act of 2008. The program will be organized under the Department of Public Health and run by a not for profit entity with a board of directors with representation from the CMA, CSAM, CPA, and CHA. The program will allow licensed physicians to voluntarily enter a confidential drug, alcohol, and mental illness monitoring and testing program which allows the participant to continue to practice as long as they remain in compliance with program protocols and are not a threat to patients. The program will have an affirmative duty to report a participant who does not remain within program requirements and becomes a threat to patient safety. This bill is intended to fill the void left when the MBC eliminated the Physician Diversion Program.
AB 1155 (Huffman) - DMHC Enforcement
This bill would require that enforcement actions by the Department of Managed Health Care (DMHC) make physicians whole. Where the DMHC has found that an HMO has underpaid a physician (pursuant to the law created by AB 1455), the bill would require the penalty amount to, at a minimum, equal the amount of the underpayment plus interest. The enforcement action would also have to ensure that the physician is compensated by the HMO for the full amount of the underpayment plus interest.
AB 1945 (De La Torre) - Health Care Coverage
This bill would require a health service plan or health insurer to seek and obtain final approval of its regulator prior to rescinding, canceling, or limiting a plan contract or policy, as applicable. The bill would also authorize each regulator, as applicable, to suspend or revoke the license or certificate of a plan or insurer in violation of this prohibition or to assess administrative penalties.
AB 1962 (De La Torre) - Maternity Coverage
This bill will ensure fair, affordable access to maternity coverage in health care benefits, regardless of the type of plan offered. This bill will close a loophole exploited by health insurance companies in order to sell cheap, “subprime” non-comprehensive coverage. This bill brings two bodies of law into conformity by requiring all individual and group health insurance policies regulated under the Department of Insurance to cover maternity services, while HMOs regulated by the Department of Managed Health Care (DMHC) are already required to meet these standards.
AB 2440 (Laird) - MediCal Procedure Coding
This bill would require the department of Health Care Services (DHCS) to update specific diagnostic codes within 60 days of their publication. It would also require DHCS to publish the updated codes in the Medi-Cal provider bulletin within the same period of time. If DHCS fails to publish the new codes within the 60 day period, providers will be allowed to use the current year codes or use a miscellaneous billing code.
AB 2805 (Ma) - Assignment of Benefits
This bill would add individual health care service plans to Knox-Keene requirements to permit assignment of benefits allowing the physician to be paid directly by a health plan. Under current practice some health plans are providing service reimbursement directly to the patient and requiring the physician to bill the patient even when the patient specifies that they would like the provider to be paid directly.
AB 2839 (Huffman) - Confidentiality Clauses
This bill would prohibit a health care service plan health insurer from requiring a health care provider to execute an unfair and unreasonable agreement as a condition of entering into contract negotiations with the plan or insurer. This bill would authorize the Department of Managed Health Care (DMHC) or the Insurance Commissioner to suspend or revoke the license of a health care service plan or the certificate of authority of a health insurer or assess administrative penalities if the director or commissioner determines that the plan or insurer has violated those provisions.
AB 2847 (Krekorian) - Health Care Service Plans: Liability
This bill shifts the burden of proof to health insurance companies that deny medical treatment, requiring them to show why a particular medical service is not medically necessary. This legislation will seek to protect consumers and the doctor-patient relationship by creating a presumption that a physician’s diagnosis and treatment is medically necessary. This bill will also amend the independent medical review law in order to authorize physicians to appeal denials of health care treatment by insurance companies.
SB 527 (Steinberg) - Autism Spectrum Disorders: Screening Pilot
This bill will establish a privately funded, voluntary pilot program that would establish best practices to improve early screening, diagnosis, referral, and treatment for children with an autism spectrum disorder (ASD). AAP California is a co-sponsor of this measure. This bill is part of a package of bills carried by the legislative leadership to address gaps in services for families of children with ASD.
SB 1379 (Ducheny) - Steven M. Thompson Loan Repayment Program
This bill would use certain fines and penalties paid by health plans to the Department of Managed Health Care to fund the Steven M. Thompson Loan Repayment Program. The Program provides up to $105,000 in loan repayment to new physicians who agree to serve in an underserved area for at least three years.
AB 374 (Berg) California Compassionate Choices Act
This bill will allow physicians in California to prescribe lethal doses of pharmaceutical drugs to people who have been diagnosed with a terminal illness and are in intractable pain. The bill is modeled after the Oregon law allowing physicians and surgeons to help a person end their life.
