BILL ANALYSIS
AB 1235
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1235 (Hayashi)
As Amended February 16, 2010
Majority vote
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|ASSEMBLY: | |(June 1, 2009) |SENATE: | |(August 18, |
| | | | |33-0 |2010) |
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(vote not relevant)
Original Committee Reference: L. & E.
SUMMARY : Amends the medical peer review process by recommending
external peer review in limited circumstances, requires peer
review bodies to share information, establishes the duties of a
hearing officer, and sets parameters for attorney
representation.
The Senate amendments delete the Senate version of the bill, and
instead:
1)Find and declare that it is essential that California's peer
review system generate a culture of trust and safety so that
health care practitioners will participate robustly in the
process by engaging in critically important safety activities,
such as reporting incidents they believe to reflect
substandard care or unprofessional conduct and serving on peer
review, quality assurance, and other committees necessary to
protect patients.
2)Indicate that to ensure that the peer review process is not
circumvented, prohibits requiring a member of a medical or
professional staff, by contract or otherwise, from altering or
surrendering staff privileges, status, or membership solely
due to the termination of a contract between that member and a
health care facility.
3)State that with respect to services that may only be provided
by members who have, or who are members of a medical group
that has, a current exclusive contract for those identified
services, termination of the contract or termination of the
member's employment by the medical group holding the contract,
may result in the member's ineligibility to provide the
services covered by the contract.
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4)Entitle a peer review body of a health care facility to review
and make timely recommendations to the governing body of the
facility and its designee regarding quality considerations
relating to clinical services whenever the selection,
performance evaluation, or any change in the retention or
replacement of licentiates with whom the health care facility
has a contract occurs. Require the governing body to give
great weight to the recommendations.
5)State that it is the policy of the state that in certain
limited circumstances, external peer review may be necessary
to promote and protect patient care in order to eliminate
perceived bias, obtain needed medical expertise, or respond to
other particular circumstances.
6)Encourage a peer review body to obtain external peer review
for the evaluation or investigation of an applicant,
privilegeholder, or member of the medical staff in the
following circumstances:
a) Committee or department reviews that could affect a
licentiate's membership or privileges do not provide a
sufficiently clear basis for action or inaction;
b) No current medical staff member can provide the
necessary expertise in the clinical procedure or area under
review; and,
c) To promote impartial peer review.
7)Define external peer review as peer review provided by
licentiates who do not practice in the same health care
facility as the licentiate under review, who are impartial,
and who have the necessary expertise in the clinical procedure
or area under review.
8)Require a peer review body, upon receipt of reasonable copying
and processing costs, to respond to the request of another
peer review body and produce the records reasonably requested
concerning a licentiate under review to the extent not
otherwise prohibited by state or federal law.
9)Provide that the responding peer review body has the
discretion whether to produce minutes from peer review body
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meetings.
10)State that the records produced by a peer review body
pursuant to this provision will be used solely for peer review
purposes and not subject to discovery, as specified.
11)Entitle the peer review body responding to the request all
confidentiality protections and privileges provided by law as
to the information and records disclosed pursuant to this
provision.
12)State that a licentiate under review by a peer review body
requesting records must release the responding peer review,
its members, and the health care entity for which the
responding peer review body conducts peer review, from
liability for the disclosure of records, and the contents of
the records, as specified.
13)Provide that if a licentiate does not provide a reasonable
release that is acceptable to the responding peer review body,
the responding peer review body is not obligated to produce
records.
14)Require a hearing officer to:
a) Disclose all actual and potential conflicts of interest
within the last five years reasonably known to the hearing
officer;
b) Be an attorney licensed to practice law in the State of
California. This provision does not apply to a hearing
held before a panel of dental professional peer review
body;
c) States that unless agreed by the parties, an attorney
from a firm utilized by the hospital, the medical staff, or
the involved licentiate within the preceding two years is
not eligible to serve as a hearing officer; and,
d) Endeavor to ensure that all parties maintain proper
decorum and have a reasonable opportunity to be heard and
present all relevant oral and documentary evidence.
Entitles the hearing officer to determine the order of, or
procedure for, presenting evidence and argument during the
hearing and have the authority and discretion to make all
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rulings on questions pertaining to matters of law,
procedure, or the admissibility of evidence. Further
requires the hearing officer to take all appropriate steps
to ensure a timely resolution of the hearing, but may not
terminate the hearing process, unless in the case of
flagrant noncompliance with the procedural rules governing
the hearing process or egregious interference with the
orderly conduct of the hearing, the hearing officer may
recommend that the hearing panel terminate the hearing,
provided that this activity is authorized by the applicable
bylaws of the peer review body.
15)Give both parties the right to be represented by an attorney
of the party's choice at the party's expense.
16)Prohibit a peer review body from being represented by an
attorney if the licentiate notifies the peer review body in
writing no later than 15 days prior to the hearing that he or
she has elected not to be represented by an attorney. States
that unless otherwise agreed by the parties, this election is
binding.
17)State that if a licentiate does not provide the written
notice, as specified within the required timeframe, the peer
review body may be represented by an attorney even if the
licentiate later elects not to be represented by an attorney.
18)Make legislative findings and declarations.
AS PASSED BY THE ASSEMBLY , this bill extended, for a hospital
building that is owned or operated by the County of Alameda on
the Alameda County Medical Center's Fairmont Campus, the
deadline for submitting a facility master plan until July 1,
2010.
FISCAL EFFECT : Unknown
COMMENTS : This bill was substantially amended in the Senate and
the Assembly-approved provisions of this bill were deleted.
This bill, as amended in the Senate, is inconsistent with
Assembly actions. The language in this bill is similar to AB
120 (Hayashi), which was vetoed by the Governor.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301
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FN: 0003679