BILL NUMBER: AB 1140 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 14, 2009
INTRODUCED BY Assembly Member Niello
FEBRUARY 27, 2009
An act to amend Section 680 655.8 of
the Business and Professions Code, relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
AB 1140, as amended, Niello. Healing arts.
Diagnostic imaging services.
Existing law prohibits a healing arts practitioner from charging,
billing, or soliciting payment from any patient, client, customer, or
3rd-party payer for performance of the technical component of
specified diagnostic imaging services not rendered by the
practitioner or a person under the practitioner's supervision, as
defined. Existing law also defines a 3rd-party payer as any person or
entity who is responsible to pay for CT, PET, or MRI services
provided to a patient.
This bill would specify that a 3rd-party payer includes, but is
not limited to, a person or entity who contracts with insurance
carriers, self-insured employers, 3rd-party administrators, or any
other person or entity who, pursuant to a contract, is responsible to
pay for CT, PET, or MRI services.
Existing law requires a health care practitioner, as defined, to
disclose, while working, his or her name and license status on a
specified name tag. However, existing law exempts from this
requirement a health care practitioner, in a practice or office,
whose license is prominently displayed.
This bill would make a nonsubstantive, technical change to these
provisions.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 655.8 of the
Business and Professions Code is amended to read:
655.8. (a) It is unlawful for any person licensed under this
division or under any initiative act referred to in this division to
charge, bill, or otherwise solicit payment from any patient, client,
customer, or third-party payer for performance of the technical
component of Computerized Tomography (CT), Positron Emission
Tomography (PET), or Magnetic Resonance Imaging (MRI) diagnostic
imaging services if those services were not actually rendered by the
licensee or a person under his or her supervision.
(b) Radiological facilities or imaging centers performing the
technical component of CT, PET, or MRI diagnostic imaging services
shall directly bill either the patient or the responsible third-party
payer for such services rendered by those facilities. Radiological
facilities or imaging centers shall not bill the licensee who
requests the services.
(c) This section shall not apply to any of the following:
(1) Any person who, or radiological facility or imaging center
that, contracts directly with a health care service plan licensed
pursuant to Chapter 2.2 (commencing with Section 1340) of Division 2
of the Health and Safety Code.
(2) Any person who, or clinic that, provides diagnostic imaging
services without charge to the patient, or on a sliding scale payment
basis if the patient's charge for services is determined by the
patient's ability to pay.
(3) Health care programs operated by public entities, including,
but not limited to, colleges and universities.
(4) Health care programs operated by private educational
institutions to serve the health care needs of their students.
(5) Any person who, or clinic that, contracts with an employer to
provide medical services to employees of the employer if the
diagnostic imaging services are provided under the contract.
(6) Diagnostic imaging services that are performed within a
physician and surgeon's office, as defined in paragraph (5) of
subdivision (b) of Section 650.01, or the office of a group practice,
as defined in paragraph (6) of subdivision (b) of Section 650.01.
(d) Nothing in this section prohibits a licensee or a physician
entity from billing globally for professional and technical
components if both of the following conditions are met:
(1) Neither the physician, or any member of his or her medical
group, nor the physician entity has ordered the diagnostic imaging
services.
(2) The physician, or a member of his or her medical group, or the
physician entity provides the professional interpretation of the
diagnostic imaging service.
(e) Nothing in subdivision (d) is intended to authorize or permit
an imaging center to engage in the practice of medicine or exercise
other professional rights, privileges, or powers in violation of
Section 2400 of the Business and Professions Code.
(f) For the purposes of this section, the following terms shall
have the following meanings:
(1) "Physician entity" means a professional medical corporation
formed pursuant to Section 2406 or a general partnership that
consists entirely of physicians and surgeons or professional medical
corporations.
(2) "Responsible third-party payer" means any person or entity who
is responsible to pay for CT, PET, or MRI services provided to a
patient , including, but not limited to, a person or entity who
contracts with insurance carriers, self-insured employers,
third-party administrators, or any other person or entity who,
pursuant to a contract, is responsible to pay for CT, PET, or
MRI services provided to a patient covered by that contract .
(3) "Supervision" means that the referring licensee is providing
the level of supervision set forth in paragraph (3) of subsection (b)
of Section 410.32 of Title 42 of the Code of Federal Regulations.
(4) "Technical component" includes services other than those
provided by a physician and surgeon for the CT, PET, or MRI including
personnel, materials, space, equipment, and other facilities.
SECTION 1. Section 680 of the Business and
Professions Code is amended to read:
680. (a) Except as otherwise provided in this section, a health
care practitioner shall disclose, while working, his or her name and
practitioner's license status, as granted by this state, on a name
tag in at least 18-point type. A health care practitioner in a
practice or an office, whose license is prominently displayed, may
opt to not wear a name tag. If a health care practitioner or a
licensed clinical social worker is working in a psychiatric setting
or in a setting that is not licensed by the state, the employing
entity or agency shall have the discretion to make an exception from
the name tag requirement for individual safety or therapeutic
concerns. In the interest of public safety and consumer awareness, it
shall be unlawful for any person to use the title "nurse" in
reference to himself or herself and in any capacity, except for an
individual who is a registered nurse or a licensed vocational nurse,
or as otherwise provided in Section 2800. Nothing in this section
shall prohibit a certified nurse assistant from using his or her
title.
(b) Facilities licensed by the State Department of Social
Services, the State Department of Mental Health, or the State
Department of Public Health shall develop and implement policies to
ensure that health care practitioners providing care in those
facilities are in compliance with subdivision (a). The State
Department of Social Services, the State Department of Mental Health,
and the State Department of Public Health shall verify through
periodic inspections that the policies required pursuant to
subdivision (a) have been developed and implemented by the respective
licensed facilities.
(c) For purposes of this article, "health care practitioner" shall
mean any person who engages in acts that are the subject of
licensure or regulation under this division or under any initiative
act referred to in this division.