Amended in Senate June 29, 2015

Amended in Assembly June 2, 2015

Amended in Assembly April 30, 2015

Amended in Assembly April 22, 2015

Amended in Assembly April 16, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 502

Introduced by Assembly Member Chau

February 23, 2015

An act to amend begin insert Section 1925 of, and to add Article 9.1 (commencing with Section 1967) to Chapter 4 of Division 2 of, the Business and Professions Code, and to amend end insert Sections 13401 and 13401.5 of the Corporations begin delete Code, to add Section 1374.196 to the Health and Safety Code, and to add Section 10120.4 to the Insurance Code, end delete begin insert Code, end insert relating to dental hygiene.

LEGISLATIVE COUNSEL’S DIGEST

AB 502, as amended, Chau. Dental hygiene.

begin delete

(1) Existing

end delete

begin insert Existing end insert law, the Dental Practice Act, provides for the licensure and regulation of registered dental hygienists, registered dental hygienists in extended functions, and registered dental hygienists in alternative practice by the Dental Hygiene Committee of California. begin insert Existing law authorizes a registered dental hygienist in alternative practice to practice pursuant to specified provisions of law as, among other things, an independent contractor or an employee of a specified clinic. end insert Existing law, the Moscone-Knox Professional Corporation Act, prohibits a professional corporation from rendering professional services in this state without a currently effective certificate of registration issued by the governmental agency regulating the profession in which the corporation is or proposes to be engaged and excepts any professional corporation rendering professional services by persons duly licensed by specified state entities from that requirement. Existing law authorizes specified healing arts begin delete practitioners end delete begin insert licensees end insert to be shareholders, officers, directors, or professional employees of a designated professional corporation, subject to certain limitations relating to ownership of shares. begin insert However, existing law specifies that it does not limit employment by a designated professional corporation to only those healing arts licensees and authorizes any healing arts licensee to be employed to render professional services by a designated professional corporation. end insert

This bill would additionally except any professional corporation rendering professional services by persons duly licensed by the Dental Hygiene Committee of California from the certificate of registration requirement. The bill would authorize dental assistants and licensed dentists to be shareholders, officers, directors, or professional employees of a registered dental hygienist in alternative practice corporation. begin insert The bill would, in the Dental Practice Act, authorize a registered dental hygienist in alternative practice to practice as an employee of a professional corporation, as specified. The bill would make it unprofessional conduct to violate, attempt to violate, assist in or abet the violation of, or conspire to violate, specified provisions regarding registered dental hygienists in alternative practice corporations, the Moscone-Knox Professional Corporation Act, or any regulations adopted under those laws. The bill would require the bylaws of a registered dental hygienist in alternative practice corporation to include a provision requiring the capital stock of a disqualified or deceased person to be sold to specified parties within a specified period of time. The bill would also require such a corporation to provide security for claims by patients. end insert

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(2) Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law provides certain standards that govern health care service plan contracts covering dental services, health insurance policies covering dental services, specialized health care service plan contracts covering dental services, and specialized health insurance policies covering dental services.

end delete begin delete

This bill would require health care service plan contracts covering dental services, health insurance policies covering dental services, specialized health care service plan contracts covering dental services, and specialized health insurance policies covering dental services issued, amended, or renewed on or after January 1, 2016, to provide specified reimbursement for registered dental hygienists in alternative practice performing dental hygiene services that may lawfully be performed by registered dental hygienists and that are reimbursable under the contracts or policies. The bill would also require the plan or insurer to use the same fee schedule for reimbursing both registered dental hygienists and registered dental hygienists in alternative practice. Because a willful violation of the bill’s provisions by a health care service plan covering dental services or a specialized health care service plan covering dental services would be a crime, it would impose a state-mandated local program.

end delete begin delete

(3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

end delete begin delete

This bill would provide that no reimbursement is required by this act for a specified reason.

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Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program:  begin delete yes end delete begin insert no end insert .

