BILL NUMBER: SB 700	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 25, 2010
	PASSED THE ASSEMBLY  AUGUST 23, 2010
	AMENDED IN ASSEMBLY  AUGUST 20, 2010
	AMENDED IN SENATE  JANUARY 26, 2010
	AMENDED IN SENATE  MAY 20, 2009
	AMENDED IN SENATE  MAY 11, 2009
	AMENDED IN SENATE  APRIL 22, 2009
	AMENDED IN SENATE  APRIL 13, 2009

INTRODUCED BY   Senator Negrete McLeod
   (Coauthor: Senator Aanestad)

                        FEBRUARY 27, 2009

   An act to amend Sections 800, 803.1, 805, 805.1, 805.5, 2027, and
2220 of, and to add Section 805.01 to, the Business and Professions
Code, relating to healing arts.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 700, Negrete McLeod. Healing arts: peer review.
    Existing law provides for the professional review of specified
healing arts licentiates through a peer review process.
   This bill would define the term "peer review" for purposes of
those provisions.
    Under existing law, specified persons are required to file a
report, designated as an "805 report," with a licensing board within
15 days after a specified action is taken against a person licensed
by that board.
   This bill would also require specified persons to file a report
with a licensing board within 15 days after a peer review body makes
a decision or recommendation regarding the disciplinary action to be
taken against a licentiate of that board based on the peer review
body's determination, following formal investigation, that the
licentiate may have engaged in various acts, including incompetence,
substance abuse, excessive prescribing or furnishing of controlled
substances, or sexual misconduct, among other things. The bill would
authorize the board to inspect and copy certain documents in the
record of that investigation.
   Existing law requires the board to maintain an 805 report for a
period of 3 years after receipt.
   This bill would require the board to maintain the report
electronically.
   Existing law authorizes the Medical Board of California, the
Osteopathic Medical Board of California, and the Dental Board of
California to inspect and copy certain documents in the record of any
disciplinary proceeding resulting in action that is required to be
reported in an 805 report.
   This bill would specify that the boards have the authority to also
inspect, as permitted by other applicable law, any certified copy of
medical records in the record of the disciplinary proceeding.
   Existing law requires specified healing arts boards to maintain a
central file of their licensees containing, among other things,
disciplinary information reported through 805 reports.
   Under this bill, if a court finds, in a final judgment, that the
peer review resulting in the 805 report was conducted in bad faith
and the licensee who is the subject of the report notifies the board
of that finding, the board would be required to include that finding
in the licensee's central file.
    Existing law requires the Medical Board of California, the
Osteopathic Medical Board of California, and the California Board of
Podiatric Medicine to disclose an 805 report to specified health care
entities and to disclose certain hospital disciplinary actions to
inquiring members of the public. Existing law also requires the
Medical Board of California to post hospital disciplinary actions
regarding its licensees on the Internet.
   This bill would prohibit those disclosures, and would require the
Medical Board of California to remove certain information posted on
the Internet, if a court finds, in a final judgment, that the peer
review resulting in the 805 report or the hospital disciplinary
action was conducted in bad faith and the licensee notifies the board
of that finding. The bill would also require the Medical Board of
California to include certain exculpatory or explanatory statements
in those disclosures or postings and would require the board to post
on the Internet a factsheet that explains and provides information on
the 805 reporting requirements.
   Existing law also requires the Medical Board of California, the
Osteopathic Medical Board of California, and the California Board of
Podiatric Medicine to disclose to an inquiring member of the public
information regarding enforcement actions taken against a licensee by
the board or by another state or jurisdiction.
   This bill would also require those boards to make those
disclosures regarding enforcement actions taken against former
licensees.
   The bill would make related technical and nonsubstantive changes.



THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 800 of the Business and Professions Code is
amended to read:
   800.  (a) The Medical Board of California, the Board of
Psychology, the Dental Board of California, the Osteopathic Medical
Board of California, the State Board of Chiropractic Examiners, the
Board of Registered Nursing, the Board of Vocational Nursing and
Psychiatric Technicians, the State Board of Optometry, the Veterinary
Medical Board, the Board of Behavioral Sciences, the Physical
Therapy Board of California, the California State Board of Pharmacy,
the Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board, the California Board of Occupational Therapy, and
the Acupuncture Board shall each separately create and maintain a
central file of the names of all persons who hold a license,
certificate, or similar authority from that board. Each central file
shall be created and maintained to provide an individual historical
record for each licensee with respect to the following information:
   (1) Any conviction of a crime in this or any other state that
constitutes unprofessional conduct pursuant to the reporting
requirements of Section 803.
