for disciplinary action by the Medical Board of California.
allocation for physician services and protecting physicians’
In light of California’s physician supply crisis, this bill would have a more immediate impact toward increasing the amount of licensed physicians that could practice in the state.
ability to own an ambulatory surgery center. Based on these changes (including mandatory and ongoing coding updates by carriers and discarding ACOEM guidelines in favor of an expanded hierarchy of evidence), CMA took a support position on the measure.
Status: Enrolled and sent to Governor. Signed into law 7/25/12.
Status: Enrolled and sent to Governor. Signed into law 9/18/12. AB 1808 (Williams) Meyers-Milias-Brown, Act Public Employees (CMA Position: Support) This bill would only impact County of Ventura employed physicians that have, since 2006, sought union recognition. Since 2006, the county has rejected multiple legal opinions by the Public Employee Relations Board (PERB) that has sided with the physicians’ efforts for unionization. This bill simply includes the definition of “joint employer” used in the 2009 PERB decision, which would remove any doubt as to whether or not Ventura County is the employer of the physicians at the Ventura County Clinics. Status: Failed pursuant to legislative deadline. SB 863 (De Leon): Workers’ Compensation (CMA Position: Support) This bill was substantially amended in the final weeks of session to contain a package of policy changes in the name of reforming the state’s workers’ compensation system. The bill’s text was initially developed by labor and business interests, but CMA was able to negotiate a number of significant amendments to the bill. When those amendments were adopted, CMA took a support position on the measure. SB 863 does many things, but a couple of the biggest changes for physicians are that it directs the state to adopt the Medicare fee schedule—based on the Resource-Based Relative Value Scale (RBRVS)—as well as establishing Independent Medical Review and Independent Bill Review in an effort to utilize third-party processes to adjudicate treatment and billing disputes, instead of the court system. CMA was able to secure many important changes to the bill, including medical provider network reforms, expanding categories of payment for physicians, as well as increasing the entire funding
16 | THE BULLETIN | NOVEMBER / DECEMBER 2012
SB 1524 (Hernandez): Nurse Practitioners (CMA Position: Watch) This bill deletes the statutory requirement that nurse practitioners complete at least six months of physician and surgeon supervised experience in the furnishing or ordering of drugs and a course in pharmacology covering the drugs that will be furnished. The author contends this statute is antiquated and was put into place before there was any significant training in pharmacology. He contends the proper training and proper education now exists and the six month requirement only delays employment of new advanced practice registered nurses (APRN). However, not everyone’s experience and education is equal and should be dealt with on a case-by-case basis. CMA recommended amendments, which the author accepted, that clarified that the physician may include a six month supervised experience (or longer) requirement in the standardized protocol between the physician and the APRN. Status: Enrolled and sent to Governor. Signed into law 9/29/12. SB 1538 (Simitian): Mammograms (CMA Position: Neutral) This bill would require physicians to notify mammography patients with highly dense breasts about the density of their breast tissue. This issue has been debated within the house of medicine for nearly two years, but physician advocates were able to secure amendments to the bill that allowed both CMA as well as ACOG District IX to take neutral positions. Status: Enrolled and sent to Governor. Signed into law 9/22/12.