LEGISLATIVE WRAP UP 2022

2022 Legislative Wrap-Up

By Janice Rocco, CMA Chief of Staff

By Janice Rocco, CMA Chief of Staff

In 2021, with emergency use authorization for COVID-19 vaccines, the hope was that the pandemic would end and life could go back to normal. Instead, it wasn’t until 2022 that the state legislature began moving back to something resembling business as usual.

In 2021, with emergency use authorization for COVID-19 vaccines, the hope was that the pandemic would end and life could go back to normal. Instead, it wasn’t until 2022 that the state legislature began moving back to something resembling business as usual. The state declaration of the COVID-19 State of Emergency remains in effect. The State Capitol is again open to the public, but even that has changed in ways that provide less access to legislators and their staff than was the case prior to the pandemic. The Capitol building is undergoing construction and legislators have moved their offices outside the Capitol. Committee hearings are being conducted in person again, though often with a hybrid phone-in option. Separate from the legislature, public meetings held by state departments and commissions have begun shifting back to a hybrid approach, so that we can be back in person again. These changes mean that we have adjusted and found new ways that we, as advocates, communicate with legislators and their staff. In California, we had five legislative seats become vacant during the year, which meant five special elections to fill them. By the time each of these races had concluded, a total of five new Democrats had been sworn into office. With these additions, Democrats continue to have a supermajority in both the Assembly and the Senate. The closing of the 2021–2022 legislative session also brought with it the end of an era for a well-respected member of the legislature. Senator Richard Pan, M.D., spent 12 years serving California in the legislature by focusing on improving the state’s health care system, fighting for patients and the practice of medicine. Though Dr. Pan has many legislative accomplishments, we are particularly grateful for his leadership during the COVID-19 pandemic, where his expertise was critical to our state on a daily basis.

HEALTH CARE REFORM

As the legislative year began, AB 1400, the single payer health care coverage bill, was before the State Assembly for a vote. That bill died in the Assembly at the end of January, which then shifted the discussion to other health care reform measures. The Governor’s Office of Health Care Affordability proposal from 2021 was back for discussion and debate, with the California Medical Association (CMA) fighting to prevent this broad measure from becoming an administrative burden for physician practices. Ultimately, we were successful in getting physician practices with fewer than 25 physicians exempted from both the data submission requirements and the cost targets that the state will develop. Similarly, we fought to prevent independent practice associations (IPAs) from being included as a way to impose cost targets and data submission requirements on smaller physician groups, ultimately seeing them removed from the bill. We were also able to get the Newsom Administration to commit to include $200 million in the state budget for grants to assist physician practices with implementation of some of the provisions in Office of Health Care Affordability legislation, such as a shift to alternative payment models.

STATE BUDGET

Another victory in the health care reform space was achieved via the 2022–23 state budget. Continuing California’s commitment to achieving universal health care access, the $308-billion budget includes a phasedin system to provide full scope Medi-Cal coverage to all income-eligible Californians regardless of age or documentation status by January 1, 2024. This makes California the first state in the nation to expand its Medicaid program to provide full benefits to all eligible individuals—a critical step in our shared goal of ensuring that every Californian has access to quality health care. Many other CMA priorities and supported issues were addressed in the 2022–23 budget, including: a permanent extension of key Medi-Cal telehealth flexibilities implemented during the pandemic; full funding for the Prop. 56 Medi-Cal supplemental payments and graduate medical education funding programs; major investments in health care workforce development; $1.3 billion for health care worker retention pay; $700 million in equity and practice transformation payments; and $200 million for reproductive health and reproductive justice issues. (For more details on the state budget, see cmadocs.org/ budget-22-23.)

MICRA

When the year began, the expectation was that CMA’s focus in 2022 would be working to defeat the socalled “Fairness for Injured Patients Act” (FIPA) ballot initiative that had qualified for the November 2022 ballot. The ballot initiative, if it had passed, would have eviscerated the protections of California’s Medical Injury Compensation Reform Act (MICRA). After Californians Allied for Patient Protection (CAPP), led by CMA CEO Dustin Corcoran, negotiated a legislative deal with FIPA proponents, Assemblymember Eloise Gómez Reyes put that legislative deal into AB 35, the MICRA Modernization Act. Just 16 days later, Governor Newsom signed the bill into law and FIPA proponents removed their initiative from the ballot. This historic agreement prevented a costly ballot fight and ushered in a new and sustained era of stability around malpractice liability.