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert

begin insert Section 1925 of the end insert begin insert Business and Professions
Code end insert begin insert is amended to read: end insert

1925.  

A registered dental hygienist in alternative practice may
practice, pursuant to subdivision (a) of Section 1907, subdivision
(a) of Section 1908, subdivisions (a) and (b) of Section 1910,
Section 1910.5, and Section 1926.05 as an employee of a dentist
or of another registered dental hygienist in alternative practice, as
an independent contractor, as a sole proprietor of an alternative
dental hygiene practice, as an employee of a primary care clinic
or specialty clinic that is licensed pursuant to Section 1204 of the
Health and Safety Code, as an employee of a primary care clinic
exempt from licensure pursuant to subdivision (c) of Section 1206
of the Health and Safety Code, as an employee of a clinic owned
or operated by a public hospital or health system, begin delete or end delete as an employee
of a clinic owned and operated by a hospital that maintains the
primary contract with a county government to fill the county’s role
under Section 17000 of the Welfare and Institutions begin delete Code. end delete begin insert Code,
or as an employee of a professional corporation under the
Moscone-Knox Professional Corporation Act (commencing with
Section 13400) of Part 4 of Division 3 of Title 1 of the Corporations
Code. end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Article 9.1 (commencing with Section 1967) is added
to Chapter 4 of end insert begin insert Division 2 of the end insert begin insert Business and Professions Code end insert begin insert ,
to read: end insert

begin insert

 

Article begin insert 9.1. end insert   Registered Dental Hygienist in Alternative Practice
Corporations

 

begin insert 1967. end insert   

A registered dental hygienist in alternative practice
corporation is a professional corporation that is authorized to
render professional services, as defined in Section 13401 of the
Corporations Code, so long as that professional corporation and
its shareholders, officers, directors, and professional employees
rendering professional services are in compliance with the
Moscone-Knox Professional Corporation Act (commencing with
Section 13400) of Part 4 of Division 3 of Title 1 of the Corporations
Code, this article, and all other statutes and regulations now or
hereafter adopted pertaining to the professional corporation and
the conduct of its affairs. With respect to a registered dental
hygienist in alternative practice corporation, the governmental
agency referred to in the Moscone-Knox Professional Corporation
Act is the Dental Hygiene Committee of California.

begin insert 1967.1. end insert   

It shall constitute unprofessional conduct and a
violation of this article for any person licensed under this article
to violate, attempt to violate, directly or indirectly, assist in or
abet the violation of, or conspire to violate any provision or term
of this article, the Moscone-Knox Professional Corporation Act,
or any regulations duly adopted under those laws.

begin insert 1967.2. end insert   

A registered dental hygienist in alternative practice
corporation shall not do or fail to do any act the doing of which
or the failure to do would constitute unprofessional conduct under
any statute or regulation, now or hereafter adopted. In the conduct
of its practice, it shall observe and be bound by such statutes and
regulations to the same extent as a person holding a license under
Article 9 (commencing with Section 1900).

begin insert 1967.3. end insert   

The income of a registered dental hygienist in
alternative practice corporation attributable to professional
services rendered while a shareholder is a disqualified person, as
defined in subdivision (e) of Section 13401 of the Corporations
Code, shall not in any manner accrue to the benefit of such
shareholder or his or her shares in the registered dental hygienist
in alternative practice corporation.

begin insert 1967.4. end insert   

(a) The bylaws of a registered dental hygienist in
alternative practice corporation shall include a provision whereby
the capital stock of the professional corporation owned by a
disqualified person, as defined in subdivision (e) of Section 13401
of the Corporations Code, or a deceased person, shall be sold to
the professional corporation or to the remaining shareholders of
the professional corporation not later than 90 days after
disqualification, if the shareholder becomes a disqualified person,
or not later than six months after death, if the shareholder becomes
deceased.

