BILL ANALYSIS                                                                                                                                                                                                    







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        |Hearing Date:June 29, 2009         |Bill No:AB                         |
        |                                   |1070                               |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS  
                                          AND    
                                  ECONOMIC DEVELOPMENT
                         Senator Gloria Negrete McLeod, Chair

                          Bill No:        AB 1070Author:Hill
                         As Amended:June 23, 2009 Fiscal: Yes

        
        SUBJECT:   Healing Arts 
        
        SUMMARY:  Makes changes to the reporting by licensees of the Medical  
        Board of California (MBC), the Osteopathic Medical Board of California  
        (OMBC), or the California Board of Podiatric Medicine (CBPM) of  
        settlements over $30,000 or any arbitration or civil judgment of any  
        amount; requires a state or governmental agency that self-insures  
        licensees, to perform specific actions with respect to each licensee  
        who will be identified in a report; requires that medical records of  
        patients requested by MBC to be produced be certified; extends the  
        sunset date of the vertical enforcement and prosecution model and the  
        Health Quality Enforcement Section (HQES) within the Department of  
        Justice (DAG) to July 1, 2012.

        Existing law, the Business and Professions Code:

        1)Establishes MBC to license, regulate and discipline physicians and  
          surgeons in California and  states that the protection of the public  
          is the highest priority of MBC in exercising its functions.

        2)Requires a complete  report  to be sent to MBC, OMBC or CBPM with  
          respect to its licensees on the following: a settlement offer over  
          $30,000 or arbitration award of any amount or a civil judgment of  
          any amount, as specified; a settlement over $30,000 if based on the  
          licensee's negligence, error, or omission in practice, or by the  
          licensee's rendering of authorized professional services, as  
          specified.  

        3)Requires the report specified in item #2) above to come from the  
          insurer providing professional liability insurance to the licensee,  





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          the licensee or his or her counsel, if the licensee does not possess  
          professional liability insurers, and state or local government  
          agency that  self-insures  the licensee. 

        4)Requires the report to be sent to MBC, OMBC, and CBPM within 30 days  
          after the written settlement agreement has been reduced to writing  
          and signed by all parties, within 30 days after service of the  
          arbitration award on the parties, or within 30 days after the date  
          of entry of the civil judgment. 

        5)Requires MBC, OMBC, and CBPM to develop a prescribed form for the  
          report, and specifies the information that must be included in the  
          form, including the name and address of the claimant or plaintiff  
          involved in the matter, the name and address of every licensee, the  
          name and address of the insurer providing professional liability  
          insurance to any person, and a summary of the facts of each claim,  
          charge or allegation.

        6)States that failure of the licensee or claimant, or counsel  
          representing the licensee or claimant to report is a public offense  
          punishable by a fine of not less than $50 and not more than $500.   
          Indicates that a knowing and intentional failure to comply, as  
          specified, is a public offense punishable by a fine of not less than  
          $5,000 and not more than $50,000.

        7)Allows MBC to appoint panels for its members, and specifies the  
          number of public members assigned to panels.  

        8)States that a licensee who fails or refuses to comply with a request  
          for the medical records of a patient, that is accompanied by a  
          patient's written authorization for release of records to the board,  
          within 15 days of receiving the request and authorization, and may  
          be assessed a civil penalty of $1,000 for each day that the  
          documents have not been produced, unless there is good cause.

        9)Provides that a licensee whose matter has been heard by an  
          administrative law judge, as specified, or whose default has been  
          entered, and who is found guilty, or who has entered into a  
          stipulation for disciplinary action with MBC, may have his or her  
          license revoked upon order of MBC, have his or her right to practice  
          suspended for a period not to exceed one year upon order of the  
          division, be placed on probation and be required to pay the costs of  
          probation monitoring upon order of the division, be publicly  
          reprimanded by MBC, or have any other action taken in relation to  
          discipline as part of an order of probation, as MBC or the  
          administrative law judge may deem proper.  





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        10)Requires a licensed physician to report to MBC at the time of  
          license renewal any specialty board certification, practice status,  
          and informational on cultural background and foreign language  
          proficiency. 

        Existing law, the Government Code:

        1)Establishes in the DOJ the HQES to investigate and prosecute  
          proceedings against licensees and applicants within the jurisdiction  
          of MBC, CBPM, the Board of Psychology, or any committee under the  
          jurisdiction of MBC or a division of MBC.  

        2)Requires the Attorney General (AG) to ensure that HQES is properly  
          staffed with a sufficient number of experienced and able employees  
          who are capable of handling the most complex and varied types of  
          disciplinary actions against licensees.  

