Special Newsletter Vol.2 #2

New State Laws Affecting the Medical Profession

The 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 profession.

Physicians

AB271 requires malpractice insurance for surgery performed outside of an acute care hospital and has minimum staffing requirements.

SB450 requires the source of “board certification” in advertisements.

SB836 states requirements for advertising using pictures or results of procedures.

SB19 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.

Hospitals

AB394 is the bill that requires specified nurse patient ratios.  Hospitals do not have to comply until January1, 2001. 

AB794 requires certain times for attorney copy services for medical records.  It also increases the allowable charge from $16 to $24 per hour.

SB97 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 to retaliation.

AB261 authorizes pharmacists under standardized policies to order assessments, tests, adjust drug regimens and administer injections.

AB26 defines the 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.

Managed Care

SB21 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.

AB55 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.

SB189 require health plans to provide written responses to denial grievances by enrollees.  It also opens up the ability to be considered for experimental procedures.

SB19 prohibits health plans for using medical information for commercial purposes and requires policies and procedures to protect medical information security. (See above.)

SB260 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.  

Other Legislation

AB891 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 legal.

AB1108 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.

AB1670 allows contract employees to sue for sexual harassment.  This bill also makes it illegal to not make reasonable accommodation for pregnant females.

AB519 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.

SB1161 requires the payment of costs for expert witnesses by the party opposing an offer to compromise. This is to encourage pre trial settlement.

AB794 allows the 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.

AB60  states 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.

SB911 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.

All new State laws with full text and analysis may be found at www.leginfo.ca.gov.

HCFA is requiring critical care time (CPT99291-92) medical chart documented and is reducing the RVU by 10%.

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.