AB 425 (Adams) Vehicles: Motorcycles: Safety Helmets: Exceptions This bill would exempt from the motorcycle helmet law a driver who is 18 years of age or older who has either completed a motorcycle rider training program, or has been issued a class M1 license or endorsement or a comparable license or endorsement from another jurisdiction.
Status: Failed to get out of Assembly Transportation Committee.
AB 636 (Levine) - Acupunture This bill would add the use of "low-level laser stimulation" to the modalities that may be performed under an acupuncturist's license. This therapy would be performed with a biostimulation laser device designated as a class IIIb laser by the Federal Food and Drug Administration.
AB 1276 (Karnette) - Prescription Labels
This bill will make it unprofessional conduct for each instance that a physician and surgeon writes a prescription without specifically asking the patient if they would like the intended purpose of the drug to be written on the prescription label.
AB 1436 (Hernandez) - Nurse Practitioners
This bill significantly expands the scope of practice of a nurse practitioner. The bill attempts to recognize nurses as independent practitioners and would authorize them to provide comprehensive healthcare including making diagnoses and initiating emergency procedures. Though this proposal constitutes the practice of medicine for NP’s, AB 1436 gives the board of Registered Nursing the sole authority to interpret the practice of nurse practitioners and divests the Medical Board from the authority of any oversight.
Status: Held in Senate Business and Professions Committee.
AB 1444 (Emmerson) - Physical Therapists This bill is currently a "spot" bill relating to the scope of practice of physical therapists and is sponsored by the California Physical Therapy Association (CPTA).
AB 1944 (Swanson) - Healing Arts
This bill eliminates the corporate bar on the practice of medicine by allowing health care districts to hire and charge for physician services. The bill deletes a pilot project that contained a limited exemption to the bar by allowing healthcare districts in medically underserved areas with financial problems to hire physicians.
AB 2146 (Feuer) - Health Care Providers: Billing
This bill requires the state to develop and implement policies on non-payment of health care providers in the Healthy Families and Medi-Cal programs for hospital-acquired conditions and adverse events. AB 2146 gives broad policy-making authority to the Department of Health Care Services and the Managed Risk Medical Insurance Board with minimal legislative oversight, allowing these entities to establish non-payment policies governing non-payment for hospital-acquired conditions using rules from the Centers for Medicare and Medicaid Services (CMS) as a guideline. AB 2146 does not establish an independent, fair process to determine who was responsible for the error that led to the hospital-acquired condition nor does it include a risk-adjustment mechanism. This bill will conflict with new federal rules, which apply only to hospitals, and allows the state to go beyond the CMS regulations, without the same detailed financial, clinical and scientific considerations.
Status: Held on Senate Appropriations Suspense File.
AB 2516 (Mendoza) - Prescriptions: Electronic Transmissions
This bill requires all prescriptions (except in emergencies, direct administration in a hospital, or as prohibited by federal law) to be electronically transmitted to the patients pharmacy of choice by January 1, 2010.
Status: Held in Assembly Business and Professions Committee.
SB 389 (Yee) - Billing for Services Rendered
This bill would prohibit out-of-network hospital-based physicians working at hospitals that have contracts with HMOs from billing enrollees of HMOs and, effectively, allow HMOs to unilaterally set rates for out-of-network emergency care. This bill would also require the Department of Managed Health Care and the Department of Insurance to implement an independent provider dispute resolution system, in consultation with representatives of health plans or insurers, providers and consumer representatives.
SB 840 (Kuehl) - Single Payer Health Coverage This bill is a reintroduction of Senator Kuehl’s legislation to create a single-payer system of health care in California. Specifically, SB 840 creates a single payer purchasing pool and would prohibit most private health insurance from being sold. The new system would be funded by employer fees, individual contributions, and consolidating state and federal funding. An individual could select a primary care provider or enroll in an HMO. The new office of the Health Care Commissioner (HCC) would determine premium costs, provider rates, and program costs, drug pricing and financing mechanism. All Californians residents would be eligible.
SB 981 (Perata) - Health Care Coverage
This bill prohibits non-contracted emergency room physicians from seeking the balance of payment due from health plan enrollees, a term known as “balance billing”. The bill provides an interim payment mechanism of 250% of Medicare rates. Because Medicare rates are subject to annual budget constraints, such rates could prove to be unstable. The bill also requires the Department of Managed Health Care (DMHC) to establish an Independent Dispute Resolution Program to be administered by an organization chosen by DMHC. It also establishes DMHC’s jurisdiction on non-contracting emergency physicians (E.G., imposition of civil penalties on non-contracting emergency physicians for violating the law). Though SB 981 is specific to emergency room physicians, it has the potential for setting up the framework for future legislation that could be harmful for other providers treating patients in an emergency setting.