MEDICAL BOARD

CMA aggressively fought AB 2060 (Quirk), which would have created a public member majority on the Medical Board of California. We were able to kill this bill in its first house.

At the same time, CMA sponsored legislation—AB 1636 by Assemblymember Akilah Weber, M.D.—to preserve the integrity of the medical profession by ensuring physicians convicted of sexual assault with a patient lose their license with no ability for it to be reinstated. This bill removes the medical board’s discretion to give or reinstate the license of a physician or surgeon who lost their license due to sexual misconduct with a patient. This bill would also deny a physician’s and surgeon’s license to an applicant who has been or is required to register as a sex offender.

HEALTH IT

CMA had three significant victories addressing health information technology issues. The passage of AB 852 (Wood) eliminates administrative burdens associated with complying with California’s electronic prescribing mandate. AB 32 (Aguiar-Curry) permanently ensures parity in reimbursement for telehealth services provided through Medi-Cal managed care plans, so that this reimbursement reform lasts beyond the public health emergency. Finally, SB 1419 (Becker) helps physicians comply with the new federal information blocking rule and protects patients’ sensitive medical information.

REPRODUCTIVE RIGHTS

In June, the U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health caused shockwaves on a national

scale, as access to reproductive health care services was stripped away from millions of Americans overnight. CMA and other organizations had begun planning for this reality in late 2021 by forming the Future of Abortion Council to develop legislative and budget proposals to ensure that access to abortion care would not be denied in California once the court overturned Roe v. Wade. This year, 15 reproductive health care bills were signed into law by Governor Newsom, including bills meant to strengthen protections for physicians and other health care providers from civil or criminal actions that could arise in other states if providers treat patients from outside California. Additionally, $200 million was included in the 2022–23 state budget to expand access to reproductive health care, including abortion.

ADMINISTRATIVE BURDENS

CMA sponsored SB 250 (Pan) to reduce administrative burdens from health plans’ prior authorization requirements and ensure that patients get the care they need, when they need it. This bill was strongly opposed by the health plans and although it passed the Senate, it fell short in the Assembly Appropriations Committee.

SCOPE OF PRACTICE

Another big fight this year was CMA’s work with the California Academy of Eye Physicians and Surgeons to oppose AB 2236 (Low), which would have allowed optometrists to perform certain surgical procedures without the same training as ophthalmologists. This bill was hard-fought in the legislature and was the last bill to pass the Assembly before midnight on the final night of the legislation session, when it eventually received the 41st vote it needed for passage. Even though this bill narrowly made it out of the legislature, Governor Newsom heard from hundreds of physicians and vetoed it to protect patients, issuing a strong statement about the inadequacy of its training requirements.

LOOKING BACK AT A BUSY SESSION

By the time the Governor’s bill final signing period for the 2021–22 legislative session ended, Governor Newsom had signed 997 bills into law and vetoed 169 bills. On the following pages, you will find summaries of many of the key bills that CMA was involved with in 2022.

For more details on the major bills that CMA followed this year, visit cmadocs.org/legwrap2022. Subscribe to CMA’s free biweekly Newswire and stay informed on CMA’s legislative efforts and other issues critical to the practice of medicine at cmadocs.org/subscribe. The California Medical Association (CMA), working to empower physicians to lead and transform the health care system, recently welcomed Stuart Thompson, J.D., as its new Senior Vice President. In that role, he will lead the association’s government relations and political operations efforts.

“Stuart’s impressive record of success inside the halls of government and across California’s political landscape will be a great asset as we navigate rapid changes in our health care delivery system and look for opportunities to improve the health of all Californians by helping people get timely, high-quality care,” said CMA CEO Dustin Corcoran. “We have a big year ahead of us and Stuart’s deep understanding of health care policy, and the legislative and regulatory agencies in California, will position CMA as an even greater force in the health care advocacy space.”

