BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1848
                                                                  Page  1

          Date of Hearing:   April 24, 2012

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER 
                                     PROTECTION
                                 Mary Hayashi, Chair
                    AB 1848 (Atkins) - As Amended:  April 18, 2012
           
          SUBJECT  :   Physicians and surgeons: expert witness testimony.

           SUMMARY  :   Requires physicians licensed in other states to 
          register with, and obtain authorization from, the Medical Board 
          of California (MBC) before providing expert witness testimony in 
          California courts.  Specifically,  this bill  :  

          1)Requires a physician and surgeon who holds an active and valid 
            license to practice medicine in another state to file a 
            written request for authorization with the MBC, using a form 
            that the MBC shall create, and receive the approval of the MBC 
            prior to providing expert witness testimony, under oath, 
            relating to the practice of medicine in any legal proceeding 
            in the state. 

          2)Requires, prior to providing that testimony, the person to do 
            all of the following:

             a)   Obtain authorization from the MBC to provide expert 
               witness testimony after submitting to the MBC a copy of his 
               or her valid license or certificate from each state in 
               which the person holds licensure or certification and a 
               photographic identification issued by one of those states 
               in which the person holds licensure or certification.  The 
               MBC must notify the person, within 20 calendar days of 
               receiving a request for authorization, whether the MBC has 
               approved or denied that request.  If the person requests 
               authorization to testify within 20 calendar days of the 
               MBC's receipt of the person's request for authorization, 
               the MBC shall make reasonable efforts to notify the person 
               whether that request is approved or denied within that 
               shorter time period.

             b)   Satisfy the following requirements:

               i)     The person has not committed any act or been 
                 convicted of a crime constituting grounds for denial of 
                 licensure or registration under current law, as 








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                 specified, and is in good standing in each state in which 
                 he or she holds licensure or certification.

               ii)    The person has the appropriate education and 
                 experience to provide expert witness testimony, as 
                 determined by the MBC.

               iii)   The person shall agree to comply with all applicable 
                 practice requirements set forth in current law pertaining 
                 to the healing arts and the regulations adopted pursuant 
                 to that law.

             c)   Submit to the MBC, on a form prescribed by the MBC, a 
               request for authorization to provide expert witness 
               testimony.

             d)   Submit a statement declaring whether the person has 
               previously held or applied for a California medical license 
               and whether that license or application was ever suspended, 
               revoked, or denied.

             e)   Submit a list of any felonies or misdemeanors of which 
               the person has been convicted in any jurisdiction.

             f)   Submit a statement indicating whether the person has 
               previously applied for, or held, an expert witness 
               registration and whether any previous expert witness 
               registration has been revoked by the MBC, or a similar 
               board, committee, medical society, or administrative body 
               in any other jurisdiction.

             g)   Submit any additional information required by the MBC.

          3)Requires the request to be accompanied by a fee in an amount 
            set by the MBC by regulation sufficient to cover the 
            reasonable costs of processing the request.  All fees 
            collected shall be deposited in the Contingent Fund of the MBC 
            and shall be available, upon appropriation by the Legislature, 
            to cover the cost of developing the authorization process and 
            processing the requests for authorization.

          4)Provides that, if the MBC fails to approve or deny the request 
            within 20 business days after receipt of the request and 
            payment of the filing fee, the request shall be deemed 
            approved.  The MBC shall issue an expert witness registration, 








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            which shall be valid for two years from issuance, to all 
            approved requesters.

          5)Specifies that an expert witness registration does not 
            authorize the holder to practice medicine, as specified, that 
            an expert witness registration shall be treated as a license 
            in any disciplinary action, and that the holder of the 
            registration shall be subject to discipline by the MBC.

          6)Provides that a physician and surgeon who is authorized under 
            this bill to provide expert testimony relating to the practice 
            of medicine shall be deemed to consent to the jurisdiction, 
            and regulatory and disciplinary powers, of the MBC and shall 
            be subject to current law enforcement provisions for 
            unprofessional conduct.

