BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1070
                                                                  Page  1

          Date of Hearing:   April 28, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
                     AB 1070 (Hill) - As Amended:  April 22, 2009
           
          SUBJECT  :   Healing arts.

           SUMMARY  :   Makes revisions to the 801.1 reporting process of  
          settlement, judgment or arbitration awards related to the  
          practice of medicine. .  Specifically,  this bill :  

          1)Consolidates reporting requirements to specify that the  
            entity, person, or licensee required to report send a copy of  
            the report to the claimant or to his or her counsel if the  
            claimant is represented by counsel. 

          2)Increases the minimum fine for failure to comply with the  
            reporting requirements from $50 to $500 and the maximum from  
            $500 to $5,000.   

          3)Deletes the fines related to a knowing and intentional failure  
            to comply with the reporting requirements, or conspiracy or  
            collusion not to comply, or hindering or impeding another's  
            compliance with the reporting requirements.    

          4)Requires a report to include:

             a)   The date of the alleged occurrence and the licensee's  
               role in the care or professional services provided to the  
               patient with respect to those services at issue in the  
               claim or action; and,

             b)   A copy of the judgment.

          5)Requires any entity making a report to, within 15 days after  
            filing the report, notify the licensee that the report was  
            filed with the appropriate licensing board.

          6)Prohibits any entity that provides early intervention, patient  
            safety, or risk management programs to patients, or contracts  
            for those programs for patients, from including, as part of  
            any of those programs or contracts, any of the following:

             a)   A provision that prohibits a patient or patients from  








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               contacting or cooperating with the board;

             b)   A provision that prohibits a patient or patients from  
               filing a complaint with the board; or,

             c)   A provision that requires a patient or patients to  
               withdraw a complaint that has been filed with the board.

          7)Permits the president of the Medical Board of California (MBC)  
            to be a member of any panels necessary to carry out the work  
            of the MBC if there is a vacancy in the membership of the MBC.

          8)Requires all medical records requested by the MBC to be  
            certified.

          9)Places a cap of $10,000 on the penalty that can be assessed on  
            a physician for not complying with the MBC's request for  
            certified medical records.

          10)Permits an administrative law judge to recommend the issuance  
            of a public reprimand that includes additional education and  
            training in a proposed decision.  

          11)Specifies that licensees must report to the MBC, both at the  
            time of renewal and upon initial licensure:

             a)   information regarding any specialty board certifications  
               he or she holds that is issued by a member of the Board of  
               American Specialties or approved by the MBC;

             b)   his or her practice status; and, if desired, 

             c)   his or her cultural background and foreign language  
               proficiency.

          12)Defines the following terms:  

             a)   "certified medical records" means a copy of the  
               patient's medical records authenticated by the licensee or  
               health care facility, as appropriate, on a form prescribed  
               by the board;

             b)    "licensee" means a licensee of the MBC, the Osteopathic  
               Medical Board of California, or the California Board of  
               Podiatric Medicine.








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             c)   "state governmental agency" includes the University of  
               California for purposes of reporting medical settlements.

          13)Declares Legislative intent.

           EXISTING LAW  :

          1)Provides for the licensure and regulation of osteopathic  
            physicians and surgeons by the Osteopathic Medical Board of  
            California, physicians and surgeons by the Medical Board of  
            California, and podiatrists by the California Board of  
            Podiatric Medicine. 

          2)Requires those licensees, insurers providing professional  
            liability insurance to those licensees, and governmental  
            agencies that self-insure those licensees to report specified  
            settlements, arbitration awards, or civil judgments to the  
            licensee's board if based on the licensee's alleged  
            negligence, error, or omission in practice or his or her  
            rendering of unauthorized professional services.

          3)Requires licensees and insurers required to make these reports  
            to send a copy of the report to the claimant or his or her  
            counsel and requires a claimant or his or her counsel who does  
            not receive a copy of the report within a specified time  
            period to make the report to the appropriate board. 

          4)Makes a failure of a licensee, claimant, or counsel to comply  
            with these requirements a public offense punishable by a  
            specified fine.

          5)Existing law prescribes the disciplinary action that may be  
            taken against a physician and surgeon or podiatrist. Among  
            other things, existing law authorizes the licensee to be  
            publicly reprimanded.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           Purpose of this bill  .  According to the author's office, "In  
          certain settings when a person sustains injury resulting from  
          services rendered by professional staff, the hospital or an  
          insurance group may choose to offer the patient an amount of  








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          money to cover the costs of the future treatment in order to  
          eliminate the need for a malpractice claim.  When such action is  
          taken, the matter is not reported to the MBC because it does not  
          fit into the criteria set forth in Business and Professions Code  
          section 801.01, as a civil case has not been filed.  However,  
          this does not negate the need for the MBC to investigate the  
          matter, if the injury allegedly occurred due to the actions of a  
          physician and surgeon.

          "The intent of the reporting malpractice settlements, judgments,  
          or arbitration awards to the MBC is to ensure consumer  
          protection by reviewing the care and treatment for the physician  
          and surgeon involved in the care provided to the patient.  ? The  
          MBC ?.does with to be notified of physicians and surgeons whose  
          care may fall below the standard."     

           Background  .  The sponsors, the MBC, made changes to the 801.01  
          reporting requirements because they believe there are some  
          entities that are not reporting appropriately.  These changes to  
          current law attempt to share reporting responsibility from the  
          physician and surgeon to other parties in the process and put a  
          priority on consumer protection.  The MBC offers the following  
          explanation for the other amendments:        

             l    Currently, the Board President is not permitted to sit  
               on a panel.  When the Board does not have enough members to  
               fill both panels, usually due to term expirations, it is  
               often the case that Board members must serve on two  
               disciplinary panels at the same time in order to have a  
               quorum with which to take action.  Allowing the Board  
               President to sit on a panel would expedite the process of  
               decision making and reduce the workload for the members who  
               are sitting on more than one panel.

             l    When the Board requests medical records upon initial  
               complaint, certified records are requested but not always  
               provided.  The initial review can be performed without  
               certified records, however, if the complaint goes to  
               investigation, the Board will need certified medical  
               records.  Currently, the Board often has to request medical  
               records more than once, which prolongs the process of  
               investigation.  Requiring the requested medical records to  
               be certified would expedite the process of review and  
               investigation of complaints.  The board has a form that can  
               be filled out to certify the records and the provider of  








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               the records can ask the board to send its copy service thus  
               reducing the cost to the physician or entity. 

             l    Puts a cap of ten thousand dollars ($10,000) on the  
               penalty that can be assessed a physician for not complying  
               with the Board's request for medical records.  Currently  
               the penalty is one thousand dollars ($1,000) a day for not  
               complying with the request for medical records.  This cap  
               is the same as what is in current law for hospitals.

             l    Allows an administrative law judge to recommend the  
               issuance of a public reprimand that includes additional  
               education and training in a proposed decision.  Currently,  
               when the Medical Board feels the appropriate level of  
               discipline for a physician is a public letter of reprimand  
               with required training or education, prior to the filing of  
               an Accusation, the Medical Board may issue the physician a  
               public letter of reprimand that includes the additional  
               education or training requirements.  However, if the  
               Medical Board has filed an accusation against a physician  
               and the accusation is heard by an administrative law judge,  
               the law does not allow the administrative law judge to  
               recommend a public reprimand to be issued to the physician  
               with a training or education requirement.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Medical Board of California (sponsor)

          Opposition 
           
          California Medical Association 
           
          Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301