Thompson has over 15 years of legislative, government and legal experience in California, most recently serving as the Chief Deputy Legislative Secretary in Governor Gavin Newsom’s administration. Having already served as Associate Director of Government Relations at CMA for five years prior to joining the Newsom administration, Thompson’s wealth of experience advocating on behalf of physicians and the patients they serve makes him uniquely suited for the role.

“This is a pivotal time for health care in our state and I am thrilled to join CMA’s lobbying team to advance meaningful, measurable improvements in California’s health care delivery system,” said Thompson. “By bridging the gap between policymakers and medical professionals, we can achieve a health care system that delivers for all Californians.”

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SPONSORED BILLS

AB 32 (AGUIAR-CURRY): TELEHEALTH

Status: Signed by Governor (Chapter 515, Statutes of 2022).

Assembly Bill 32 ensures parity in reimbursement for telehealth services provided through Medi-Cal managed care plans, adds flexibility for providers to enroll patients in certain Medi-Cal programs remotely, and requires the Department of Health Care Services to complete an evaluation to assess the benefits of telehealth in Medi-Cal by July 2025.

AB 1636 (WEBER): PHYSICIAN LICENSURE OR REVOCATION – SEXUAL MISCONDUCT

Status: Signed by Governor (Chapter 453, Statutes of 2022).

Assembly Bill 1636, by Assemblymember Akilah Weber, M.D., protects patients and maintains confidence in the medical profession by ensuring physicians convicted of sexual misconduct have their license revoked and cannot acquire or have a license reinstated. This bill removes the Medical Board of California’s ability to give a license to or reinstate a physician who lost their license due to sexual misconduct with a patient.

AB 2055 (LOW): CONTROLLED SUBSTANCES – CURES DATABASE

Status: Held in Assembly Appropriations Suspense Committee.

Assembly Bill 2055 would have rehoused the state’s prescription drug monitoring program – the Controlled Substance Utilization Review and Evaluation System (CURES) database – from the Department of Justice to the California State Board of Pharmacy. CURES should be managed with the primary goals of improving patient care and public health, and as such it should be administered by an entity whose mission and policies focus on the use of the database by health care providers and research experts.

AB 2098 (LOW): PHYSICIANS AND SURGEONS – UNPROFESSIONAL CONDUCT

Status: Signed by Governor (Chapter 938, Statutes of 2022).

Assembly Bill 2098 provides that the dissemination of misinformation or disinformation related to COVID-19 by a physician to their patient constitutes unprofessional conduct. The bill clarifies that the medical board may take action if a licensee provides misinformation that departs from the applicable standard of care or did so with malicious intent or the intent to mislead. The governor issued a statement in conjunction with his signature on the bill, which read in part: “I am signing this bill because it is narrowly tailored to apply only to those egregious instances in which a licensee is acting with malicious intent or clearly deviating from the required standard of care while interacting directly with a patient under their care. To be clear, this bill does not apply to any speech outside of discussions directly related to COVID-19 treatment within a direct physician patient relationship.”

AB 2132 (VILLAPUDUA): TUITION FOR MEDICAL SERVICE PILOT PROGRAM

Status: Held in Assembly Higher Education Committee.

Assembly Bill 2132 would have created a pilot program, administered by the California Student Aid Commission, to identify and select individuals from diverse, underrepresented communities to fund their education from community college/undergraduate school through completion of their medical residency program. The individual would have been required to commit to practicing in medically underserved areas after completing their residency program.

AB 2522 (GRAY): PUBLIC HEALTH WORKFORCE LOAN REPAYMENT PROGRAM

Status: Held in Senate Appropriations Committee.

Assembly Bill 2522 sought to create a dedicated loan repayment program for the state’s public health workforce. There are currently no existing retention or recruitment loan repayment programs for non-licensed public health personnel.

SB 250 (PAN): HEALTH CARE COVERAGE

Status: Passed Senate. Held in Assembly Appropriations Committee.

Senate Bill 250 would have comprehensively reformed the prior authorization process by requiring that physicians be included in the development and updating of plan utilization management criteria; requiring plans to create a prior authorization exemption program that allows physicians who are practicing within the plan’s criteria 90% of the time to get a blanket exemption for one year from the plan’s prior authorization requirements; and giving a treating physician who does not have a prior authorization exemption the right to have an appeal of a denial be conducted by a physician in the same or similar specialty.