(b) A registered dental hygienist in alternative practice
corporation shall provide adequate security by insurance or
otherwise for claims against it by its patients arising out of the
rendering of professional services.

end insert

begin delete SECTION 1. end delete
begin insert SEC. 3. end insert   

Section 13401 of the Corporations Code is amended
to read:

13401.  

As used in this part:

(a) “Professional services” means any type of professional
services that may be lawfully rendered only pursuant to a license,
certification, or registration authorized by the Business and
Professions Code, the Chiropractic Act, or the Osteopathic Act.

(b) “Professional corporation” means a corporation organized
under the General Corporation Law or pursuant to subdivision (b)
of Section 13406 that is engaged in rendering professional services
in a single profession, except as otherwise authorized in Section
13401.5, pursuant to a certificate of registration issued by the
governmental agency regulating the profession as herein provided
and that in its practice or business designates itself as a professional
or other corporation as may be required by statute. However, any
professional corporation or foreign professional corporation
rendering professional services by persons duly licensed by the
Medical Board of California or any examining committee under
the jurisdiction of the board, the Osteopathic Medical Board of
California, the Dental Board of California, the Dental Hygiene
Committee of California, the California State Board of Pharmacy,
the Veterinary Medical Board, the California Architects Board,
the Court Reporters Board of California, the Board of Behavioral
Sciences, the Speech-Language Pathology and Audiology Board,
the Board of Registered Nursing, or the State Board of Optometry
shall not be required to obtain a certificate of registration in order
to render those professional services.

(c) “Foreign professional corporation” means a corporation
organized under the laws of a state of the United States other than
this state that is engaged in a profession of a type for which there
is authorization in the Business and Professions Code for the
performance of professional services by a foreign professional
corporation.

(d) “Licensed person” means any natural person who is duly
licensed under the provisions of the Business and Professions
Code, the Chiropractic Act, or the Osteopathic Act to render the
same professional services as are or will be rendered by the
professional corporation or foreign professional corporation of
which he or she is, or intends to become, an officer, director,
shareholder, or employee.

(e) “Disqualified person” means a licensed person who for any
reason becomes legally disqualified (temporarily or permanently)
to render the professional services that the particular professional
corporation or foreign professional corporation of which he or she
is an officer, director, shareholder, or employee is or was rendering.

begin delete SEC. 2. end delete
begin insert SEC. 4. end insert   

Section 13401.5 of the Corporations Code is amended
to read:

13401.5.  

Notwithstanding subdivision (d) of Section 13401
and any other provision of law, the following licensed persons
may be shareholders, officers, directors, or professional employees
of the professional corporations designated in this section so long
as the sum of all shares owned by those licensed persons does not
exceed 49 percent of the total number of shares of the professional
corporation so designated herein, and so long as the number of
those licensed persons owning shares in the professional
corporation so designated herein does not exceed the number of
persons licensed by the governmental agency regulating the
designated professional corporation. This section does not limit
employment by a professional corporation designated in this section
to only those licensed professionals listed under each subdivision.
Any person duly licensed under Division 2 (commencing with
Section 500) of the Business and Professions Code, the
Chiropractic Act, or the Osteopathic Act may be employed to
render professional services by a professional corporation
designated in this section.

(a) Medical corporation.

(1) Licensed doctors of podiatric medicine.

(2) Licensed psychologists.

(3) Registered nurses.

(4) Licensed optometrists.

(5) Licensed marriage and family therapists.

(6) Licensed clinical social workers.

(7) Licensed physician assistants.

(8) Licensed chiropractors.

(9) Licensed acupuncturists.

(10) Naturopathic doctors.

(11) Licensed professional clinical counselors.

(12) Licensed physical therapists.

(b) Podiatric medical corporation.

(1) Licensed physicians and surgeons.

(2) Licensed psychologists.

(3) Registered nurses.

(4) Licensed optometrists.

(5) Licensed chiropractors.

(6) Licensed acupuncturists.

