BILL NUMBER: AB 926 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 27, 2011
INTRODUCED BY Assembly Member Hayashi
FEBRUARY 18, 2011
An act to add and repeal Section 2401.1 of the Business and
Professions Code, relating to physicians and surgeons , and
declaring the urgency thereof, to take effect immediately .
LEGISLATIVE COUNSEL'S DIGEST
AB 926, as amended, Hayashi. Physicians and surgeons: direct
employment.
Existing law, the Medical Practice Act, restricts the employment
of licensed physicians and surgeons and podiatrists by a corporation
or other artificial legal entity, subject to specified exemptions.
Existing law established, until January 1, 2011, a pilot project to
allow qualified district hospitals that, among other things,
provide provided more than 50% of patient days
to the care of Medicare, Medi-Cal, and uninsured patients, to employ
a physician and surgeon, if the hospital does
did not interfere with, control, or otherwise direct the
professional judgment of the physician and surgeon. The pilot project
authorized the direct employment of not more than 20 physicians and
surgeons by all of those hospitals to provide medically necessary
services in rural and medically underserved communities. Existing law
imposed specified duties on the Medical Board of California with
regard to the pilot project.
This bill would, until January 1, 2022, reenact the pilot project
to allow all qualified district hospitals to employ not more than 50
physicians and surgeons, under circumstances described above. The
bill would require the Medical Board of California to report to the
Legislature by October 1, 2020, on the effectiveness of the pilot
project.
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: majority 2/3 . Appropriation:
no. Fiscal committee: yes. State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 2401.1 is added to the Business and Professions
Code, to read:
2401.1. (a) The Legislature finds and declares as follows:
(1) Due to the large number of uninsured and underinsured
Californians, a number of California communities are having great
difficulty recruiting and retaining physicians and surgeons.
(2) In order to recruit physicians and surgeons to provide
medically necessary services in rural and medically underserved
communities, many district hospitals have no viable alternative but
to directly employ physicians and surgeons in order to provide
economic security adequate for a physician and surgeon to relocate
and reside in their communities.
(3) The Legislature intends that a district hospital meeting the
conditions set forth in this section be able to employ physicians and
surgeons directly and to charge for their professional services.
(4) The Legislature reaffirms that Section 2400 provides an
increasingly important protection for patients and physicians and
surgeons from inappropriate intrusions into the practice of medicine,
and further intends that a district hospital not interfere with,
control, or otherwise direct a physician and surgeon's professional
judgment.
(b) A pilot project to provide for the direct employment of a
total of 50 physicians and surgeons by qualified district hospitals
is hereby established in order to improve the recruitment and
retention of physicians and surgeons in rural and other medically
underserved areas.
(c) For purposes of this section, a qualified district hospital
means a hospital that meets all of the following requirements:
(1) Is a district hospital organized and governed pursuant to the
Local Health Care District Law (Division 23 (commencing with Section
32000) of the Health and Safety Code).
(2) Provides a percentage of care to Medicare, Medi-Cal, and
uninsured patients that exceeds 50 percent of patient days.
(3) Is located in a county with a total population of less than
750,000.
(4) Has net losses from operations in fiscal year 2008-09, as
reported to the Office of Statewide Health Planning and Development.
(d) In addition to the requirements of subdivision (c), and in
addition to other applicable laws, a qualified district hospital may
directly employ a licensee pursuant to subdivision (b) if all of the
following conditions are satisfied:
(1) The total number of physicians and surgeons employed by all
qualified district hospitals under this section does not exceed 50.
(2) The medical staff and the elected trustees of the qualified
district hospital concur by an affirmative vote of each body that the
physician and surgeon's employment is in the best interest of the
communities served by the hospital.
(3) The licensee enters into or renews a written employment
contract with the qualified district hospital prior to December 31,
2015, for a term not in excess of four years. The contract shall
provide for mandatory dispute resolution under the auspices of the
board for disputes directly relating to the licensee's clinical
practice.
(4) The total number of licensees employed by the qualified
district hospital does not exceed five at any time.
(5) The qualified district hospital notifies the board in writing
that the hospital plans to enter into a written contract with the
licensee and the board has confirmed that the licensee's employment
is within the maximum number permitted by this section. The board
shall provide written confirmation to the hospital within five
working days of receipt of the written notification to the board.
(e) (1) The board shall report to the Legislature not later than
October 1, 2020, on the evaluation of the effectiveness of the pilot
project in improving access to health care in rural and medically
underserved areas and the project's impact on consumer protection as
it relates to intrusions into the practice of medicine.
(2) The report to be submitted pursuant to paragraph (1) shall be
submitted in compliance with Section 9795 of the Government Code.
(f) Nothing in this section shall exempt the district hospital
from any reporting requirements or affect the board's authority to
take action against a physician and surgeon's license.
(g) This section shall remain in effect only until January 1,
2022, and as of that date is repealed, unless a later enacted statute
that is enacted before January 1, 2022, deletes or extends that
date.
SEC. 2. This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
In order to increase the recruitment and retention of physicians
and surgeons in rural and other medically underserved areas and to
provide improved access to health care in those areas at the earliest
possible time, it is necessary that this act take effect
immediately.