SB 1419 (BECKER): HEALTH INFORMATION

Status: Signed by Governor (Chapter 888, Statutes of 2022).

Senate Bill 1419 helps California physicians comply with the federal information blocking rule. In spring 2021, the federal 21st Century Cures Act final rule took effect. That rule has had unintended consequences for patients and physicians regarding sensitive medical information.

SB 1419 improves quality of care by guaranteeing that physicians and patients have all the information needed for integrated health care. This bill provides patients with the right to receive results of their imaging scans in written or oral form, the same protection currently provided to lab results. It also provides enhanced protection for sensitive medical information, as defined by the Confidentiality of Medical Information Act. Additionally, this bill provides a framework for application programming interfaces by incorporating the requirements of the Interoperability and Patient Access final rule for state-regulated health plans and insurers.

CO-SPONSORED BILLS

AB 1608 (GIPSON): COUNTY OFFICERS – CONSOLIDATION OF OFFICES

Status: Passed Assembly. Held on Senate Floor.

Assembly Bill 1608 would have eliminated the ability of a county board of supervisors to consolidate the offices of the sheriff and the coroner. The bill would have also required counties that currently consolidate those offices to separate the roles. The intent behind the bill was to retain physician autonomy and prevent forensic pathologists from being pressured to change their cause of death determinations due to pressure from a sheriff/coroner in order to reduce any indications of law enforcement misconduct.

PRIORITY SUPPORT BILLS

AB 35 (REYES): CIVIL DAMAGES – MEDICAL MALPRACTICE

Status: Signed by Governor (Chapter 17, Statutes of 2022).

Assembly Bill 35, the MICRA Modernization Act, implements the compromise that was negotiated between CAPP and the proponents of the “Fairness for Injured Patients Act” ballot proposition. The bill extends the longterm predictability and sustainability of the state’s medical malpractice laws and settles a decades-long divide on the issue. After the bill was signed, FIPA proponents withdrew their ballot measure, avoiding a million-dollar fight.

AB 852 (WOOD): ELECTRONIC PRESCRIBING

Status: Signed by Governor (Chapter 518, Statutes of 2022).

Assembly Bill 852 gives physicians more flexibility in complying with California’s electronic prescribing mandate. This bill exempts low-volume prescribers (many of them retired or semi-retired physicians who maintain a license), prescribers in areas of natural disasters, and prescribers who are granted a waiver based on extraordinary circumstances. These new exceptions also track with exceptions in the Medicare program.

AB 1242 (BAUER-KAHAN, BONTA AND GARCIA): REPRODUCTIVE RIGHTS – PROTECTIONS FOR PATIENTS AND PROVIDERS

Status: Signed by Governor (Chapter 627, Statutes of 2022).

Assembly Bill 1242 protects those performing, aiding in the performance of or obtaining an abortion from arrest and prohibits law enforcement from cooperating with or providing information to those outside of California regarding lawful abortion. This bill went into effect immediately when it was signed into law on September 27, 2022.

AB 1666 (BAUER-KAHAN): ABORTION – CIVIL ACTIONS

Status: Signed by Governor (Chapter 42, Statutes of 2022).

Assembly Bill 1666 enacts legal protections from civil and criminal liability for clinicians that provide abortions to patients who reside in other states with hostile abortion laws. These protections include precluding liability for any of the following “crimes” in other states: aiding or abetting in the inducing of an abortion; receiving or seeking an abortion; and performing and inducing an abortion. This bill went into effect immediately when it was signed into law on June 24, 2022.

AB 1797 (WEBER): IMMUNIZATION REGISTRY

Status: Signed by Governor (Chapter 582, Statutes of 2022).

Assembly Bill 1797 requires health care providers and other agencies, including but not limited to, schools, childcare facilities, Women, Infants, and Children service providers, health care plans, foster care agencies, and county human services agencies to disclose immunization information to local health departments and the California Department of Public Health (CDPH). The data includes disclosure of a new data point related to a patient’s or client’s race and ethnicity. This bill was part of the legislature’s broader “vaccine work group” legislative package.