   (2) Any judgment or settlement requiring the licensee or his or
her insurer to pay any amount of damages in excess of three thousand
dollars ($3,000) for any claim that injury or death was proximately
caused by the licensee's negligence, error or omission in practice,
or by rendering unauthorized professional services, pursuant to the
reporting requirements of Section 801 or 802.
   (3) Any public complaints for which provision is made pursuant to
subdivision (b).
   (4) Disciplinary information reported pursuant to Section 805,
including any additional exculpatory or explanatory statements
submitted by the licentiate pursuant to subdivision (f) of Section
805. If a court finds, in a final judgment, that the peer review
resulting in the 805 report was conducted in bad faith and the
licensee who is the subject of the report notifies the board of that
finding, the board shall include that finding in the central file.
For purposes of this paragraph, "peer review" has the same meaning as
defined in Section 805.
   (5) Information reported pursuant to Section 805.01, including any
explanatory or exculpatory information submitted by the licensee
pursuant to subdivision (b) of that section.
   (b) Each board shall prescribe and promulgate forms on which
members of the public and other licensees or certificate holders may
file written complaints to the board alleging any act of misconduct
in, or connected with, the performance of professional services by
the licensee.
   If a board, or division thereof, a committee, or a panel has
failed to act upon a complaint or report within five years, or has
found that the complaint or report is without merit, the central file
shall be purged of information relating to the complaint or report.
   Notwithstanding this subdivision, the Board of Psychology, the
Board of Behavioral Sciences, and the Respiratory Care Board of
California shall maintain complaints or reports as long as each board
deems necessary.
   (c) The contents of any central file that are not public records
under any other provision of law shall be confidential except that
the licensee involved, or his or her counsel or representative, shall
have the right to inspect and have copies made of his or her
complete file except for the provision that may disclose the identity
of an information source. For the purposes of this section, a board
may protect an information source by providing a copy of the material
with only those deletions necessary to protect the identity of the
source or by providing a comprehensive summary of the substance of
the material. Whichever method is used, the board shall ensure that
full disclosure is made to the subject of any personal information
that could reasonably in any way reflect or convey anything
detrimental, disparaging, or threatening to a licensee's reputation,
rights, benefits, privileges, or qualifications, or be used by a
board to make a determination that would affect a licensee's rights,
benefits, privileges, or qualifications. The information required to
be disclosed pursuant to Section 803.1 shall not be considered among
the contents of a central file for the purposes of this subdivision.
   The licensee may, but is not required to, submit any additional
exculpatory or explanatory statement or other information that the
board shall include in the central file.
   Each board may permit any law enforcement or regulatory agency
when required for an investigation of unlawful activity or for
licensing, certification, or regulatory purposes to inspect and have
copies made of that licensee's file, unless the disclosure is
otherwise prohibited by law.
   These disclosures shall effect no change in the confidential
status of these records.
  SEC. 2.  Section 803.1 of the Business and Professions Code is
amended to read:
   803.1.  (a) Notwithstanding any other provision of law, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
disclose to an inquiring member of the public information regarding
any enforcement actions taken against a licensee, including a former
licensee, by the board or by another state or jurisdiction, including
all of the following:
   (1) Temporary restraining orders issued.
   (2) Interim suspension orders issued.
   (3) Revocations, suspensions, probations, or limitations on
practice ordered by the board, including those made part of a
probationary order or stipulated agreement.
   (4) Public letters of reprimand issued.
   (5) Infractions, citations, or fines imposed.
   (b) Notwithstanding any other provision of law, in addition to the
information provided in subdivision (a), the Medical Board of
California, the Osteopathic Medical Board of California, and the
California Board of Podiatric Medicine shall disclose to an inquiring
member of the public all of the following:
   (1) Civil judgments in any amount, whether or not vacated by a
settlement after entry of the judgment, that were not reversed on
appeal and arbitration awards in any amount of a claim or action for
damages for death or personal injury caused by the physician and
surgeon's negligence, error, or omission in practice, or by his or
her rendering of unauthorized professional services.
