Thriving in Medicine
NEW HEALTH CARE LAWS 2016 Laws of Interest to California Physicians
Governor Brown spent four weeks up to his October 11 deadline working on deciding the fates of the over 650 bills sent to his desk by California legislators. Below is a list of the most important bills pertaining to the practice of medicine and/or impacting physicians. All laws are effective January 1, 2016, unless otherwise specified.
Approved Healthcare-Related Legislation
AB 637 - Expanded Role of NPs and PAs on POLST Assembly Bill (AB) 637 authorizes as valid the completion and signature on the Physician Orders for Life Sustaining Treatment form (POLST) by a nurse practitioner (NP) or a physician assistant (PA) acting under the supervision of the physician. The bill stemmed from a SFMS resolution and was a CMA-sponsored piece of legislation.
AB 679 – CURES Prescriber Enrollment
All California-licensed physicians authorized to prescribe, order, administer, furnish, or dispense Schedule II, III, or IV controlled substances must be registered to access the Controlled Substance Utilization Review and Evaluation System (CURES), as required by California Health and Safety Code Section 11165.1. AB 679 extends the current deadline for enrollment with the Department of Justice to access information contained in the CURES database from January 1, 2016, to a new deadline of July 1, 2016.
SB 277 – Public Health and Safety: Vaccinations
Legislation championed by SFMS, CMA, and Senator Richard Pan, MD, Senate Bill (SB) 277 eliminates the personal belief exemption from school vaccination requirements, barring parents from skipping their children’s school-required immunizations unless they have a medical exemption from a physician. Students may obtain a written medical exemption to vaccinations from a licensed physician (MD or DO) that includes the following information: • That the physical condition or medical circumstances of the child, which may include family medical history, are such that the required immunization(s) is not indicated • Which vaccines are being exempted • Whether the medical exemption is permanent or temporary • The expiration date, if the exemption is temporary
SB 299 – Medi-Cal: Provider Enrollment
SB 299 grants an exemption from notarization requirements for any Medi-Cal provider that choose to enroll electronically. It also mandates the Department of Health Care Services to collect an application fee for continued enrollment. WWW.SFMS.ORG
AB 1177 – Primary Care Clinics Written Transfer Agreements AB 1177 requires primary care clinics to directly send with each patient at the time of transfer all medical records and pertinent information related to the patient’s transfer (or in the case of an emergency, as promptly as possible). Medical records should include current medical findings and a brief summary of the treatment provided prior to the patient’s transfer. The bill removes the current requirement that all clinics must have a hospital transfer agreement in place as a condition of licensure.
AB X2-15 – End of Life Option Act
AB X2-15 enacts the End of Life Option Act, authorizing an adult who meets certain qualifications and who has been determined by his or her attending physician to be suffering from a terminal disease resulting in death within six months to request and obtain a prescription for a drug that the individual may self-administer to end the individual’s life. The bill makes the participation of a physician providing care to a qualified patient seeking an aid-indying drug entirely voluntary, and establishes procedures and reporting processes, as well as provides the necessary forms required for both medical records and reporting to the State Department of Public Health. AB X2-15 will not go into effect until 90 days after the extraordinary session on health care is adjourned, which is projected to be in January 2016 at the earliest and November 2016 at the latest. The bill has a sunset date of January 1, 2026.
SB 337 – Physician Assistants
SB 337 requires physicians and surgeons supervising PAs to review a minimum of 5% of the medical records of patients treated by the PA within 30 days of the date of treatment. It also authorizes a PA, while under prescribed supervision of a physician and surgeon, to administer or provide medication to a patient or to transmit an order to furnish medication or a medical device. SB 337 also prohibits a PA from administering, providing, or issuing a drug order to a patient for Schedule II through Schedule V controlled substances without advance approval by a supervising physician and surgeon for that particular patient unless the PA has completed an education course that covers controlled substances and that meets approved standards. All PAs who are authorized by their supervising physicians to issue drug orders for controlled substances will need to register with the United States Drug Enforcement Administration (DEA). The act requires that the medical record of any patient cared for by a PA for whom a PA’s Schedule II drug order has been issued or carried out be reviewed, countersigned, and dated by a supervising physician and surgeon within seven days.
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