BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 646
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          Date of Hearing:   April 21, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
                    AB 646 (Swanson) - As Amended:  April 13, 2009
           
          SUBJECT  :   Physicians and surgeons:  employment.

           SUMMARY  :   Permits health care districts (districts) and certain  
          public hospitals, independent community nonprofit hospitals, and  
          clinics, as specified, to directly employ physicians and  
          surgeons.  Specifically, this bill  :  

          1)Permits a district to directly employ, and charge for  
            professional services rendered by, a physician and surgeon  
            with the approval of the physician and surgeon.  

          2)Permits a public or an independent community nonprofit  
            hospital or clinic located in a medically underserved area, or  
            an area where unmet priority needs for physicians and surgeons  
            exist, with a patient census that consists of more than 50%  
            medically underserved populations, to employ physicians and  
            surgeons, and to charge for professional services rendered by  
            a physician and surgeon, with the approval of the physician  
            and surgeon.

          3)Prohibits a district, a public or an independent community  
            nonprofit hospital or clinic from interfering with,  
            controlling, or otherwise directing a physician and surgeon's  
            professional judgment.  

          4)Deletes the 2003 pilot project permitting certain hospitals to  
            directly employ physicians and surgeons, as specified.

           EXISTING LAW  :

          1)Prohibits corporations and other artificial legal entities  
            from having any professional rights, privileges, or powers  
            (known as the "prohibition against the corporate practice of  
            medicine (CPM)"), and further provides that the Division of  
            Licensing of the Medical Board of California (MBC) may,  
            pursuant to regulations it has adopted, grant approval for the  
            employment of physicians on a salaried basis by a licensed  
            charitable institution, foundation, or clinic if no charge for  
            professional services rendered to patients is made by that  








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            institution, foundation, or clinic.

          2)Exempts medical or podiatry professional corporations  
            organized and practicing pursuant to the Moscone-Knox  
            Professional Corporations Act from the CPM prohibition,  
            providing that a majority of the owners or shareholders of the  
            corporation are licensed physicians or podiatrists,  
            respectively.

          3)Provides certain additional exceptions to the prohibition  
            against CPM.

          4)Authorizes until January 1, 2011, a pilot project to allow  
            qualified district hospitals, as defined, to employ a  
            physician, if the hospital does not interfere with, control,  
            or otherwise direct the professional judgment of the  
            physician.  To qualify for the project, a district hospital  
            must:  be in a county with population of 750,000 or less; have  
            reported net losses in 2000-01; and, have at least 50% of  
            combined patient days from Medicare, Medi-Cal and uninsured  
            patients.

          5)Permits the establishment of local health care districts to  
            provide health care services and authorizes health care  
            districts to establish, maintain, and operate, or provide  
            assistance in the operation of, one or more health facilities  
            or health services, including, but not limited to, outpatient  
            programs, services, and facilities; retirement programs,  
            services, and facilities; chemical dependency programs,  
            services, and facilities; or other health care programs,  
            services, facilities and activities at any location within or  
            without the district for the benefit of the district and the  
            people served by the district.

           FISCAL EFFECT  :   Unknown.  This bill is keyed non-fiscal.

           COMMENTS  :   

           Purpose of this bill  .  According to the author's office, "Many  
          California communities have suffered from a chronic, severe  
          shortage of doctors for over a decade.  This shortage is worst  
          in California's rural and underserved inner-city areas where  
          Medi-Cal and Medicare are the primary "payors" for health care  
          services.  In many of our communities, doctors cannot support  
          themselves financially in independent practice.  The majority of  








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          doctors in California do not accept Medi-Cal patients.  This  
          makes it extremely difficult for rural and inner city  
          communities to attract and keep the doctors their residents  
          need.  Many physicians now working in these communities are  
          planning to retire within the next two to three years.   
          Residents in these communities are often unable to get access to  
          the medical care they need, or must travel hundreds of miles  
          from home in order to get it.

          "This proposal, jointly sponsored by AFSCME, ACHD, and UAPD,  
          will empower all 75 of California's Health Care Districts, as  
          well as all nonprofit hospitals and clinics in Health  
          Professional Shortage Areas, to recruit and keep the doctors  
          their communities need to provide care to Medi-Cal patients and  
          the uninsured.  It would do so by allowing physician employers  
          to provide doctors with the financial security they need to stay  
          in our communities."

           Background  .  The corporate practice of medicine (CPM) is  
          typically referred to in the context of a prohibition, banning  
          hospitals from employing physicians.  CPM evolved in the early  
          20th century when mining companies had to hire physicians  
          directly to provide care for their employees in remote areas.   
          However, problems arose when physicians' loyalty to the mining  
          companies conflicted with patients' needs.  Eventually,  
          physicians, courts, and legislatures prohibited CPM in an effort  
          to preserve physicians' autonomy and improve patient care.

          California's 75 health care districts (HCDs) are voter-created  
          local government entities governed by publicly elected boards of  
          trustees.  HCDs currently operate 46 of California's 72 public  
          hospitals, providing health care services to over 2 million  
          Californians annually.  HCDs are subject to California's CPM  
          prohibition.  This bill would enable 46 HCD hospitals and  
          approximately 130 other public, independent community nonprofit  
          hospitals and clinics to hire physicians directly.   