AB 2223 (WICKS): REPRODUCTIVE HEALTH

Status: Signed by Governor (Chapter 629, Statutes of 2022).

Assembly Bill 2223 clarifies the law to prevent anyone in California from being investigated, prosecuted, or incarcerated for ending a pregnancy or experiencing pregnancy loss.

AB 2626 (CALDERON): MEDICAL BOARD OF CALIFORNIA – LICENSEE DISCIPLINE – ABORTION

Status: Signed by Governor (Chapter 565, Statutes of 2022).

Assembly Bill 2626 prevents state licensing boards from suspending or revoking the license of someone who performs an abortion in accordance with California law. Additionally, the bill prohibits the boards from taking an adverse action against an applicant or licensee that was disciplined in another state for performing an abortion if the abortion met the applicable standard of care for the procedure in California.

SB 866 (WIENER): MINORS – VACCINE CONSENT

Status: Passed Senate, but not taken up on Assembly Floor.

Senate Bill 866 would have allowed minors 15 years of age or older to consent to vaccines that the United States Food and Drug Administration and Advisory Committee on Immunization Practices have approved. Existing law allows minors 12 years of age or older to make certain medical decisions without parental consent, most notably as it relates to consenting to general medical care if the minor lives separately from their parents or legal guardians. Due to timing and vocal opposition, this legislation was not taken up for a vote on the Assembly floor.

SB 871 (PAN): PUBLIC HEALTH – IMMUNIZATIONS

Status: Held in Senate Health Committee.

Senate Bill 871 would have added the COVID-19 vaccine to the list of required vaccinations before a pupil can be admitted into any private or public elementary or secondary school, childcare center, day nursery, nursery, family day care home or development center. The bill also would also have removed the personal belief exemption for the COVID-19 vaccination. This bill was part of the legislature’s broader “vaccine work group” package of legislation.

SB 883 (ROTH): UMBILICAL CORD BLOOD COLLECTION PROGRAM

Status: Signed by Governor (Chapter 604, Statutes of 2022).

Senate Bill 883 extends the University of California’s Umbilical Cord Blood Collection Program through January 1, 2026. Stored umbilical cord blood is a lifesaving resource that is used to treat more than 80 diseases such as leukemia, lymphoma and immune deficiency.

SB 1473 (PAN): HEALTH CARE COVERAGE

Status: Signed by Governor (Chapter 545, Statutes of 2022).

Senate Bill 1473 requires health plans to cover COVID-19 therapeutics consistent with current law related to coverage of COVID-19 testing and vaccinations, which was signed into law in 2021 through CMA-sponsored SB 510 (Pan). Additional provisions of the bill extend coverage for out-of-network cost-sharing for COVID-19 testing and vaccination to six months after the federal public health emergency expires.

SCA 10 (ATKINS): REPRODUCTIVE FREEDOM

Status: Signed by Governor (Chapter 97, Statutes of 2022).

Senate Constitutional Amendment 10 creates a pathway for California to constitutionally protect an individual’s right to reproductive freedom and to obtain health services, including abortion and contraception. Approved with a two-thirds vote of the legislature, the provisions of this bill became Proposition 1 on the November 2022 ballot, which passed with an overwhelming margin of support.

PRIORITY OPPOSE BILLS

AB 1278 (NAZARIAN): PHYSICIANS AND SURGEONS – PAYMENTS: DISCLOSURE: NOTICE

Status: Signed by Governor (Chapter 750, Statutes of 2022).

Assembly Bill 1278 requires physicians to provide each patient with a written or electronic notice about the federal Open Payments database at their initial office visit, and obtain a signature from the patient or a patient representative. This bill was introduced in 2021 and originally would have required physicians to provide each patient with detailed information about the physician’s personal receipt of gifts or funds from pharmaceutical companies, device manufacturers, etc., as reported by those entities in the federal Open Payments database on an annual basis. CMA sought amendments, and the bill was narrowed to a onetime, general notice to patients about the existence of the Open Payments database.

AB 1328 (IRWIN): CLINICAL LABORATORY TECHNOLOGY AND PHARMACISTS

Status: Held on Senate Floor.

