BILL ANALYSIS �
AB 1886
Page 1
Date of Hearing: April 29, 2014
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Susan A. Bonilla, Chair
AB 1886 (Eggman) - As Amended: April 22, 2014
SUBJECT : Medical Board of California.
SUMMARY : Removes time limitations for Web site posting of
specified public disciplinary information about licensees of the
Medical Board of California (MBC). Specifically , this bill:
Will require the following disciplinary information regarding a
licensee to be posted on MBC's Web site for as long as that
information is public:
1)A revocation, suspension, probation, or limitation on
practice, as specified;
2)A malpractice judgment or arbitration award reported to MBC
after January 1, 1993;
3)Discipline from a board of another state or jurisdiction; and,
4)Any misdemeanor conviction that results in a disciplinary
action or an accusation that is not subsequently withdrawn or
dismissed.
EXISTING LAW :
1)Establishes MBC to administer and enforce the provisions of
the Medical Practice Act. (Business and Professions Code (BPC)
Sections 2001, 2004)
2)Requires any complaint against an MBC licensee determined to
involve quality of care to meet the following criteria before
referral to a field office for further investigation:
a) It shall be reviewed by one or more medical experts with
the pertinent education, training, and expertise to
evaluate the specific standard of care issues raised by the
complaint to determine if further field investigation is
required; and,
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b) It shall include review of the following:
i) Relevant patient records;
ii) The statement of explanation of the care and
treatment provided by the physician and surgeon;
iii) Any additional expert testimony or literature
provided by the physician and surgeon; and,
iv) Any additional facts or information requested by the
medical expert reviewers that may assist them in
determining whether the care rendered constitutes a
departure from the standard of care. (BPC 2220.08)
3)Requires MBC to file an accusation within three years after
MBC discovers an act or omission alleged as the ground for
disciplinary action, or within seven years after the act or
omission alleged as the ground for disciplinary action occurs,
whichever occurs first, as specified. (BPC 2230.5)
4)Authorizes MBC to discipline a licensee by placing him or her
on probation, which may include, but is not limited to, the
following:
a) Requiring the licensee to obtain additional professional
training and to pass an examination upon the completion of
the training;
b) Requiring the licensee to submit to a complete
diagnostic examination by one or more physicians and
surgeons appointed by MBC; or,
c) Restricting or limiting the extent, scope, or type of
practice of the licensee, including requiring notice to
applicable patients that the licensee is unable to perform
the indicated treatment, where appropriate. (BPC 2228)
5)Requires a public letter of reprimand issued concurrently with
a physician and surgeon's certificate to be purged from the
record three years from the date of issuance. (BPC 2221.05)
6)Permits MBC, by stipulation or settlement with a physician and
surgeon, to issue a public letter of reprimand after it has
conducted an investigation or inspection rather than filing or
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prosecuting a formal accusation. The public letter of
reprimand may, at the discretion of MBC, include a requirement
for specified training or education. Use of a public letter
of reprimand shall be limited to minor violations. (BPC 2233)
7)Declares as public information all civil judgments in any
amount, whether or not vacated by a settlement after entry of
the judgment, that were not reversed on appeal and arbitration
awards in any amount of a claim or action for damages for
death or personal injury caused by the physician and surgeon's
negligence, error, or omission in practice, or by his
rendering of unauthorized professional services. (BPC 803.1
(b)(1))
8)Requires the following information to be posted on MBC's Web
site for a period of ten years from the date MBC obtains
possession, custody, or control of the information, and after
the end of that period, be removed:
a) Whether a license is subject to a temporary restraining
order or interim suspension order;
b) A public letter of reprimand;
c) Revocations, suspensions, probations, or limitations on
practice ordered by MBC, including those made as part of a
probationary order or stipulated agreement.
d) Discipline from a board of another state or
jurisdiction;
e) Current accusations filed by the Attorney General,
including those on appeal;
f) Any malpractice judgment or arbitration award reported
to MBC after January 1, 1993; and,
g) Any misdemeanor conviction that results in a
disciplinary action or an accusation that is not
subsequently withdrawn or dismissed. (BPC 2027)
9)Requires the following information to be posted on MBC's Web
site indefinitely:
a) Whether a licensee is in good standing;
AB 1886
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b) Any felony convictions reported to MBC after January 3,
1991; and,
c) Any hospital disciplinary actions that resulted in the
termination or revocation of a licensee's hospital staff
privileges for a medical disciplinary cause or reason, and
information about additional explanatory or exculpatory
information submitted by the licensee, as specified. (BPC
2027)
10)If a licensee's hospital staff privileges are restored, and
the licensee notifies MBC of the restoration, the information
pertaining to the termination or revocation of those
privileges, as specified, shall remain posted for a period of
ten years from the restoration date of the privileges. (BPC
2027)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of this bill . This bill will require MBC to post
indefinitely on its Web site certain public data related to
physician and surgeon discipline (such as suspensions and
probation, malpractice judgments, discipline from other
states, and certain misdemeanor convictions) that is currently
taken down after ten years. This bill is sponsored by MBC.