        3)States that funding for the HQES is budgeted from the special funds  
          of MBC.

        4)Sunsets the above provisions on January 1, 2010 and will be repealed  
          on or before January 1, 2011, if no statute extends the sunset date.

        5)Requires that all complaints or relevant information concerning  
          licensees that are within the jurisdiction of MBC be made available  
          to the HQES.  Requires the AG to assist the board, division or  
          committees in designing and providing initial and in-service  
          training programs for staff of the division, boards, or committees,  
          including, but not limited to, information collection and  
          investigation.

        6)Requires the Senior Assistant AG to assign attorneys to assist MBC  
          in intake and investigations and to direct discipline-related  
          prosecutions.  Requires attorneys to work closely with each major  
          intake and investigatory unit of the boards, to assist in developing  
          uniform standards and procedures for the handling of complaints and  
          investigations.

        7)Finds and declares that MBC, by ensuring the quality and safety of  
          medical care, performs one of the most critical functions of state  
          government.  Because of the critical importance of the board's  
          public health and safety function, the complexity of cases involving  
          alleged misconduct by physicians and surgeons, and the evidentiary  
          burden in the board's disciplinary cases, the Legislature finds and  
          declares that using a vertical enforcement and prosecution model for  





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          those investigations is in the best interests of the people of  
          California.

        8)States that as of January 1, 2006, each complaint that is referred  
          to a district office of the board for investigation shall be  
          simultaneously and jointly assigned to an investigator and to the  
          deputy AG in the HQES responsible for prosecuting the case if the  
          investigation results in the filing of an accusation.  States that  
          the joint assignment of the investigator and the deputy AG exist for  
          the duration of the disciplinary matter.  States that during the  
          assignment, the investigator assigned shall, under the direction but  
          not the supervision of the deputy attorney general, be responsible  
          for obtaining the evidence required to permit the Attorney General,  
          to advise the board on legal matters such as whether the board  
          should file a formal accusation, dismiss the complaint for a lack of  
          evidence required to meet the applicable burden of proof or take  
          other appropriate legal action.

        9)Requires MBC by July 1, 2009, in consultation with the Department of  
          Justice, the Department of Consumer Affairs, the Department of  
          Finance, and the Department of Personnel Administration to report  
          and make recommendations to the Governor and the Legislature on the  
          vertical enforcement and prosecution model.

        This bill, within the Business and Professions Code:

        1)Finds and declares that existing law provisions requiring the  
          reporting of settlements over $30,000, arbitration or civil judgment  
          of any amount, with MBC, OMBC or CBPM is essential to the protection  
          of the public.  States further that it is the intent of the  
          Legislature that the reporting requirements be interpreted broadly  
          in order to expand reporting obligations.

        2)States that the definition of a state governmental agency that  
          self-insures is required to make a report includes, but is not  
          limited to, the University of California.  

        3)Deletes the existing law requirement that an insurer that is  
          required to send a report to notify the claimant or the claimant's  
          counsel that the insurer has sent a report to the applicable state  
          agency, as specified.

        4)States that a copy of a judgment must be included in the information  
          that is reported to MBC, OMBC, and CBPM.  Makes other clarifying  
          changes to the information that must be reported.






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        5)Revises the penalty for failure to comply with the reporting  
          requirements by deleting references to knowing and intentional  
          failure to comply, and instead provides that failure to


        comply is a public offense punishable by a fine of not less than $500  
          and not more than $5,000.

        6)Requires a state or local governmental agency that self-insures  
          licensee, prior to sending a report, to do all of the following with  
          respect to each licensee who will be identified in the report:

           6)   Provide written notice to the licensee that the agency intends  
             to submit a report in which the licensee will be identified.   
             Requires the notice to describe the specific reasons for  
             identifying the licensee and the specific reasons for the amount  
             of the settlement the agency apportioned to the licensee.   
             Requires the agency to include with this notice a copy of all  
             records used by the agency in deciding the licensee in the  
             report.

           6)   Advise the licensee that he or she may, within 10 days of  
             receiving the notice specified above, provide written response to  
             the agency and written materials in support of the licensee's  
             position.  Requires the agency to include this response and  
             materials in the report submitted to MBC.

           6)   Provide the licensee, after giving at least five days prior to  
             written notice, with the opportunity to present his or her  
             arguments to the body that will make the final decision on behalf  
             of the agency regarding identification of the licensee in the  
             report.