(7) Naturopathic doctors.

(8) Licensed physical therapists.

(c) Psychological corporation.

(1) Licensed physicians and surgeons.

(2) Licensed doctors of podiatric medicine.

(3) Registered nurses.

(4) Licensed optometrists.

(5) Licensed marriage and family therapists.

(6) Licensed clinical social workers.

(7) Licensed chiropractors.

(8) Licensed acupuncturists.

(9) Naturopathic doctors.

(10) Licensed professional clinical counselors.

(d) Speech-language pathology corporation.

(1) Licensed audiologists.

(e) Audiology corporation.

(1) Licensed speech-language pathologists.

(f) Nursing corporation.

(1) Licensed physicians and surgeons.

(2) Licensed doctors of podiatric medicine.

(3) Licensed psychologists.

(4) Licensed optometrists.

(5) Licensed marriage and family therapists.

(6) Licensed clinical social workers.

(7) Licensed physician assistants.

(8) Licensed chiropractors.

(9) Licensed acupuncturists.

(10) Naturopathic doctors.

(11) Licensed professional clinical counselors.

(g) Marriage and family therapist corporation.

(1) Licensed physicians and surgeons.

(2) Licensed psychologists.

(3) Licensed clinical social workers.

(4) Registered nurses.

(5) Licensed chiropractors.

(6) Licensed acupuncturists.

(7) Naturopathic doctors.

(8) Licensed professional clinical counselors.

(h) Licensed clinical social worker corporation.

(1) Licensed physicians and surgeons.

(2) Licensed psychologists.

(3) Licensed marriage and family therapists.

(4) Registered nurses.

(5) Licensed chiropractors.

(6) Licensed acupuncturists.

(7) Naturopathic doctors.

(8) Licensed professional clinical counselors.

(i) Physician assistants corporation.

(1) Licensed physicians and surgeons.

(2) Registered nurses.

(3) Licensed acupuncturists.

(4) Naturopathic doctors.

(j) Optometric corporation.

(1) Licensed physicians and surgeons.

(2) Licensed doctors of podiatric medicine.

(3) Licensed psychologists.

(4) Registered nurses.

(5) Licensed chiropractors.

(6) Licensed acupuncturists.

(7) Naturopathic doctors.

(k) Chiropractic corporation.

(1) Licensed physicians and surgeons.

(2) Licensed doctors of podiatric medicine.

(3) Licensed psychologists.

(4) Registered nurses.

(5) Licensed optometrists.

(6) Licensed marriage and family therapists.

(7) Licensed clinical social workers.

(8) Licensed acupuncturists.

(9) Naturopathic doctors.

(10) Licensed professional clinical counselors.

(l) Acupuncture corporation.

(1) Licensed physicians and surgeons.

(2) Licensed doctors of podiatric medicine.

(3) Licensed psychologists.

(4) Registered nurses.

(5) Licensed optometrists.

(6) Licensed marriage and family therapists.

(7) Licensed clinical social workers.

(8) Licensed physician assistants.

(9) Licensed chiropractors.

(10) Naturopathic doctors.

(11) Licensed professional clinical counselors.

(m) Naturopathic doctor corporation.

(1) Licensed physicians and surgeons.

(2) Licensed psychologists.

(3) Registered nurses.

(4) Licensed physician assistants.

(5) Licensed chiropractors.

(6) Licensed acupuncturists.

(7) Licensed physical therapists.

(8) Licensed doctors of podiatric medicine.

(9) Licensed marriage and family therapists.

(10) Licensed clinical social workers.

(11) Licensed optometrists.

(12) Licensed professional clinical counselors.

(n) Dental corporation.

(1) Licensed physicians and surgeons.

(2) Dental assistants.

(3) Registered dental assistants.

(4) Registered dental assistants in extended functions.

(5) Registered dental hygienists.

(6) Registered dental hygienists in extended functions.

(7) Registered dental hygienists in alternative practice.