          Advocates argue that physician recruitment is essential to the  
          continued existence of HCDs.  According to a 2007 California  
          Medical Association report, the average age of physicians in the  
          rural and underserved urban communities is approaching 60, with  
          many of those planning to retire in the next two years.   
          Co-sponsors of this bill, the Association of California  
          Healthcare Districts (ACHD) reports that, "In their struggle to  
          recruit and keep physicians, rural and underserved urban  








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          communities in California must compete with large physician  
          groups, Kaiser, the state Department of Corrections, rural  
          hospitals in almost every other state in the nation as well as  
          other entities that may directly employ physicians."  

          Proponents of the bill argue that exempting HCDs from the CPM  
          ban will enable them to attract physicians by absorbing all of  
          the overhead and administrative duties of establishing a medical  
          practice, and providing a stable, competitive salary.

          Opponents argue that the bar on CPM is an important public  
          policy provision to ensure physician independence and the  
          ability to practice in the patient's best interests.  Some argue  
          that the difficulty in recruiting physicians in some parts of  
          California is more likely the result of declining reimbursement  
          than physicians' employment status.  This decline in  
          reimbursement is driven by the increased market dominance of  
          large health care plans and insurers, which would in no way be  
          affected by this bill.   

          SB 326 (Chesbro) Chapter 411, Statutes of 2003, established a  
          pilot project permitting district hospitals meeting specific  
          requirements to hire and employ up to two physicians each, for a  
          total of 20 physicians statewide, if the district hospital met  
          the following conditions: 

                    operates in a county of 750,000 or less population;
                    reported net operating losses in fiscal year 2000-01;  
                and,
                    has a patient base of at least 50% combined Medi-Cal,  
                Medicare, and uninsured patients.  

          SB 326 required the Medical Board of California (MBC) to  
          administer and evaluate the project prior to its sunset on  
          January 1, 2011.  In its 2008 report, the MBC stated that it was  
          "challenged in evaluating the program and preparing this report  
          because the low number of participants did not afford us  
          sufficient information to prepare a valid analysis of the pilot.  
          ?[W]hile the Board supports the ban on the corporate practice of  
          medicine, it also believes there may be justification to extend  
          the pilot so that a better evaluation can be made. 

          "However, until there is sufficient data to perform a full  
          analysis of an expanded pilot, the Board
          contends that the statutes governing the corporate practice of  








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          medicine should not be amended
          as a solution to solve the problem of access to healthcare."

          This bill is not consistent with the MBC report because it  
          permanently repeals the ban on the corporate practice of  
          medicine in districts, certain public hospitals, independent  
          community nonprofit hospitals, and clinics.

           Arguments in support  .  The sponsors, American Federation of  
          State, County and Municipal Employees (AFSCME), AFL-CIO, state,  
          "Due to the large number of uninsured and underinsured  
          Californians, a number of California communities are  
          experiencing difficulty recruiting and retaining physicians and  
          surgeons.  In particular, the rural and underserved urban  
          communities served by California's Health Care Districts suffer  
          from a long-standing shortage of doctors?.  In order to recruit  
          professionals to provide medically necessary services in these  
          communities, many district hospitals must directly employ them  
          in order to provide adequate economic security?.

          "All Californians should have the right to accessible medical  
          facilities and qualified medical professionals in the areas in  
          which they live.  Assembly Bill 646 will better enable district  
          hospitals across the state to guarantee this right, while  
          assuring patients that the professional judgment of their  
          physicians and surgeons will not be influenced by the district  
          hospital."

           Arguments in opposition  .  The California Medical Association  
          writes, "The bar against the corporate practice of medicine has  
          been in place in California since 1938 and has been protected by  
          the courts and the legislature since.  The bar provides a  
          fundamental protection for patients by ensuring their  
          physicians' sole interest is what is best for the patient.  When  
          hospitals are allowed to directly employ and charge for  
          physician services, quality of care suffers due to the fact that  
          hospitals derive income from patient beds being filled?.

          "Hospital employment of physicians eliminates competition for  
          outpatient services and instead forces all care to be delivered  
          through the hospital.  As hospitals gain market share in small  
          communities, physicians not employed will likely be forced out  
          of business.  This results in increased costs as the hospital is  
          able to negotiate higher rates from third party payers for both  
          physician and hospital services."








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           Related legislation  .  AB 648 (Chesbro) of 2009 would allow rural  
          hospitals, as specified, to directly employ physicians and  
          surgeons.  This bill is pending in the Assembly Business and  
          Professions Committee.

           Prior legislation  .  AB 1944 (Swanson) of 2008 was a similar bill  
          that would allow health care districts to employ a physician and  
          surgeon. This bill died in Senate Health Committee. 

          SB 1294 (Ducheny) of 2008 would have expanded the pilot project  
          enabling HCDs to directly employ physicians.  This bill failed  
          passage in the Assembly Appropriations Committee. 

          SB 1640 (Ashburn) of 2008 would have expanded the pilot project  
          to enable general acute care hospitals to directly employ  
          physicians.  This bill failed passage in the Assembly Business  
          and Professions Committee. 

           Double referred  .  This bill is double-referred to the Assembly  
          Health Committee.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          American Federation of State, County and Municipal Employees  
          (AFSCME), AFL-CIO (co-sponsor)
          Association of California Healthcare Districts (co-sponsor)
          Union of American Physicians and Dentists (UAPD/AFSCME)  
          (co-sponsor)
          Congress of California Seniors
          Regional Council of Rural Counties
          Numerous individuals

           

          Opposition 
           
          California Medical Association
          California Society of Pathologists 
           

          Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301  









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