   (2) (A) All settlements in the possession, custody, or control of
the board shall be disclosed for a licensee in the low-risk category
if there are three or more settlements for that licensee within the
last 10 years, except for settlements by a licensee regardless of the
amount paid where (i) the settlement is made as a part of the
settlement of a class claim, (ii) the licensee paid in settlement of
the class claim the same amount as the other licensees in the same
class or similarly situated licensees in the same class, and (iii)
the settlement was paid in the context of a case where the complaint
that alleged class liability on behalf of the licensee also alleged a
products liability class action cause of action. All settlements in
the possession, custody, or control of the board shall be disclosed
for a licensee in the high-risk category if there are four or more
settlements for that licensee within the last 10 years except for
settlements by a licensee regardless of the amount paid where (i) the
settlement is made as a part of the settlement of a class claim,
(ii) the licensee paid in settlement of the class claim the same
amount as the other licensees in the same class or similarly situated
licensees in the same class, and (iii) the settlement was paid in
the context of a case where the complaint that alleged class
liability on behalf of the licensee also alleged a products liability
class action cause of action. Classification of a licensee in either
a "high-risk category" or a "low-risk category" depends upon the
specialty or subspecialty practiced by the licensee and the
designation assigned to that specialty or subspecialty by the Medical
Board of California, as described in subdivision (f). For the
purposes of this paragraph, "settlement" means a settlement of an
action described in paragraph (1) entered into by the licensee on or
after January 1, 2003, in an amount of thirty thousand dollars
($30,000) or more.
   (B) The board shall not disclose the actual dollar amount of a
settlement but shall put the number and amount of the settlement in
context by doing the following:
   (i) Comparing the settlement amount to the experience of other
licensees within the same specialty or subspecialty, indicating if it
is below average, average, or above average for the most recent
10-year period.
   (ii) Reporting the number of years the licensee has been in
practice.
   (iii) Reporting the total number of licensees in that specialty or
subspecialty, the number of those who have entered into a settlement
agreement, and the percentage that number represents of the total
number of licensees in the specialty or subspecialty.
   (3) Current American Board of Medical Specialty certification or
board equivalent as certified by the Medical Board of California, the
Osteopathic Medical Board of California, or the California Board of
Podiatric Medicine.
   (4) Approved postgraduate training.
   (5) Status of the license of a licensee. By January 1, 2004, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
adopt regulations defining the status of a licensee. The board shall
employ this definition when disclosing the status of a licensee
pursuant to Section 2027.
   (6) Any summaries of hospital disciplinary actions that result in
the termination or revocation of a licensee's staff privileges for
medical disciplinary cause or reason, unless a court finds, in a
final judgment, that the peer review resulting in the disciplinary
action was conducted in bad faith and the licensee notifies the board
of that finding. In addition, any exculpatory or explanatory
statements submitted by the licentiate electronically pursuant to
subdivision (f) of that section shall be disclosed. For purposes of
this paragraph, "peer review" has the same meaning as defined in
Section 805.
   (c) Notwithstanding any other provision of law, the Medical Board
of California, the Osteopathic Medical Board of California, and the
California Board of Podiatric Medicine shall disclose to an inquiring
member of the public information received regarding felony
convictions of a physician and surgeon or doctor of podiatric
medicine.
   (d) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine may
formulate appropriate disclaimers or explanatory statements to be
included with any information released, and may by regulation
establish categories of information that need not be disclosed to an
inquiring member of the public because that information is unreliable
or not sufficiently related to the licensee's professional practice.
The Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
include the following statement when disclosing information
concerning a settlement:


   "Some studies have shown that there is no significant correlation
between malpractice history and a doctor's competence. At the same
time, the State of California believes that consumers should have
access to malpractice information. In these profiles, the State of
California has given you information about both the malpractice
settlement history for the doctor's specialty and the doctor's
history of settlement payments only if in the last 10 years, the
doctor, if in a low-risk specialty, has three or more settlements or
the doctor, if in a high-risk specialty, has four or more
settlements. The State of California has excluded some class action
lawsuits because those cases are commonly related to systems issues
such as product liability, rather than questions of individual
professional competence and because they are brought on a class basis
where the economic incentive for settlement is great. The State of
California has placed payment amounts into three statistical
categories: below average, average, and above average compared to
others in the doctor's specialty. To make the best health care
decisions, you should view this information in perspective. You could
miss an opportunity for high-quality care by selecting a doctor
based solely on malpractice history.
   When considering malpractice data, please keep in mind:
   Malpractice histories tend to vary by specialty. Some specialties
are more likely than others to be the subject of litigation. This
report compares doctors only to the members of their specialty, not
to all doctors, in order to make an individual doctor's history more
meaningful.
   This report reflects data only for settlements made on or after
January 1, 2003. Moreover, it includes information concerning those
settlements for a 10-year period only. Therefore, you should know
that a doctor may have made settlements in the 10 years immediately
preceding January 1, 2003, that are not included in this report.
After January 1, 2013, for doctors practicing less than 10 years, the
data covers their total years of practice. You should take into
account the effective date of settlement disclosure as well as how
long the doctor has been in practice when considering malpractice
averages.
   The incident causing the malpractice claim may have happened years
before a payment is finally made. Sometimes, it takes a long time
for a malpractice lawsuit to settle. Some doctors work primarily with
high-risk patients. These doctors may have malpractice settlement
histories that are higher than average because they specialize in
cases or patients who are at very high risk for problems.