        7)States that the provisions relating to self-insurers must not be  
          construed to modify either the content of the report or the  
          timeframe for filing the report.

        8)States that the Legislature recognizes that various types of  
          entities are creating, implementing, and maintaining patient safety  
          and risk management programs that encourage early intervention in  
          order to address known complications and other unanticipated events  
          requiring medical care.  Provides further that the Legislature  
          recognizes that some entities even provide financial assistance to  
          individual patients to help them address these unforeseen health  
          care concerns.  States that it is the intent of the Legislature that  
          financial assistance does not limit a patient's interaction with or  





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          his or her rights before MBC.

        9)Indicates that any entities that provides early intervention,  
          patient safety, or risk management programs to patients, or  
          contracts for those programs for patients, shall not include, as  
          part of any of those programs or contracts, any of the following:

           9)   A provision that prohibits a patient or patients from  
             contacting or cooperating with MBC. 

           9)   A provision that prohibits a patient or patients from filing a  
             complaint with MBC.

           9)   A provision that requires a patient or patients to withdraw a  
             complaint that has been filed with MBC.

        10)States that any reference to an investigation by MBC shall be  
          deemed to refer to a joint investigation by the employees of the DOJ  
          and MBC under the vertical enforcement prosecution model. 

        11)Clarifies that the president of MBC is not a member of any panel  
          unless there is a vacancy in the membership of MBC.

        12)Requires that medical records of patients requested by MBC to be  
          produced by licensees or health care facilities be certified, as  
          specified.  Defines certified medical records as a copy of the  
          patient's medical records authenticated by the licensee or health  
          care facility, as appropriate, on a form prescribed by MBC.  Caps  
          the civil penalty that MBC can assess on licensees for failure to  
          produce requested documents or for failure to comply with a court  
          order for the production of documents at $10,000.

        13)States that a public reprimand may include a requirement that a  
          licensee completes relevant educational courses approved by MBC.

        14)Requires a licensed physician and surgeon to report to MBC  
          immediately upon issuance of an initial license any specialty board  
          certification practice status, and cultural background, as  
          specified.

        This bill, within the Government Code:

        1)Extends the sunset date of the HQES within DOJ which has the primary  
          responsibility of investigating and prosecuting proceedings against  
          licensees and applicants within the jurisdiction of MBC, CBPM, the  
          Board of Psychology and any committee under the jurisdiction of MBC  





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          to July 1, 2012.

        2)Requires MBC to establish and implement a plan to assist in team  
          building between its enforcement staff and the staff of the HQES to  
          ensure a common and consistent knowledge base.

        3)Extends the sunset date of the vertical enforcement and prosecution  
          model to July 1, 2012.  Requires MBC, in consultation with DOJ and  
          the Department of Consumer Affairs to report and make  
          recommendations to the Governor and the Legislature on the vertical  
          enforcement and prosecution model by March 1, 2011.  

        4)Makes other technical, nonsubstantive changes.

        
        FISCAL EFFECT:  According to the Assembly Appropriations Committee,  
        absorbable workload to MBC to continue oversight of settlements,  
        awards, and judgments, and to comply with the reporting requirements  
        pursuant to this bill.

        
        COMMENTS:
        
        1.Purpose.  According to the  Medical Board of California  , the Sponsor  
          of this measure, the provisions contained in this bill seek to  
          ensure that MBC continues to protect the health care of consumers.   
          Specifically, MBC points out that current law leaves room for  
          interpretation of laws governing reporting requirements for MBC.   
          MBC argues that it cannot effectively protect consumers if reporting  
          is not consistent and enforced.  Furthermore, in certain settings  
          when a person sustains injury resulting from services rendered by  
          professional staff, a hospital, or an insurance group, they may  
          choose to offer a patient an amount of money to cover the cost of  
          future treatments in order to eliminate the need for a malpractice  
          claim.  When such action is taken, the matter is not reported to MBC  
          because it does not fit into the reporting requirements as a civil  
          case that has not been filed.  MBC argues that this does not negate  
          the need for 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 MBC is to ensure consumer protection by reviewing the care  
          and treatment of the physician and surgeon involved in the care  
          provided to the patient.  In addition, this bill would allow an  
          administrative judge to recommend that a licensee be issued a public  
          reprimand that includes additional requirements for education and  
          training.  MBC points out that this would prevent the Board from  





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          having to go through the process of modifying a recommendation made  
          by an administrative judge.  In addition, MBC points out that when  
          it requests medical records upon initial patient compliant,  
          certified records are requested but not always provided.  The  
          initial review can be performed without certified records; however,  
          if the complaint goes into investigation, MBC will need certified  
          medical records.  Under the current system where MBC has to request  
          records more than once, investigations are prolonged.