          7)Requires an expert witness registration issued pursuant to 
            this bill to be disclosed upon request to a member of the 
            public and to be posted on the MBC's Internet Web site.

           EXISTING LAW  

          1)Provides, under the Medical Practice Act (Act), for the 
            licensing and regulation of physicians and surgeons by the MBC 
            under the Department of Consumer Affairs, including 
            disciplinary procedures for physicians and surgeons who 
            violate the Act. 

          2)Provides exceptions from MBC's licensing requirements to 
            permit physicians and surgeons who are licensed in other 
            states to practice medicine in California in specified 
            circumstances.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           Purpose of this bill  .  According to the author, "The intent of 
          this bill is to fix the problem of deceptive or fraudulent 
          testimony provided by medical expert witnesses - in particular, 
          those that are licensed from out of the state.  In California, 
          because medical expert witness testimony is considered the 
          practice of medicine, the Medical Board of California (MBC) has 
          jurisdiction over California licensees who provide expert 
          witness testimony.  Thus, in the event that a CA licensed 








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          physician provides fraudulent or deceptive medical expert 
          witness testimony, the MBC has the authority to investigate and 
          discipline that licensee.  Unfortunately, however, in the case 
          of a licensee from other than California, the MBC has no 
          recourse in deterring such behavior nor preventing additional 
          opportunities for the out of state licensee from continuing to 
          be a medical expert witness in other cases."

           Background  .  In 2004, the California Attorney General issued a 
          formal opinion concluding that "when a physician testifies as an 
          expert in a civil proceeding regarding the applicable standard 
          of medical care and whether the defendant has breached that 
          standard, the physician may not, on the basis of his or her 
          testimony, be held liable in a subsequent tort action brought by 
          the adverse party, but may be subject to professional discipline 
          by the Medical Board of California if the testimony constitutes 
          unprofessional conduct."

          Under current law, the MBC can discipline its licensees for 
          unprofessional conduct, which would include providing expert 
          witness testimony that is fraudulent or meets the definition of 
          unprofessional conduct.  Because physicians who are licensed in 
          other states do not fall under MBC's authority, the MBC cannot 
          impose disciplinary action against out-of-state physicians who 
          provide false expert witness testimony.

          This bill establishes a mandatory process for physicians 
          licensed in other states to register with, and obtain 
          authorization from, the MBC prior to providing expert witness 
          testimony in court and gives the MBC 20 days within which to 
          process requests for registration.

          Support  .  The California Medical Association states, "Currently, 
          loopholes in state law do not prevent medical expert witnesses 
          that hold an out of state license that provide deceptive or 
          fraudulent testimony from repeat offenses.  AB 1848 would 
          address this problem by requiring out of state medical expert 
          witnesses (to) apply and register with the MBC, prior to serving 
          as a medical expert witness in this state."

           Opposition  .  The Consumer Attorneys of California have raised a 
          number of concerns with this bill.  They assert that California 
          law has ample restrictions and qualifications in place to ensure 
          experts are qualified to testify, that the playing field is 
          already uneven for patients, and that patients face great 








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          difficulty finding experts to testify against large healthcare 
          providers.  They believe the bill will prevent juries from 
          hearing from the most qualified experts in the field, and that 
          it will have a chilling effect on potential out-of-state experts 
          who would be subject to discipline by the MBC with exclusive 
          authority to grant or deny their certification.  They also 
          believe the bill encompasses areas outside of medical 
          malpractice litigation and that it unnecessarily duplicates the 
          MBC's Expert Reviewer Program, which is tasked with reviewing 
          whether a departure from a professional standard of conduct has 
          occurred by a licensed physician.   They also state that the 
          bill's sponsor has failed to provide any examples for why the 
          bill is needed.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Medical Association (sponsor)
          American Academy of Pediatrics, California
          American Society for Dermatologic Surgery
          Association of Northern California Oncologists
          Medical Oncology Association of Southern California

           Opposition 
           
          Consumer Attorneys of California
          Consumer Federation of California
           
          Analysis Prepared by  :    Angela Mapp / B.,P. & C.P. / (916) 
          319-3301