   Settlement of a claim may occur for a variety of reasons that do
not necessarily reflect negatively on the professional competence or
conduct of the doctor. A payment in settlement of a medical
malpractice action or claim should not be construed as creating a
presumption that medical malpractice has occurred.
   You may wish to discuss information in this report and the general
issue of malpractice with your doctor."


   (e) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine shall,
by regulation, develop standard terminology that accurately
describes the different types of disciplinary filings and actions to
take against a licensee as described in paragraphs (1) to (5),
inclusive, of subdivision (a). In providing the public with
information about a licensee via the Internet pursuant to Section
2027, the Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine shall
not use the terms "enforcement," "discipline," or similar language
implying a sanction unless the physician and surgeon has been the
subject of one of the actions described in paragraphs (1) to (5),
inclusive, of subdivision (a).
   (f) The Medical Board of California shall adopt regulations no
later than July 1, 2003, designating each specialty and subspecialty
practice area as either high risk or low risk. In promulgating these
regulations, the board shall consult with commercial underwriters of
medical malpractice insurance companies, health care systems that
self-insure physicians and surgeons, and representatives of the
California medical specialty societies. The board shall utilize the
carriers' statewide data to establish the two risk categories and the
averages required by subparagraph (B) of paragraph (2) of
subdivision (b). Prior to issuing regulations, the board shall
convene public meetings with the medical malpractice carriers,
self-insurers, and specialty representatives.
   (g) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine shall
provide each licensee, including a former licensee under subdivision
(a), with a copy of the text of any proposed public disclosure
authorized by this section prior to release of the disclosure to the
public. The licensee shall have 10 working days from the date the
board provides the copy of the proposed public disclosure to propose
corrections of factual inaccuracies. Nothing in this section shall
prevent the board from disclosing information to the public prior to
the expiration of the 10-day period.
   (h) Pursuant to subparagraph (A) of paragraph (2) of subdivision
(b), the specialty or subspecialty information required by this
section shall group physicians by specialty board recognized pursuant
to paragraph (5) of subdivision (h) of Section 651 unless a
different grouping would be more valid and the board, in its
statement of reasons for its regulations, explains why the validity
of the grouping would be more valid.
  SEC. 3.  Section 805 of the Business and Professions Code is
amended to read:
   805.  (a) As used in this section, the following terms have the
following definitions:
   (1) (A) "Peer review" means both of the following:
   (i) A process in which a peer review body reviews the basic
qualifications, staff privileges, employment, medical outcomes, or
professional conduct of licentiates to make recommendations for
quality improvement and education, if necessary, in order to do
either or both of the following:
   (I) Determine whether a licentiate may practice or continue to
practice in a health care facility, clinic, or other setting
providing medical services, and, if so, to determine the parameters
of that practice.
   (II) Assess and improve the quality of care rendered in a health
care facility, clinic, or other setting providing medical services.
   (ii) Any other activities of a peer review body as specified in
subparagraph (B).
   (B) "Peer review body" includes:
   (i) A medical or professional staff of any health care facility or
clinic licensed under Division 2 (commencing with Section 1200) of
the Health and Safety Code or of a facility certified to participate
in the federal Medicare Program as an ambulatory surgical center.
   (ii) A health care service plan licensed under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that contracts with licentiates to
provide services at alternative rates of payment pursuant to Section
10133 of the Insurance Code.
   (iii) Any medical, psychological, marriage and family therapy,
social work, dental, or podiatric professional society having as
members at least 25 percent of the eligible licentiates in the area
in which it functions (which must include at least one county), which
is not organized for profit and which has been determined to be
exempt from taxes pursuant to Section 23701 of the Revenue and
Taxation Code.
   (iv) A committee organized by any entity consisting of or
employing more than 25 licentiates of the same class that functions
for the purpose of reviewing the quality of professional care
provided by members or employees of that entity.
   (2) "Licentiate" means a physician and surgeon, doctor of
podiatric medicine, clinical psychologist, marriage and family
therapist, clinical social worker, or dentist. "Licentiate" also
includes a person authorized to practice medicine pursuant to Section
2113 or 2168.
   (3) "Agency" means the relevant state licensing agency having
regulatory jurisdiction over the licentiates listed in paragraph (2).

   (4) "Staff privileges" means any arrangement under which a
licentiate is allowed to practice in or provide care for patients in
a health facility. Those arrangements shall include, but are not
limited to, full staff privileges, active staff privileges, limited
staff privileges, auxiliary staff privileges, provisional staff
privileges, temporary staff privileges, courtesy staff privileges,
locum tenens arrangements, and contractual arrangements to provide
professional services, including, but not limited to, arrangements to
provide outpatient services.
