BILL ANALYSIS Ó
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|Hearing Date:June 6, 2011 |Bill No:AB |
| |1127 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: AB 1127Author:Brownley
As Amended:April 4, 2011 Fiscal: Yes
SUBJECT: Medicine.
SUMMARY: Makes it unprofessional conduct for a physician and surgeon
to repeatedly fail, in the absence of good cause, to attend and
participate in an interview scheduled by the mutual agreement of the
physician and surgeon and the Medical Board of California (MBC).
States that this provision applies only to a physician and surgeon who
is the subject of an investigation by the MBC.
Existing law:
1)Establishes the Medical Practice Act, administered by the MBC to
regulate the practice of physicians and surgeons.
2)Establishes the Health Quality Enforcement Section (HQE) within the
Attorney General's Office to prosecute disciplinary cases on behalf
of the MBC.
3)Requires the MBC to take any action against any physician and
surgeon who is charged with unprofessional conduct. (Business and
Professions Code (BPC) § 2234)
4)States that unprofessional conduct includes, but is not limited to,
the following:
a) Violating or attempting to violate, directly or indirectly,
assisting in or abetting the violation of, or conspiring to
violate any provisions of the Medical Practice Act.
b) Gross negligence.
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c) Repeated negligent acts, as specified.
d) Incompetence.
e) The commission of any act involving dishonesty or corruption
which is substantially related to the qualifications, functions,
or duties of a physician and surgeon.
f) Any action or conduct which would have warranted the denial of
a certificate.
g) The practice of medicine from this state into another state or
country without meeting the legal requirements of that state or
country for the practice of medicine, as specified. (BPC § 2234)
This bill:
1)Makes it unprofessional conduct for a physician and surgeon to
repeatedly fail, in the absence of good cause, to attend and
participate in an interview scheduled by the mutual agreement of the
physician and surgeon and the MBC.
2)States that the above provision applies only to a physician and
surgeon who is the subject of an investigation by the MBC.
FISCAL EFFECT: According to the Assembly Appropriations Committee,
potential minor cost savings from a reduction in administrative duties
related to the failure of physicians to appear for interviews at the
scheduled time, to the extent that this bill deters physicians from
failing to appear.
COMMENTS:
1. Purpose. The Medical Board of California is the Sponsor of this
measure. MBC states that current law authorizes it to license and
regulate the practices of physicians and enforce penalties against
violators. However, unlike other healing arts boards and the State
Bar of California, there is no law that authorizes the MBC to
impose penalties on physicians who refuse to participate in
interviews at the beginning of an investigation. According to the
MBC, repeated failure of a physician to participate in interviews
must be included in the definition of "unprofessional conduct"
because despite best practices by the MBC to dismiss frivolous
complaints and pursue those that warrant formal accusations, there
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have been documented delays in investigations as some physicians
have repeatedly and purposefully failed to appear before the MBC
after scheduling interviews absent good cause. This has resulted
in cases being delayed between 60 days to over one year. MBC
indicates that over the last three years, it has been forced to
issue 338 subpoenas to compel participation of these physicians
(representing nearly 10% of all cases), wasting valuable staff time
and resources. The MBC believes this bill will help expedite the
closure of disciplinary cases by providing an incentive for
physicians to cooperate and participate in physician interviews.
2. Background. SB 1950 (Figueroa, 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 initial report, released in
2004, entitled Initial Report of the Medical Board Enforcement
Program, made numerous findings and 65 specific recommendations for
reform. One of the findings was that the policies for subject
interviews, which are a key part of the investigative process, are
inconsistent and ineffective. As a result, during 2003-2004, an
average of 60 days elapsed between MBC's request for an interview
and the physician's appearance or refusal to appear. The Monitor
recommended that MBC and HQE agree upon and consistently enforce a
new policy requiring prompt physician cooperation with interview
requests and regular tape-recording of interviews. In response to
this recommendation, MBC's enforcement staff revised its
Enforcement Operations Manual section 6.2 to institute new subject
interview policies and deadlines. According to the Monitor,
implementation of these new policies has somewhat reduced the
interview delay: In 2004 - 2005, the average time between initial
request and actual subject interview was 57 days; the average time
between request and interview refusal was 49 days. Although these
figures are down slightly from the overall average of 60 days in
2003 - 2004, they still represent a large portion of the
undesirable lengthy investigative timeframe. According to the MBC,
this bill further addresses the delays that occur when physicians
repeatedly and purposefully fail to appear before the MBC after
scheduling interviews absent good cause.
3. Arguments in Support. The Center for Public Interest Law (Center)
supports this bill which implements a recommendation that was made
by the Enforcement Monitor in 2004 and would help reduce the
excessive processing times of disciplinary cases. The Center
points out that this measure is narrowly drafted to encompass only
a repeated failure, in the absence of good cause, as a ground for
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disciplinary action.
SUPPORT AND OPPOSITION:
Support:
Medical Board of California (Sponsor)
Center for Public Interest Law
Opposition:
None on file as of May 31, 2011
Consultant:Rosielyn Pulmano