New State Laws
Affecting the Medical Profession
California laws, enacted during the last legislative session and signed by the
Governor went into effect on January 1, 2000. There are many bills covering
healthcare, either directly or tangentially.
I can not in this short excerpt list them all. I will list those that I consider important for the
requires malpractice insurance for
surgery performed outside of an acute care hospital and has minimum staffing
source of “board certification”
states requirements for advertising using
pictures or results of procedures.
on medical record privacy states that a provider who creates or
maintains medical records preserve confidentiality of those records.
If the records are negligently disposed, abandoned or destroyed the
provider will be subject to the penalties of this Act.
is the bill
that requires specified nurse patient
ratios. Hospitals do not have
to comply until January1, 2001.
requires certain times for attorney copy services for medical
records. It also increases the
allowable charge from $16 to $24 per hour.
allow fines up to $25,000 for retaliation for whistle
blowing and states there is a rebuttable presumption that if the
whistleblower is disciplined within 120 days of filing the complaint it is due
authorizes pharmacists under standardized policies to order
assessments, tests, adjust drug regimens and administer injections.
term domestic partners and allows
registration and termination of domestic partners with the Secretary of State.
It also provides hospital visitation rights for domestic partners.
makes Health Care Plans liable under the duty of ordinary care for their
providing covered benefits. They are now liable for negligence in denying,
delaying or modifying treatments requested by their physicians AND
when the patient suffers substantial physical or financial harm.
Prior to filing suit the patient must complete the plan’s internal or a
new external grievance process. This
was given a one year grace period and does not go into effect until January1,
2001. This law may be challenged
under Federal ERISA laws.
allows an independent
review paid by the plan for any treatment denial and requires second
opinions if requested by an enrollee who questions treatment appropriateness.
require health plans to provide written
responses to denial grievances by enrollees.
It also opens up the ability to be considered for experimental
health plans for using medical
information for commercial purposes and requires policies and procedures to
protect medical information security. (See above.)
may put many
small and medium size IPAs out of
business. It requires enough assets to cover costs that may exceed the rates
being paid to them.
repeals the Natural Death Act.
The new law is the Health Care Decision Law.
This allows an adult having legal capacity to make oral or written
individual health care instructions and/or appoint an agent under a power of
attorney for health care. This
becomes effective July1, 2000 and is not retroactive. All prior requests remain
allows adult residential facilities
to obtain a waiver from the State to allow a diagnosed terminally ill resident
to remain in the facility under certain conditions.
contract employees to sue for sexual
harassment. This bill also
makes it illegal to not make reasonable accommodation for pregnant females.
is another sexual
harassment law extends the definition of sexual harassment to verbal, visual
or physical conduct of a sexual nature. It
also deletes the requirement that the harassee must request the harasser to stop
and the harasser continues the practice.
payment of costs for expert witnesses
by the party opposing an offer to compromise. This is to encourage pre trial
subpoena of electronic records.
It also expands the definition of a witness whose holding of information
is subpoenable to include various healthcare professionals. These include
dentist, optometrist and physical therapist, podiatrist, acupuncturist, medical
centers, clinics, radiology or MRI Centers or diagnostic laboratories.
employers must now again repay “nonexempt” workers “time and one
half” for over eight hours per day work.
Also one needs now to pay “double time” for any time over twelve
hours per day or after eight hours on the seventh day of the workweek. Prior,
one would only need to pay for over forty hours per week.
This will void many “alternative” schedules.
No hourly employee, including professionals, may be exempt from this
rule. A separate bill
SB651 places pharmacy personnel under this rule unless they meet a test for
executive or administrative employees.
gives immunity from liability to anyone who, in good faith and without pay, in
an emergency uses an automated electronic
defibrillator (AED). The person
must have basic CPR training and an AED use course.
Instructors of those courses are also immune from liability for the acts
of their students.
new State laws with full text and analysis may be found at www.leginfo.ca.gov.
is requiring critical care time (CPT99291-92) medical chart documented and is
reducing the RVU by 10%.
hope this short discussion of some of the new laws will be helpful to you.
Again, if you wish any specific medical-legal topic discussed or if I may
be of service to you or your Medical Staff please call, write or E-mail me.
DISCLAIMER: Although this article is updated periodically, it reflects the
author's point of view at the time of publication. Nothing in this article
constitutes legal advice. Readers should consult with their own legal counsel
before acting on any of the information presented.