   (5) "Denial or termination of staff privileges, membership, or
employment" includes failure or refusal to renew a contract or to
renew, extend, or reestablish any staff privileges, if the action is
based on medical disciplinary cause or reason.
   (6) "Medical disciplinary cause or reason" means that aspect of a
licentiate's competence or professional conduct that is reasonably
likely to be detrimental to patient safety or to the delivery of
patient care.
   (7) "805 report" means the written report required under
subdivision (b).
   (b) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after the effective date on
which any of the following occur as a result of an action of a peer
review body:
   (1) A licentiate's application for staff privileges or membership
is denied or rejected for a medical disciplinary cause or reason.
   (2) A licentiate's membership, staff privileges, or employment is
terminated or revoked for a medical disciplinary cause or reason.
   (3) Restrictions are imposed, or voluntarily accepted, on staff
privileges, membership, or employment for a cumulative total of 30
days or more for any 12-month period, for a medical disciplinary
cause or reason.
   (c) If a licentiate takes any action listed in paragraph (1), (2),
or (3) after receiving notice of a pending investigation initiated
for a medical disciplinary cause or reason or after receiving notice
that his or her application for membership or staff privileges is
denied or will be denied for a medical disciplinary cause or reason,
the chief of staff of a medical or professional staff or other chief
executive officer, medical director, or administrator of any peer
review body and the chief executive officer or administrator of any
licensed health care facility or clinic where the licentiate is
employed or has staff privileges or membership or where the
licentiate applied for staff privileges or membership, or sought the
renewal thereof, shall file an 805 report with the relevant agency
within 15 days after the licentiate takes the action.
   (1) Resigns or takes a leave of absence from membership, staff
privileges, or employment.
   (2) Withdraws or abandons his or her application for staff
privileges or membership.
   (3) Withdraws or abandons his or her request for renewal of staff
privileges or membership.
   (d) For purposes of filing an 805 report, the signature of at
least one of the individuals indicated in subdivision (b) or (c) on
the completed form shall constitute compliance with the requirement
to file the report.
   (e) An 805 report shall also be filed within 15 days following the
imposition of summary suspension of staff privileges, membership, or
employment, if the summary suspension remains in effect for a period
in excess of 14 days.
   (f) A copy of the 805 report, and a notice advising the licentiate
of his or her right to submit additional statements or other
information, electronically or otherwise, pursuant to Section 800,
shall be sent by the peer review body to the licentiate named in the
report. The notice shall also advise the licentiate that information
submitted electronically will be publicly disclosed to those who
request the information.
   The information to be reported in an 805 report shall include the
name and license number of the licentiate involved, a description of
the facts and circumstances of the medical disciplinary cause or
reason, and any other relevant information deemed appropriate by the
reporter.
   A supplemental report shall also be made within 30 days following
the date the licentiate is deemed to have satisfied any terms,
conditions, or sanctions imposed as disciplinary action by the
reporting peer review body. In performing its dissemination functions
required by Section 805.5, the agency shall include a copy of a
supplemental report, if any, whenever it furnishes a copy of the
original 805 report.
   If another peer review body is required to file an 805 report, a
health care service plan is not required to file a separate report
with respect to action attributable to the same medical disciplinary
cause or reason. If the Medical Board of California or a licensing
agency of another state revokes or suspends, without a stay, the
license of a physician and surgeon, a peer review body is not
required to file an 805 report when it takes an action as a result of
the revocation or suspension.
   (g) The reporting required by this section shall not act as a
waiver of confidentiality of medical records and committee reports.
The information reported or disclosed shall be kept confidential
except as provided in subdivision (c) of Section 800 and Sections
803.1 and 2027, provided that a copy of the report containing the
information required by this section may be disclosed as required by
Section 805.5 with respect to reports received on or after January 1,
1976.
   (h) The Medical Board of California, the Osteopathic Medical Board
of California, and the Dental Board of California shall disclose
reports as required by Section 805.5.
   (i) An 805 report shall be maintained electronically by an agency
for dissemination purposes for a period of three years after receipt.

   (j) No person shall incur any civil or criminal liability as the
result of making any report required by this section.
