BILL ANALYSIS
SB 820
Page 1
Date of Hearing: August 19, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
SB 820 (Negrete-McLeod) - As Amended: August 17, 2009
Policy Committee: Business &
Professions Vote: 11-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill modifies disciplinary reporting and peer review
policies and procedures related to professionals under the
jurisdiction of the Medical Board of California (MBC), the
Osteopathic Medical Board of California (OMBC), and the
California Board of Podiatric Medicine (CPBM) (boards).
Specifically, this bill:
1)Increases the amount of information available in a board's
central file. Requires specified information to be disclosed
to the public about a former licensee. Specifies that
information will not be disclosed if a court finds that a peer
process was conducted in bad faith.
2)Expands the definition of peer review to include a process in
which information is reviewed to determine whether a
licentiate may practice and to determine parameters of that
practice.
3)Requires the chief of staff of a medical or professional
staff, a chief executive officer, medical director, or other
administrator of a peer review body to find a report following
a formal investigation with 15 days after a peer review final
determination that specified acts may have occurred, including
gross negligence, substance abuse, and excessive prescribing
of controlled substances.
FISCAL EFFECT
No direct fiscal impact to the healing arts boards addressed by
this bill to continue oversight of medical professionals in
SB 820
Page 2
California.
COMMENTS
1)Rationale . This bill addresses peer review processes and "805
reports." Section 805 of the Business & Professions Code
details the peer review process and reporting related to
disciplinary investigations and conclusions related to alleged
physician misconduct.
2)Recent amendments modify the definition of peer review,
clarify the definition of a formal investigation, clarify the
circumstances of a confidential report required by the bill,
and make other technical changes.
3)Background . The term peer review generally refers to when a
group of medical professionals review their colleagues'
performance. Peer reviews are conducted in many health care
settings, including hospitals, clinics, health plans, and
medical groups. Peer reviews are not always related to
performance concerns, but may also be used in a routine review
of a physician's practices. The methods of peer review can
vary widely. Under state law, when peer review involves
disciplinary action, the review and outcomes must be reported
to the respective boards, including the MBC.
4)Medical Board 805 Reports . In 2007-08, the MBC received 138
Section 805 reports regarding the approximately 100,000
physicians practicing in California and licensed by the MBC.
These reports included 74 reports from hospitals and clinics,
17 from health plans, and 47 from medical groups. Of these
reports, charges were filed in one case, 92 cases are pending
and 45 cases were closed. The number of 805 reports varies
from year to year but population-adjusted data show a
reduction in the number of reports year-over. Pursuant to
Section 805, the information reported to the MBC is
confidential. Section 805 also specifies that willful failure
to file an 805 report is punishable by a maximum fine of
$100,000 per violation and any failure to file an 805 report
is punishable by a fine of $50,000.
5)Concerns . The California Hospital Association (CHA) opposes
this bill unless it is amended to address several concerns.
These concerns include the addition of the terms "negligence"
and "gross negligence" which CHA indicates are legal and not
SB 820
Page 3
medical terms. CHA indicates asking physicians serving on peer
review bodies to determine negligence is not a reasonable part
of customary peer review processes. CHA has concerns about the
addition of "certified medical records" which is not defined
in the bill or elsewhere in the codes. The disclosure of
medical records needs to meet stringent federal and state laws
with respect to medical privacy. CHA also has concerns about
the use of the term "employment" in Section 805(c)(2) and
"imposed on licentiate" in Section 805(b). CHA indicates the
use of the former imposes inappropriate reporting requirements
and the latter term should be changed to a report must be
filed when "specified events occur".
6) Related Legislation . SB 231 (Figueroa), Chapter 674, Statutes
of 2005 required the MBC to contract for a comprehensive study
of the peer review process. The report was completed in 2008
and discussed extensively in oversight hearings in 2009. The
MBC and stakeholders expressed a number of concerns about the
conclusion of the contracted report.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081