BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de Le�n, Chair


          SB 670 (Steinberg) - Physicians and surgeons: drug prescribing  
          privileges: investigation.
          
          Amended: April 8, 2013          Policy Vote: B&P 8-0
          Urgency: No                     Mandate: No
          Hearing Date: April 29, 2013                            
          Consultant: Brendan McCarthy    
          
          This bill does not meet the criteria for referral to the  
          Suspense File.
          
          
          Bill Summary: SB 670 would make several statutory changes to  
          expand the authority of the Medical Board of California to  
          investigate and sanction physicians and surgeons.

          Fiscal Impact: 
              One-time costs between $75,000 and $150,000 for the Medical  
              Board to adopt regulations (Contingent Fund of the Medical  
              Board).

              Minor cost savings to the Medical Board due to streamlined  
              processes when conducting investigations (Contingent Fund of  
              the Medical Board).

          Background: Under current law, physicians and surgeons are  
          licensed and regulated by the Medical Board of California. The  
          Medical Board is authorized to investigate physicians and  
          surgeons under certain circumstances. For example, if a report  
          is filed with the Medical Board by a coroner when a death may be  
          the result of gross negligence by a physician and surgeon. As  
          part of an investigation, the Medical Board reviews the deceased  
          person's medical records. Current law requires the Medical Board  
          to get the permission of the deceased's next of kin or get a  
          court order if the next of kin cannot be located or does not  
          give permission.

          Current law includes other procedures and protections for  
          physicians and surgeons under investigation. For example, a  
          licensee under investigation is required to meet with Medical  
          Board staff, but only at a mutually agreed upon time.









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          Current law also allows an administrative law judge to issue an  
          interim suspension order to suspend a license to practice or  
          place other limitations on a physician and surgeon's license.

          Proposed Law: SB 670 would make several statutory changes to  
          expand the authority of the Medical Board of California to  
          investigate and sanction physicians and surgeons.

          Specific provisions of the bill include:
              Authority for the Medical Board to inspect the medical  
              records of a deceased person without the permission of the  
              next of kin or a court order, upon receipt of a report from  
              a coroner;
              Expansion of the definition of unprofessional conduct to  
              include the failure of a licensee who is under investigation  
              to attend an interview with the Medical Board within 30 days  
              of notification;
              Authority for an administrative law judge to issue an  
              interim suspension order limiting the ability of a licensee  
              to prescribe controlled substances while under  
              investigation;
              A requirement that the Medical Board impose limitations on  
              a licensee to prescribe controlled substances during an  
              investigation if there is reasonable suspicion that the  
              licensee has either overprescribed drugs or engaged in other  
              behavior relating to prescribing that has resulted in a  
              patient death.

          Related Legislation: 
              SB 62 (Price) would require coroners to report to the  
              Medical Board of California when toxicity from a  
              prescription drug was a contributing factor in a cause of  
              death. That bill will be heard in this committee.
              SB 445 (Price) would prohibit pharmacies from advertising  
              regarding the sale of controlled substances. That bill will  
              be heard in this committee.

          Staff Comments: The bill expands some of the Medical Board's  
          authority to investigate and sanction licensees. According to  
          the Medical Board, the changes in the bill are likely to  
          streamline the investigatory process. For example, by  
          simplifying the process for gaining access to medical records or  
          by requiring licensees under investigation to meet with Medical  
          Board staff earlier in an investigation. Thus, the overall  








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          impact of the bill is likely to be reduced investigation costs.