   (k) A willful failure to file an 805 report by any person who is
designated or otherwise required by law to file an 805 report is
punishable by a fine not to exceed one hundred thousand dollars
($100,000) per violation. The fine may be imposed in any civil or
administrative action or proceeding brought by or on behalf of any
agency having regulatory jurisdiction over the person regarding whom
the report was or should have been filed. If the person who is
designated or otherwise required to file an 805 report is a licensed
physician and surgeon, the action or proceeding shall be brought by
the Medical Board of California. The fine shall be paid to that
agency but not expended until appropriated by the Legislature. A
violation of this subdivision may constitute unprofessional conduct
by the licentiate. A person who is alleged to have violated this
subdivision may assert any defense available at law. As used in this
subdivision, "willful" means a voluntary and intentional violation of
a known legal duty.
            (l) Except as otherwise provided in subdivision (k), any
failure by the administrator of any peer review body, the chief
executive officer or administrator of any health care facility, or
any person who is designated or otherwise required by law to file an
805 report, shall be punishable by a fine that under no circumstances
shall exceed fifty thousand dollars ($50,000) per violation. The
fine may be imposed in any civil or administrative action or
proceeding brought by or on behalf of any agency having regulatory
jurisdiction over the person regarding whom the report was or should
have been filed. If the person who is designated or otherwise
required to file an 805 report is a licensed physician and surgeon,
the action or proceeding shall be brought by the Medical Board of
California. The fine shall be paid to that agency but not expended
until appropriated by the Legislature. The amount of the fine
imposed, not exceeding fifty thousand dollars ($50,000) per
violation, shall be proportional to the severity of the failure to
report and shall differ based upon written findings, including
whether the failure to file caused harm to a patient or created a
risk to patient safety; whether the administrator of any peer review
body, the chief executive officer or administrator of any health care
facility, or any person who is designated or otherwise required by
law to file an 805 report exercised due diligence despite the failure
to file or whether they knew or should have known that an 805 report
would not be filed; and whether there has been a prior failure to
file an 805 report. The amount of the fine imposed may also differ
based on whether a health care facility is a small or rural hospital
as defined in Section 124840 of the Health and Safety Code.
   (m) A health care service plan licensed under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that negotiates and enters into a
contract with licentiates to provide services at alternative rates of
payment pursuant to Section 10133 of the Insurance Code, when
determining participation with the plan or insurer, shall evaluate,
on a case-by-case basis, licentiates who are the subject of an 805
report, and not automatically exclude or deselect these licentiates.
  SEC. 4.  Section 805.01 is added to the Business and Professions
Code, to read:
   805.01.  (a) As used in this section, the following terms have the
following definitions:
   (1) "Agency" has the same meaning as defined in Section 805.
   (2) "Formal investigation" means an investigation performed by a
peer review body based on an allegation that any of the acts listed
in paragraphs (1) to (4), inclusive, of subdivision (b) occurred.
   (3) "Licentiate" has the same meaning as defined in Section 805.
   (4) "Peer review body" has the same meaning as defined in Section
805.
   (b) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file a report with
the relevant agency within 15 days after a peer review body makes a
final decision or recommendation regarding the disciplinary action,
as specified in subdivision (b) of Section 805, resulting in a final
proposed action to be taken against a licentiate based on the peer
review body's determination, following formal investigation of the
licentiate, that any of the acts listed in paragraphs (1) to (4),
inclusive, may have occurred, regardless of whether a hearing is held
pursuant to Section 809.2. The licentiate shall receive a notice of
the proposed action as set forth in Section 809.1, which shall also
include a notice advising the licentiate of the right to submit
additional explanatory or exculpatory statements electronically or
otherwise.
   (1) Incompetence, or gross or repeated deviation from the standard
of care involving death or serious bodily injury to one or more
patients, to the extent or in such a manner as to be dangerous or
injurious to any person or to the public. This paragraph shall not be
construed to affect or require the imposition of immediate
suspension pursuant to Section 809.5.
   (2) The use of, or prescribing for or administering to himself or
herself, any controlled substance; or the use of any dangerous drug,
as defined in Section 4022, or of alcoholic beverages, to the extent
or in such a manner as to be dangerous or injurious to the
licentiate, any other person, or the public, or to the extent that
such use impairs the ability of the licentiate to practice safely.
   (3) Repeated acts of clearly excessive prescribing, furnishing, or
administering of controlled substances or repeated acts of
prescribing, dispensing, or furnishing of controlled substances
without a good faith effort prior examination of the patient and
medical reason therefor. However, in no event shall a physician and
surgeon prescribing, furnishing, or administering controlled
substances for intractable pain, consistent with lawful prescribing,
be reported for excessive prescribing and prompt review of the
applicability of these provisions shall be made in any complaint that
may implicate these provisions.
   (4) Sexual misconduct with one or more patients during a course of
treatment or an examination.
   (c) The relevant agency shall be entitled to inspect and copy the
following documents in the record of any formal investigation
required to be reported pursuant to subdivision (b):
   (1) Any statement of charges.
