BILL ANALYSIS
AB 2292
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Date of Hearing: April 21, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2292 (Lowenthal) - As Introduced: February 18, 2010
Policy Committee: Health Vote:19-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill prohibits ambulatory surgical clinics (ASC) (same day
surgery centers) from prescribing medications unless they have
been licensed by the California Board of Pharmacy (Board).
Specifically, this bill:
1)Defines ASC subject to licensure according to current state
laws pertaining to health facilities and eligibility for
Medicare reimbursement.
2)Requires the Board to conduct licensure inspections.
FISCAL EFFECT
Annual fee-supported special fund costs of $200,000 for the
Board to conduct licensure inspections and provide oversight of
1,100 ASC.
COMMENTS
1) Rationale . This bill clarifies licensure of ASC to
ensure physicians are able to prescribe medication legally to
patients receiving outpatient surgery and diagnostic
procedures. This area of law has been complicated by a recent
legal decision, discussed below. According to the author this
bill ensures patient safety and access to care. In the absence
of the licensure framework proposed in this bill, the author
indicates clinics will essentially have to set up their own
pharmacies, which creates a number of risks and oversight
problems for both the provider and the regulator.
2) Capen vs. Shewry 155 Cal. App.4th 378 in 2007 addressed
AB 2292
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licensure of ASC. Prior to the Capen, DPH interpreted the
licensure exemption for physician-owned clinics to mean that
each licensed provider at the clinic had to have a share in
the ownership and operation of the clinic or the clinic was
subject to DPH licensure.
In Capen, a California appellate court ruled that an ASC owned,
in whole or in part, by physicians, was no longer eligible for
licensure by the Department of Public Health (DPH). The DPH
therefore stopped licensing certain clinics owned by
physicians. This bill addresses the regulatory gap created by
Capen.
3) Related Legislation . AB 1574 (Plescia) in 2008, AB 2122
(Plescia) in 2008, AB 543 (Plescia) in 2007, and AB 2308
(Plescia) in 2006 each addressed surgical clinic licensure
issues such as reimbursement, inspections, and patient safety.
AB 1574 was vetoed due to concerns the bill did not adequately
address the Capen decision. AB 2122 was held on the Suspense
File of this committee. AB 543 and AB 2308 were both vetoed
due to concerns about the lack of clarity of licensing
standards.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081