BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: SB 1261 Hearing Date: April 18,
2016
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|Author: |Stone |
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|Version: |February 18, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Huchel |
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Subject: Physicians and surgeons: licensure exemption
SUMMARY: Authorizes physicians licensed out of state to work in
California free clinics for up to 60 days a year, as specified.
Existing law:
1) Establishes the Medical Board of California (MBC), to
regulate the practice of medicine in California. (Business
and Professions Code (BPC) § 2000 et seq.)
2) Establishes the Osteopathic Medical Board (OMBC) to enforce
provisions of law related to osteopathic physicians and
surgeons. (BPC § 2450)
3) Provides that a physician and surgeon who practices or
attempts to practice medicine in California without a license
or certificate is guilty of a public offense punishable by a
fine not exceeding $10,000, by imprisonment, or by both fine
and imprisonment. (BPC § 2052)
4)Exempts health care practitioners licensed in another state or
territory from California licensure during a state of
emergency, as specified. (BPC § 900)
5)Authorizes the MBC and the OMBC to establish reciprocity
provisions for those individuals holding an unlimited license
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to practice osteopathic medicine in another state, as
specified. (BPC §§ 2135, 2153.5)
6) Exempts from California licensure, until January 1, 2018, out
of state health care practitioners who voluntarily
participate in "sponsored events" for uninsured or
underinsured individuals for no more than ten calendar days,
as specified.
(BPC § 901)
This bill:
1) Defines "board" as the MBC.
2) Defines a "free clinic" as a clinic operated by a
tax-exempt, nonprofit corporation supported in whole or in
part by voluntary donations, bequests, gifts, grants,
government funds or contributions, that may be in the form of
money, goods, or services. In a free clinic there shall be no
charges directly to the patient for services rendered or for
drugs, medicines, appliances, or apparatuses furnished.
3)Defines a "uninsured or underinsured person" as a person who
does not have health care coverage, including private coverage
or coverage through a program funded in whole or in part by a
governmental entity, or a person who has health care coverage,
but the coverage is not adequate to obtain those health care
services offered by the physician.
4)Exempts a physician who offers or provides health care
services at a free clinic from California licensure if all of
the following are met:
a) The physician obtains authorization from the MBC to
participate in a free clinic after submitting a copy of his
or her valid license or certificate from each state in
which he or she holds licensure or certification and a
photographic identification. The MBC shall notify the free
clinic, within 20 calendar days of receiving a request for
authorization, whether that request is approved or denied.
b) The physician has not committed any act or been
convicted of a crime constituting grounds for denial of
licensure or registration, as specified, and is in good
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standing in each state in which he or she holds licensure
or certification.
c) The physician has the appropriate education and
experience to participate in a free clinic, as determined
by the MBC.
d) The physician agrees to comply with all applicable
California practice requirements.
e) The services are provided under all of the following
circumstances:
i) To uninsured or underinsured persons;
ii) On voluntary basis, for a total of days not to
exceed 60 days in a calendar year. The 60 days need not
be consecutive.
iii) In association with a free clinic enrolled in the
Medi-Cal program.
iv) Without charge to the recipient or to a third party
on behalf of the recipient.
5)Requires the free clinic seeking to provide, or arrange for
the provision of, health care services under this section to
register with the MBC and the county health department of the
county in which the health care services were provided, as
specified.
6)Requires the free clinic to maintain a list of physicians
associated with the provision of health care services and
maintain a copy of each physician's current license or
certification and to require each physician to attest in
writing that his or her license or certificate is not
suspended or revoked pursuant to disciplinary proceedings in
any jurisdiction.
7)Prohibits a contract of liability insurance issued, amended,
or renewed in this state on or after January 1, 2017, from
excluding coverage of a physician or a free clinic that
provides, or arranges for the provision of, health care
services, provided that the practitioner or free clinic
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complies with current law.
8)Authorizes the MBC to terminate authorization for a physician
to provide health care services for failure to comply with the
law, as specified, and provides for an appeals process for the
physician.
9)States that the provisions of this law are severable, and that
if any provision of this bill or its application is held
invalid, that invalidity shall not affect other provisions or
applications that can be given effect without the invalid
provision or application.
FISCAL
EFFECT: Unknown. This bill is keyed "fiscal" by the
Legislative Counsel.
COMMENTS:
1. Purpose. This bill is sponsored by the Author. According to
the Author, "Currently, it is prohibited for a licensed out
of state doctor to practice medicine in California for an
extended period of time. In parts of the state like Palm
Springs, many semi-retired doctors flock to the region during
the winter time. According to many of the health clinics in
that region, they receive numerous requests for doctors
looking to volunteer.
The current law limits out of state doctors to only practice
at specified events when in California. There is currently a
shortage of doctors practicing at these clinics across
California. It is good public policy to allow licensed
doctors, who are in good standing in their own state but are
visiting California, to volunteer and help alleviate that
shortage."
2. Background. This bill is modeled after current law which
exempts a broad range of health care practitioners from
California licensure requirements to participate in free
sponsored healthcare events for up to ten days. The
authorizing bill, AB 2699 (Bass, Chapter 270, Statutes of
2010), was enacted to facilitate programs provided by such
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entities as Remote Area Medical Volunteer Corps and CareNow,
which provide multi-day health fairs that provide services
for thousands of un- and underinsured individuals.
If the Author's office is concerned about the lack of primary
care services for un- and underinsured individuals, the
Author may consider instead exploring other ways to advance
practice opportunities for currently licensed California
healthcare providers without compromising state oversight for
our most vulnerable populations.
3. Prior Legislation. AB 512 (Rendon, Chapter 111, Statutes of
2013) extended the sunset date, from January 2014, to January
2018, on existing law permitting qualified, out-of-state
health care practitioners to volunteer their services on a
limited basis at health care events designed to provide free
services for underinsured and uninsured individuals in
California.
AB 2699 (Bass, Chapter 270, Statutes of 2010) exempted from
state licensure, until January 1, 2014, specified health care
practitioners who are licensed or certified in other states
and who provide health care services on a voluntary basis to
uninsured or underinsured persons in California, as
specified.
4. Policy Considerations . This bill exempts only physicians and
surgeons from California licensure requirements for the
purpose of serving in free clinics. The Author's office did
not clarify why other healthcare licensees, especially other
primary care providers such as nurse practitioners and
physicians assistants, are not included. Justification for
the exemption also lacks basic evidence of necessity,
explanation for 60 days of unlicensed practice, how many
clinics may be affected, and whether the licensing boards
affected, which should also include the OMBC, are in favor of
such a change.
SUPPORT AND OPPOSITION:
Support: None on file as of April 12, 2016.
Opposition: None on file as of April 12, 2016.
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