(o) Professional clinical counselor corporation.

(1) Licensed physicians and surgeons.

(2) Licensed psychologists.

(3) Licensed clinical social workers.

(4) Licensed marriage and family therapists.

(5) Registered nurses.

(6) Licensed chiropractors.

(7) Licensed acupuncturists.

(8) Naturopathic doctors.

(p) Physical therapy corporation.

(1) Licensed physicians and surgeons.

(2) Licensed doctors of podiatric medicine.

(3) Licensed acupuncturists.

(4) Naturopathic doctors.

(5) Licensed occupational therapists.

(6) Licensed speech-language therapists.

(7) Licensed audiologists.

(8) Registered nurses.

(9) Licensed psychologists.

(10) Licensed physician assistants.

(q) Registered dental hygienist in alternative practice
corporation.

(1) Dental assistants.

(2) Licensed dentists.

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SEC. 3.  

Section 1374.196 is added to the Health and Safety
Code, to read:

1374.196.  

(a) This section shall only apply to a health care
service plan contract covering dental services or a specialized
health care service plan contract covering dental services issued,
amended, or renewed on or after January 1, 2016.

(b) A registered dental hygienist in alternative practice, licensed
pursuant to Section 1922 of the Business and Professions Code,
may submit or allow to be submitted on his or her behalf any claim
for dental hygiene services performed as authorized pursuant to
Article 9 (commencing with Section 1900) of Chapter 4 of Division
2 of the Business and Professions Code to a health care service
plan covering dental services or a specialized health care service
plan covering dental services.

(c) If a health care service plan contract covering dental services
or a specialized health care service plan contract covering dental
services provides reimbursement for dental hygiene services that
may lawfully be performed by a registered dental hygienist,
licensed pursuant to Section 1917 of the Business and Professions
Code, reimbursement under that plan contract to a contracted
provider, or to an enrollee if out-of-network services are covered,
shall not be denied when the service is performed by a registered
dental hygienist in alternative practice.

(d) (1) Nothing in this section shall preclude a health care
service plan contract covering dental services or a specialized
health care service plan contract covering dental services from
setting different fee schedules for different services provided by
different providers.

(2) A health care service plan contract covering dental services
or a specialized health care service plan contract covering dental
services shall use the same fee schedule for dental hygiene services
whether the services are performed by a registered dental hygienist
or a registered dental hygienist in alternative practice.

SEC. 4.  

Section 10120.4 is added to the Insurance Code, to
read:

10120.4.  

(a) This section shall only apply to a health insurance
policy covering dental services or a specialized health insurance
policy covering dental services issued, amended, or renewed on
or after January 1, 2016.

(b) A registered dental hygienist in alternative practice, licensed
pursuant to Section 1922 of the Business and Professions Code,
may submit or allow to be submitted on his or her behalf any claim
for dental hygiene services performed as authorized pursuant to
Article 9 (commencing with Section 1900) of Chapter 4 of Division
2 of the Business and Professions Code to a health insurer covering
dental services or a specialized health insurer covering dental
services.

(c) If a health insurance policy covering dental services or a
specialized health insurance policy covering dental services
provides for reimbursement for dental hygiene services that may
lawfully be performed by a registered dental hygienist, licensed
pursuant to Section 1917 of the Business and Professions Code,
reimbursement under that policy to a contracted provider, or to an
insured if out-of-network services are covered, shall not be denied
when the service is performed by a registered dental hygienist in
alternative practice.

(d) (1) Nothing in this section shall preclude a health insurance
policy covering dental services or a specialized health insurance
policy covering dental services from setting different fee schedules
for different services provided by different providers.

(2) A health insurance policy covering dental services or a
specialized health insurance policy covering dental services shall
use the same fee schedule for dental hygiene services whether the
services are performed by a registered dental hygienist or a
registered dental hygienist in alternative practice.

SEC. 5.  

No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.

end delete