BILL ANALYSIS �
SB 670
Page 1
SENATE THIRD READING
SB 670 (Steinberg)
As Amended September 11, 2013
Majority vote
SENATE VOTE :35-3
BUSINESS & PROFESSIONS 11-0
-----------------------------------------------------------------
|Ayes:|Bonilla, Jones, | | |
| |Bocanegra, Campos, | | |
| |Dickinson, Eggman, | | |
| |Gordon, Hagman, Holden, | | |
| |Skinner, Ting | | |
| | | | |
-----------------------------------------------------------------
SUMMARY : Authorizes the Medical Board of California (MBC) to
inspect and copy a deceased patient's medical records, clarifies
language relating to unprofessional conduct, and permits an
interim suspension order (ISO) to place restrictions on a
physician's prescribing privileges, as specified. Specifically,
this bill :
1)Permits MBC to inspect and copy the medical records of a
deceased patient, in any investigation that involves the death
of that patient, without the authorization of the beneficiary
or personal representative of the deceased patient, or a court
order solely for the purpose of determining the extent to
which the death was the result of the physician and surgeon's
conduct in violation of the Medical Practice Act (Act), if MBC
provides a written request to the physician and surgeon that
includes a declaration that MBC has been unsuccessful in
locating or contacting the deceased patient's beneficiary or
personal representative after reasonable efforts.
2)Prohibits MBC from inspecting a deceased patient's medical
records without a court order when the beneficiary or personal
representative of the deceased patient has been located and
contacted, but has refused to consent to MBC inspecting and
copying the medical records.
3)States that the repeated failure by a physician and surgeon
who is the subject of an investigation by MBC, in the absence
SB 670
Page 2
of good cause, to attend and participate in an interview
scheduled by MBC is unprofessional conduct.
4)Permits an administrative law judge (ALJ) of the Medical
Quality Hearing Panel to issue an ISO limiting the authority
of a physician and surgeon to prescribe, furnish, administer
or dispense controlled substances.
5)Makes technical and clarifying changes.
6)Makes legislative findings and declarations that the authority
created in MBC to inspect a deceased's records according to
this bill, and a physician and surgeon's compliance with that
request, are consistent with the public interest and benefit
activities of the federal Health Insurance Portability and
Accountability Act.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, MBC may experience some minor costs associated with
use of the tools allowed in this bill, as well as some level of
increased efficiency in investigation and enforcement; however,
it is unlikely to impact the number of cases or total workload
significantly.
COMMENTS :
1)Purpose of this bill . This bill clarifies MBC's authority to
limit a physician and surgeon's prescribing authority within
the ISO process. This bill would allow MBC to inspect and
copy the medical records of a deceased patient if a patient's
representative can't be found, and declare that the repeated
failure for a physician to attend a physician interview, as
part of an investigation, is unprofessional conduct. The
author intends to amend this bill to delete controversial
provisions that would have given MBC the ability to limit
physician and surgeon's prescribing ability outside the ISO
process. This bill is author-sponsored.
2)Physician interviews . MBC reports that current statutory
requirements are too lax and do not encourage physicians to
attend mandatory investigatory interviews in a timely fashion.
This bill eliminates the "mutual agreement" provision that
requires MBC and the physician to jointly determine a meeting
time. This bill states that the repeated failure of a
SB 670
Page 3
physician under investigation to attend and participate in an
interview scheduled by MBC, in the absence of good cause, is
unprofessional conduct.
3)Deceased patient records . According to MBC, if it is
investigating a physician whose patient has died, MBC must
receive written authorization from the patient's next of kin
in order to obtain the patient's medical records. However,
the next of kin may not be found, and MBC still needs those
medical records to determine if a physician is prescribing
appropriately.
This bill would allow MBC to inspect and copy a deceased
patient's medical records if MBC provides a written request to
the physician and surgeon that includes a declaration that MBC
has been unsuccessful in locating or contacting the deceased
patient's beneficiary or personal representative after
reasonable efforts. MBC would be prohibited from inspecting
and copying those records if the beneficiary or personal
representative refuses authorization.
4)Interim Suspension Orders (ISO) . The ISO process was created
in 1990 to allow MBC to immediately halt the practice of very
dangerous physicians in egregious cases. An ISO is a broad
instrument of enforcement that can impose conditions as minor
as a drug test or as major as the suspension of a physician's
license to practice medicine.
Existing law authorizes an ALJ of the Medical Quality Hearing
Panel within the Office of Administrative Law to issue an
order to suspend for an interim period (an ISO) a physician's
license, impose drug testing, require continuing education or
supervision of procedures, or other license restrictions.
However, according to MBC, an ISO may only restrict a
physician's prescribing abilities if the physician is already
under probation and prescribing limits are part of the terms
and conditions of that probation.
To obtain an ISO against a physician, MBC must present
affidavits in support of the ISO to the ALJ showing that the
physician has, or is about to, violate the Medical Practice
Act or that the physician is unable to practice safely due to
a mental or physical condition, and that permitting the
physician to continue practice will endanger the public
SB 670
Page 4
health, safety, or welfare. It is at the ALJ's discretion to
issue the ISO as requested by MBC, and ALJs have the authority
to deny or alter the requested ISO.
This bill would permit an ISO to limit a physician's authority
to prescribe, furnish, administer, or dispense controlled
substances without those limitations being a condition of a
physician's probation.
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301
FN: 0002796