SB 993 (Calderon) - Psychologists: Prescribing Drugs This bill would allow psychologists, after training and receiving certification adopted by the Board of Psychology, to prescribe psychotropic drugs. This bill would give the Board of Psychology the ability to administer a licensing program for prescribing psychologists.
SB 1014 (Kuehl) - Single Payer Health Care Coverage Tax This bill would impose various new taxes to fund SB 840 (Kuehl). The bill would impose a new tax on taxable income above $200,000, non-wage income, self-employment income, and payroll.
Status: Held in Senate Revenue and Tax Committee .
SB 1179 (Aanestad) - Immunizations
This bill deletes the authority of the Department of Public Health to add or remove from the list of vaccines that are required for school entry. Currently, the department can “deem appropriate” any vaccination recommended by the American Academy of Pediatrics and the Advisory Committee on Immunization Practices, although they have never used this authority. The author believes that some vaccine decisions have a social and moral component and therefore every new mandatory vaccine should obtain legislative approval.
SB 1300 (Corbett) - Health Care Coverage: Provider Contracts
This bill was amended to allow health care service plans and insurers to divulge cost and quality information as they deem appropriate. The bill prohibits confidentiality clauses from being inserted into contracts between health care providers and payers.
SB 1427 (Calderon) - Psychologists: Scope of Practice
This bill would allow for psychologists to prescribe drugs for the treatment of specified disorders of certain requirements are met. This bill allows the certification and licensure process for a prescribing psychologists and all oversight to be under the Board of Psychology. The bill does require collaboration with a licensed physician and surgeon, but the language allows for many of the requirements to be waived in emergent situations or demonstration of facilities with a shortage of available psychiatrists.
SB 1640 (Ashburn) - Medical Corporations
This bill eliminates the corporate bar on the practice of medicine by affirmatively stating that corporations may have the professional rights, privileges, and powers. The provision of law which this bill seeks to upend is often cited as the primary code which prevents the corporate practice of law.
Status: Failed in Senate Business and Professions Committee.
SB 1669 (McClintock) - Health Care Coverage: Waivered Conditions
This bill would authorize a plan contract or insurance policy to include a provision that excludes coverage for any length of time for a “waivered condition” for which medical advice, diagnosis, care, or treatment was recommended or received from a licensed health practitioner during the ten years immediately preceding the coverage. The bill appears to allow health plans to exclude coverage from someone with an existing condition that dates back ten years for “any length of time,” rather than the current 12 month period.
AB 8 (Nunez) - Health Care Coverage
This bill would make a number of substantial changes to the health care system. The bill would expand the state’s Medi-Cal and Healthy Families Programs to children and their parents up to 300% of the federal poverty level, and to certain uninsured adults. The plan would create a health insurance purchasing pool and implement insurance market reforms. The plan would be financed by redirecting existing resources and requiring an employer and employee contribution.
AB 1900 (Nava) - Santa Barbara Trauma Center
This bill will allow Santa Barbra County to continue to collect $5 per every $10 in fines and penalties generated within the county on DUI related offenses for the local Maddy Fund. This bill is necessary to maintain a portion of funding for a local trauma center from a special exception that was created for Santa Barbra County due to the Board of Supervisors electing to fund courthouse renovation instead of emergency care.
SB 761 (Ridley-Thomas) - Medical Board of California
This bill would form a Clinical Advisory Council for the diversion program maintained by the Medical Board of California (MBC). The council will ensure the diversion program maintains a high level of quality care for impaired physicians. The bill also continues the pilot program on vertical integration between medical board investigators and Deputy Attorney Generals. Early results have shown a decrease in the length of investigations by the MBC.
Status: Held on the Assembly Appropriations Suspense File.
SB 1294 (Ducheny) - Healing Arts
This bill continues a pilot project that allows qualified district hospitals to directly hire and charge for physician services. There are significant protections contained within the bill. A qualified district hospital must serve a medically underserved population, medically underserved area, or a health professions shortage area as defined by the Federal Government, or be a rural hospital as defined by California law. The facility must have a net loss from operations, is limited to no more than 2 participants at any one facility and no more than 20 statewide, and the medical staff must approve with an affirmative vote that the employment is in the best interest of the community. Continuation of the pilot program is in lieu of an outright elimination of the bar against the corporate practice of medicine at health care district hospitals.
Status: Failed in Assembly Appropriations Committee.