2)Author's statement . According to the author's office,
"Currently, public disciplinary information for licensed
physicians can only be posted on the Board's website for ten
years. AB 1886 would allow the Board to post this public
information on the Board's website for as long as it remains
public. The Board believes that this bill is needed to
increase transparency and allow consumers to access public
records. This bill does not change what information is
available to the public (pursuant to [BPC] Section 803.1), it
simply allows consumers to more easily access information that
is already public."
3)Ongoing removal of public disciplinary records from MBC Web
site . Current law was amended in 2003 to require MBC to
remove certain public information from its Web site after ten
years, and MBC began removing these documents in 2013.
AB 1886
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On January 1, 2013, MBC had to remove approximately 6,900
records from its Web site due to the ten year limit, and
continues to remove 30-40 records per month, which equates to
350-400 records per year.
MBC will return the applicable records to its Web site should
this bill be enacted.
4)Differences in disclosure between public records and the MBC
Web site . The approach taken by this bill is echoed in
recommendations from MBC's 2013 Sunset Review report, in which
Senate staff recommended that the ten year posting requirement
be removed "in order to ensure transparency to the public."
The California Research Bureau also recommended this change in
their 2008 report, "Physician Misconduct and Public Disclosure
Practices at the Medical Board of California."
Although MBC posts disclaimers about the availability and
extent of information on its Web site, consumers may
reasonably believe that the MBC Web site presents all the
publicly available information on a physician and surgeon's
license. As a result, consumers may be misled into believing
- incorrectly - that some physicians have no record of
discipline. This bill would help rectify that discrepancy by
putting more - but not all - public disciplinary information
online.
The MBC Web site does currently list information on felony
convictions, with no expiration date. However, a user would
have to know this information is available and scroll to the
bottom of the page to find it.
This bill, in conjunction with other current law, would
require the following information to be posted for as long as
that information is public:
a) A revocation, suspension, probation, or limitation on
practice, as specified;
b) A malpractice judgment or arbitration award reported to
MBC after January 1, 1993;
c) Discipline from a board of another state or
jurisdiction;
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d) Any misdemeanor conviction that results in a
disciplinary action or an accusation that is not
subsequently withdrawn or dismissed;
e) Whether a licensee is in good standing;
f) Any felony convictions reported to MBC after January 3,
1991; and,
g) Any hospital disciplinary actions that resulted in the
termination or revocation of a licensee's hospital staff
privileges for a medical disciplinary cause or reason, and
information about additional explanatory or exculpatory
information submitted by the licensee, as specified.
The following information would continue to be removed after
ten years:
a) Whether a license is subject to a temporary restraining
order or interim suspension order;
b) A public letter of reprimand; and,
c) Current accusations filed by the Attorney General,
including those on appeal.
5)Examples of incomplete disclosure . MBC provided the following
examples in which the partial discipline information may be
misleading to consumers looking for professional assurance:
a) Dr. Kenneth Woods: MBC's Web site indicates that his
license was surrendered, but because it was over ten years
ago, there is no explanation that the surrender was based
on a child molestation conviction.
b) Dr. Thomas Tartaro: His license was revoked in 1995 for
egregious sexual misconduct and conviction of sexual
battery on patients. In 2002, his license was reinstated
by operation of law and was placed on ten years' probation
with the condition he could not treat female patients, in
addition to other conditions. In December 2012 he
completed his probation and can now treat female patients.
There is no evidence of any disciplinary action taken by
the MBC on the Web site.
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c) Dr. Gregory Balourdas: In 2000 he was placed on
probation for sexual misconduct and sexual battery. In
2004 he was denied a petition for termination of probation,
but his probation was removed a year later. Nothing on the
MBC Web site indicates that disciplinary action was taken,
and his license presents as "license renewed and current"
with no record of any administrative actions.
6)Arguments in support . The Center for Public Interest Law
writes, "MBC's Web site contains a stark statement of the
purpose of the Board: 'The Medical Board of California is a
state government agency which licenses and disciplines medical
doctors. The Board provides two principal types of services
to consumers: public-record information about
California-licensed physicians, and investigation of
complaints against physicians.
"MBC's 'paramount' priority is public protection. MBC should
be a repository of information about the physicians it
licenses. Its Web site should disclose - truthfully and
accurately - complete public information about the
disciplinary, hospital privileges, medical malpractice, and
criminal track record of all physicians licensed in
California."
7)Arguments in opposition . The California Medical Association
(CMA) writes, "When online posting was originally
contemplated, CMA argued for posting of information that
provides the most accurate representation of the type of
clinical care a patient can expect. The law's current
language was a compromise that addressed CMA's concern that
some of the information required to be posted does not provide
information that accurately reflects a physician's ability to
provide safe and competent clinical care.
"Under AB 1886, a physician's online record would never be
cleared of outdated information that may have occurred decades
ago, does not reflect current medical practice, or is not a
measure of the quality of care that a patient can expect to
receive."
REGISTERED SUPPORT / OPPOSITION :
Support
AB 1886
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Medical Board of California (sponsor)
Center for Public Interest Law
Consumers Union
Opposition
California Academy of Cosmetic Surgery
California Academy of Family Physicians
California Medical Association
California Radiological Society
Medical Oncology Association of Southern California
Osteopathic Physicians and Surgeons of California
Union of American Physicians and Dentists
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301