        2.Background.  

           2)   Reporting Requirements.  Existing law provides that licensees,  
             insurers providing professional liability insurance to licensees,  
             and governmental agencies that self-insures licensees to report  
             settlements over $30,000 , arbitration awards or civil judgments  
             in any amount to MBC in a form prescribed by the Board.  The  
             report must be submitted within 30 days after the written  
             settlement agreement has been reduced in writing or within 30  
             days after service of the arbitration award or the entry of the  
             civil judgment.  The report must also include specified  
             information including name and address of the licensee and the  
             insurer providing professional liability insurance, a brief  
             description or summary of the facts of each claim, charge, or  
             allegation, the amount of the judgment.  This bill clarifies the  
             definition of state governmental entity that self-insures and is  
             required to make a report to include the University of  
             California.  In addition, there are certain requirements that  
             governmental agencies that self-insures must fulfill prior to  
             sending a report to MBC, including providing written notice to  
             the licensee that the governmental agency intends to submit a  
             report to MBC in which the licensee will be identified.   
             According to MBC, these provisions put the responsibility for any  
             failure to comply with the reporting requirements on all parties,  
             not just the physicians.

           2)   Production of Patient Medical Records.  A licensee who fails  
             or refuses to comply with a request for medical records of a  
             patient, that is accompanied by a patient's written authorization  
             for release of records to MBC, within 15 days of receiving the  
             request and authorization, must pay MBC a civil penalty of $1,000  
             for each day that the documents have not been produced after the  
             15th day, unless there is good cause for the failure.  A health  
             care facility who fails to produce patient medical records within  
             30 days of receipt of the request could be levied a civil penalty  
             of up to $1,000 per day that documents have not been produced  
             after the 30th day, up to $10,000.  If a request to produce  





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             records is made pursuant to a court order, issued in the  
             enforcement of a subpoena, the offense is a misdemeanor and the  
             same monetary penalties apply.  This bill requires that the  
             medical records produced be certified and defines certified  
             medical records.

           2)   Vertical Enforcement and Prosecution Model.   SB 1950  , Chapter  
             1085, Statutes of 2002, among other provisions, required the  
             appointment of an independent enforcement monitor to evaluate  
             MBC's enforcement system and establish a priority system for the  
             investigation of complaints against physicians.  The Monitor's  
             report, released on 2004, entitled Initial Report of the Medical  
             Board Enforcement Program, made numerous findings and 65 specific  
             recommendations for reform.  One of the Monitor's recommendations  
             was the utilization of a vertical prosecution model for  
             physicians' disciplinary cases.  Vertical prosecution allows  
             lawyers and investigators to view each case as a whole, rather  
             than as two, separate and independent sequential steps: the  
             investigation and then the prosecution.  According to the  
             Monitor, the vertical prosecution model would improve efficiency  
             and reduce case cycle time, ensuring the quality and safety of  
             medical care to Californians.  

            SB 231  (Figueroa), Chapter 674, Statutes of 2005 codified many of  
             the Monitor's recommendations, including the use of the vertical  
             prosecution model effective January 1, 2006.  SB 231 also  
             required MBC to report and make recommendations to the Governor  
             and the Legislature on the vertical prosecution model by July 1,  
             2007.  This report indicated that there was an overall decrease  
             of 10 days in the average time to complete an investigation,  
             excluding all cases pending prior to the implementation of the  
             model.  The other findings of the report include: the number of  
             cases closed without prosecution was reduced from 145 days to 139  
             days; obtaining medical records was decreased from 74 days to 36  
             days; and conducting physician interviews reduced from 70 days to  
             40 days.  

            SB 797  (Ridley-Thomas), Chapter 33, Statutes of 2008, extended the  
             sunset date of the vertical enforcement model to July 1, 2010,  
             and requires another report to be submitted by MBC on the  
             effectiveness of the vertical enforcement model by July 1, 2009.   


         NOTE  :  Double-referral to Judiciary Committee (second.).  This bill is  
        double-referred.  Should it pass out of this Committee, it will be  
        referred to the Senate Judiciary Committee.





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        SUPPORT AND OPPOSITION:
        
         Support:  

        Medical Board of California (Sponsor)

         Opposition:  

        None on file as of June 23, 2009



        Consultant:Rosielyn Pulmano