   (2) Any document, medical chart, or exhibit.
   (3) Any opinions, findings, or conclusions.
   (4) Any certified copy of medical records, as permitted by other
applicable law.
   (d) The report provided pursuant to subdivision (b) and the
information disclosed pursuant to subdivision (c) shall be kept
confidential and shall not be subject to discovery, except that the
information may be reviewed as provided in subdivision (c) of Section
800 and may be disclosed in any subsequent disciplinary hearing
conducted pursuant to the Administrative Procedure Act (Chapter 5
(commencing with Section 11500) of Part 1 of Division 3 of Title 2 of
the Government Code).
   (e) The report required under this section shall be in addition to
any report required under Section 805.
   (f) A peer review body shall not be required to make a report
pursuant to this section if that body does not make a final decision
or recommendation regarding the disciplinary action to be taken
against a licentiate based on the body's determination that any of
the acts listed in paragraphs (1) to (4), inclusive, of subdivision
(b) may have occurred.
  SEC. 5.  Section 805.1 of the Business and Professions Code is
amended to read:
   805.1.  (a) The Medical Board of California, the Osteopathic
Medical Board of California, and the Dental Board of California shall
be entitled to inspect and copy the following documents in the
record of any disciplinary proceeding resulting in action that is
required to be reported pursuant to Section 805:
   (1) Any statement of charges.
   (2) Any document, medical chart, or exhibits in evidence.
   (3) Any opinion, findings, or conclusions.
   (4) Any certified copy of medical records, as permitted by other
applicable law.
   (b) The information so disclosed shall be kept confidential and
not subject to discovery, in accordance with Section 800, except that
it may be reviewed, as provided in subdivision (c) of Section 800,
and may be disclosed in any subsequent disciplinary hearing conducted
pursuant to the Administrative Procedure Act (Chapter 5 (commencing
with Section 11500) of Part 1 of Division 3 of Title 2 of the
Government Code).
  SEC. 6.  Section 805.5 of the Business and Professions Code is
amended to read:
   805.5.  (a) Prior to granting or renewing staff privileges for any
physician and surgeon, psychologist, podiatrist, or dentist, any
health facility licensed pursuant to Division 2 (commencing with
Section 1200) of the Health and Safety Code, or any health care
service plan or medical care foundation, or the medical staff of the
institution shall request a report from the Medical Board of
California, the Board of Psychology, the Osteopathic Medical Board of
California, or the Dental Board of California to determine if any
report has been made pursuant to Section 805 indicating that the
applying physician and surgeon, psychologist, podiatrist, or dentist
has been denied staff privileges, been removed from a medical staff,
or had his or her staff privileges restricted as provided in Section
805. The request shall include the name and California license number
of the physician and surgeon, psychologist, podiatrist, or dentist.
Furnishing of a copy of the 805 report shall not cause the 805 report
to be a public record.
   (b) Upon a request made by, or on behalf of, an institution
described in subdivision (a) or its medical staff the board shall
furnish a copy of any report made pursuant to Section 805 as well as
any additional exculpatory or explanatory information submitted
electronically to the board by the licensee pursuant to subdivision
(f) of that section. However, the board shall not send a copy of a
report (1) if the denial, removal, or restriction was imposed solely
because of the failure to complete medical records, (2) if the board
has found the information reported is without merit, (3) if a court
finds, in a final judgment, that the peer review, as defined in
Section 805, resulting in the report was conducted in bad faith and
the licensee who is the subject of the report notifies the board of
that finding, or (4) if a period of three years has elapsed since the
report was submitted. This three-year period shall be tolled during
any period the licentiate has obtained a judicial order precluding
disclosure of the report, unless the board is finally and permanently
precluded by judicial order from disclosing the report. If a request
is received by the board while the board is subject to a judicial
order limiting or precluding disclosure, the board shall provide a
disclosure to any qualified requesting party as soon as practicable
after the judicial order is no longer in force.
   If the board fails to advise the institution within 30 working
days following its request for a report required by this section, the
institution may grant or renew staff privileges for the physician
and surgeon, psychologist, podiatrist, or dentist.
   (c) Any institution described in subdivision (a) or its medical
staff that violates subdivision (a) is guilty of a misdemeanor and
shall be punished by a fine of not less than two hundred dollars
($200) nor more than one thousand two hundred dollars ($1,200).
  SEC. 7.  Section 2027 of the Business and Professions Code is
amended to read:
   2027.  (a) The board shall post on the Internet the following
information in its possession, custody, or control regarding licensed
physicians and surgeons:
   (1) With regard to the status of the license, whether or not the
licensee is in good standing, subject to a temporary restraining
order (TRO), subject to an interim suspension order (ISO), or subject
to any of the enforcement actions set forth in Section 803.1.
