BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1274
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          SENATE THIRD READING
          SB 1274 (Wolk)
          As Amended  April 26, 2012
          Majority vote 

           SENATE VOTE  :36-0  
           
           BUSINESS & PROFESSIONS            9-0               HEALTH      
          14-0                
           
           ----------------------------------------------------------------- 
          |Ayes:|Hayashi, Bill Berryhill,  |Ayes:|Monning, Logue, Atkins,   |
          |     |Allen, Butler, Eng,       |     |Bonilla, Eng, Garrick,    |
          |     |Hagman, Hill, Ma, Smyth   |     |Gordon, Hayashi,          |
          |     |                          |     |Roger Hern�ndez, Mansoor, |
          |     |                          |     |Mitchell, Nestande, Pan,  |
          |     |                          |     |Williams                  |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Provides an exemption from the prohibition against the 
          Corporate Practice of Medicine (CPM) to allow a hospital that is 
          owned and operated by a charitable organization and offers only 
          pediatric subspecialty care to charge for physician services.  
          Specifically,  this bill  :   

          1)Allows a hospital that meets all of the following conditions 
            to charge for professional services rendered to patients 
            beginning January 1, 2013:

             a)   Is owned and operated by a licensed charitable 
               organization;

             b)   Offers only pediatric subspecialty care;

             c)   Employed licensees on a salary basis before January 1, 
               2012; and,

             d)   Has not charged for professional services rendered to 
               patients.

          2)Allows the provision described above, provided the following 
            conditions are met:









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             a)   The hospital does not increase the number of salaried 
               licensees by more than five licensees each year;

             b)   The hospital does not expand its scope of services 
               beyond pediatric subspecialty care;

             c)   The hospital accepts each patient needing its scope of 
               services regardless of his or her ability to pay, including 
               whether the patient has any form of health care coverage;

             d)   The medical staff concur by an affirmative vote that the 
               licensee's employment is in the best interest of the 
               communities served by the hospital; and,

             e)   The hospital does not interfere with, control, or 
               otherwise direct a physician and surgeon's professional 
               judgment in a manner prohibited by existing law, as 
               specified.

           EXISTING LAW  :

          1)Prohibits corporations and other artificial legal entities 
            from having any professional rights, privileges, or powers to 
            practice medicine (known as the prohibition against CPM).  
            However, the Division of Licensing of the Medical Board of 
            California (MBC) may grant approval for the employment of 
            physicians on a salary basis by licensed charitable 
            institutions, foundations, or clinics if no charge is made for 
            professional services rendered.

          2)Exempts the following clinics from the prohibition 
            against CPM:

             a)   Clinics operated primarily for the purpose of 
               medical education by a public or private nonprofit 
               university medical school approved by the MBC or the 
               Osteopathic Medical Board, which may charge for 
               professional services rendered to teaching patients by 
               licensed physicians and surgeons who hold academic 
               appointments on the faculty of the university if the 
               charges are approved by the physician and surgeon in 
               whose name the charges are made;

             b)   Certain nonprofit clinics organized and operated 








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               exclusively for scientific and charitable purposes 
               that have been conducting research since before 1982 
               and that meet other specified requirements to employ 
               physicians and surgeons and charge for professional 
               services.  These clinics must not interfere with, 
               control, or otherwise direct a physician and surgeon's 
               professional judgment in a manner prohibited by the 
               CPM prohibition or any other provision of law; and,

             c)   A narcotic treatment program regulated by the 
               Department of Alcohol and Drug Programs, which may 
               employ physicians and surgeons and charge for 
               professional services rendered.  These programs must 
               not interfere with, control, or otherwise direct a 
               physician and surgeon's professional judgment in a 
               manner prohibited by the CPM prohibition or any other 
               provision of law.

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

           FISCAL EFFECT  :  Unknown.  This bill is keyed non-fiscal by the 
          Legislative Counsel.

           COMMENTS  :  According to the author, "The Shriners Endowment Fund 
          has fully supported the operations of the Shriners hospitals 
          since its inception in 1923.  The Endowment Fund incurred a very 
          significant decrease in value as a result of the economic 
          downturn in FY �fiscal year] 2008-09.  Shriners has continued to 
          serve children and their families through deficit spending, 
          which is an unsustainable financial model.  SB 1274 would allow 
          Shriners to recoup some of its costs by billing insurers for 
          physician services, so the hospital can continue to focus on its 
          mission to serve as many children with specialized medical needs 
          as possible.  The bill also specifies the hospital must continue 
          to accept each patient in need of care within its scope of 
          services regardless of his or her ability to pay."


           Analysis Prepared by  :    Angela Mapp / B.,P. & C.P. / (916) 
          319-3301 








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