   (2) With regard to prior discipline, whether or not the licensee
has been subject to discipline by the board or by the board of
another state or jurisdiction, as described in Section 803.1.
   (3) Any felony convictions reported to the board after January 3,
1991.
   (4) All current accusations filed by the Attorney General,
including those accusations that are on appeal. For purposes of this
paragraph, "current accusation" shall mean an accusation that has not
been dismissed, withdrawn, or settled, and has not been finally
decided upon by an administrative law judge and the Medical Board of
California unless an appeal of that decision is pending.
   (5) Any malpractice judgment or arbitration award reported to the
board after January 1, 1993.
   (6) Any hospital disciplinary actions that resulted in the
termination or revocation of a licensee's hospital staff privileges
for a medical disciplinary cause or reason. The posting shall also
provide a link to any additional explanatory or exculpatory
information submitted electronically by the licensee pursuant to
subdivision (f) of Section 805.
   (7) Any misdemeanor conviction that results in a disciplinary
action or an accusation that is not subsequently withdrawn or
dismissed.
   (8) Appropriate disclaimers and explanatory statements to
accompany the above information, including an explanation of what
types of information are not disclosed. These disclaimers and
statements shall be developed by the board and shall be adopted by
regulation.
   (9) Any information required to be disclosed pursuant to Section
803.1.
   (b) (1) From January 1, 2003, the information described in
paragraphs (1) (other than whether or not the licensee is in good
standing), (2), (4), (5), (7), and (9) of subdivision (a) shall
remain posted for a period of 10 years from the date the board
obtains possession, custody, or control of the information, and after
the end of that period shall be removed from being posted on the
board's Internet Web site. Information in the possession, custody, or
control of the board prior to January 1, 2003, shall be posted for a
period of 10 years from January 1, 2003. Settlement information
shall be posted as described in paragraph (2) of subdivision (b) of
Section 803.1.
   (2) The information described in paragraphs (3) and (6) of
subdivision (a) shall not be removed from being posted on the board's
Internet Web site.
   (3) Notwithstanding paragraph (2) and except as provided in
paragraph (4), if a licensee's hospital staff privileges are restored
and the licensee notifies the board of the restoration, the
information pertaining to the termination or revocation of those
privileges, as described in paragraph (6) of subdivision (a), shall
remain posted for a period of 10 years from the restoration date of
the privileges, and at the end of that period shall be removed from
being posted on the board's Internet Web site.
   (4) Notwithstanding paragraph (2), if a court finds, in a final
judgment, that peer review resulting in a hospital disciplinary
action was conducted in bad faith and the licensee notifies the board
of that finding, the information concerning that hospital
disciplinary action posted pursuant to paragraph (6) of subdivision
(a) shall be immediately removed from the board's Internet Web site.
For purposes of this paragraph, "peer review" has the same meaning as
defined in Section 805.
   (c) The board shall also post on the Internet a factsheet that
explains and provides information on the reporting requirements under
Section 805.
   (d) The board shall provide links to other Web sites on the
Internet that provide information on board certifications that meet
the requirements of subdivision (b) of Section 651. The board may
provide links to other Web sites on the Internet that provide
information on health care service plans, health insurers, hospitals,
or other facilities. The board may also provide links to any other
sites that would provide information on the affiliations of licensed
physicians and surgeons.
  SEC. 8.  Section 2220 of the Business and Professions Code is
amended to read:
   2220.  Except as otherwise provided by law, the board may take
action against all persons guilty of violating this chapter. The
board shall enforce and administer this article as to physician and
surgeon certificate holders, and the board shall have all the powers
granted in this chapter for these purposes including, but not limited
to:
   (a) Investigating complaints from the public, from other
licensees, from health care facilities, or from the board that a
physician and surgeon may be guilty of unprofessional conduct. The
board shall investigate the circumstances underlying a report
received pursuant to Section 805 or 805.01 within 30 days to
determine if an interim suspension order or temporary restraining
order should be issued. The board shall otherwise provide timely
disposition of the reports received pursuant to Section 805 and
Section 805.01.
   (b) Investigating the circumstances of practice of any physician
and surgeon where there have been any judgments, settlements, or
arbitration awards requiring the physician and surgeon or his or her
professional liability insurer to pay an amount in damages in excess
of a cumulative total of thirty thousand dollars ($30,000) with
respect to any claim that injury or damage was proximately caused by
the physician's and surgeon's error, negligence, or omission.
   (c) Investigating the nature and causes of injuries from cases
which shall be reported of a high number of judgments, settlements,
or arbitration awards against a physician and surgeon.