Assembly Bill 1328 would have created a scope infringement allowing pharmacists to order and perform over 1,400 Clinic Laboratory Improvement Amendmentsapproved tests, not limited to temperature, pulse and respiration. This bill would also have authorized a pharmacist to order and interpret any test results they ordered to “promote patient health.” CMA worked hard to seek amendments and ultimately stop the bill on the Senate Floor.

AB 1400 (KALRA): GUARANTEED HEALTH CARE FOR ALL

Status: Held on Assembly Floor.

Assembly Bill 1400, the California Guaranteed Health Care for All Act, would have created the CalCare program to administer and provide universal single payer health care coverage and a health care cost control system in the state. The bill contained minimal details regarding the administration of such a program.

AB 1785 (DAVIES): CALIFORNIA PARENTS’ BILL OF RIGHTS ACT

Status: Held in Assembly Education Committee.

Assembly Bill 1785 attempted to create a “California Parents’ Bill of Rights” by making numerous technical and substantive amendments to various code sections. This bill would have undermined existing protections for health care decisions, and the resulting records, that a minor has a statutory right to make. In addition, the bill attempted to erode the ability of a school district to require certain immunizations.

AB 2060 (QUIRK): MEDICAL BOARD OF CALIFORNIA

Status: Killed on Assembly Floor.

Assembly Bill 2060 sought to change the composition of the Medical Board of California to a public member majority and eliminate the licensee majority of the board’s disciplinary panels. This was the second consecutive legislative session that the Legislature sought this change to the board’s composition.

AB 2080 (WOOD): HEALTH CARE CONSOLIDATION AND CONTRACTING FAIRNESS ACT OF 2022

Status: Held in Senate Health Committee.

Assembly Bill 2080 would have required any medical group, hospital, hospital system, health care service plan or pharmacy benefit manager to provide written notice to the Attorney General (AG) at least 90 days before agreeing to a merger, acquisition or change in control with another health care entity if the transaction had a value of $15 million or more. The bill would authorize the AG to consent to, give conditional consent to, or not consent to the agreement, and if the AG did not consent to the agreement, the transaction would be stopped.

AB 2236 (LOW) OPTOMETRY: CERTIFICATION TO PERFORM ADVANCED PROCEDURES

Status: Vetoed by Governor.

Assembly Bill 2236 would have authorized optometrists to perform laser and surgical procedures on a patient’s eye if they met minimal education and training requirements, including performing 43 procedures on live patients. The bill failed to adequately educate optometrists to develop clinical competency and judgment to identify, manage and mitigate complications during surgery to prevent permanent damage to patients’ eyes and eyesight. Echoing CMA’s concerns, Governor Newsom vetoed the bill with a statement indicating: “I am not convinced that the education and training required is sufficient to prepare optometrists to perform the surgical procedures identified. This bill would allow optometrists to perform advanced surgical procedures with less than one year of training. In comparison, physicians who perform these procedures must complete at least a three-year residency program.”

SB 920 (HURTADO): MEDICAL BOARD OF CALIFORNIA: INVESTIGATIONS: RECORD REQUESTS

Status: Held in Senate Business, Professions, and Economic Development Committee.

Senate Bill 920 sought to erode privacy protections for both patients and physicians by allowing Medical Board of California investigators to inspect records prior to requesting a subpoena for the records in order to establish good cause for further investigation. This was the second consecutive legislative session that the Legislature sought this change.

SB 1023 (HURTADO): HEALTH PROFESSIONS – TRAINING AND EDUCATION: BLUE RIBBON COMMISSION

Status: Held in Assembly Health Committee.

Senate Bill 1023 sought to create a Blue-Ribbon Commission on Strengthening our Health System by Transforming Medical Training and Education to Improve Patient Protection. The bill was a misguided effort to address broader concerns about the regulation of physicians and surgeons by the medical board. In particular, the bill sought to reconsider the evidentiary standard used in disciplinary cases. CMA was able to negotiate amendments with the author to refocus the bill on seeking information and reporting on methods to increase the number of diverse physicians entering the workforce, particularly in low-income and rural communities.

SB 1467 (KAMLAGER): MATERNAL MENTAL HEALTH

Status: Held in Senate Health Committee.

Senate Bill 1467 sought to ensure that all biological mothers are offered maternal mental health care services or are screened appropriately for maternal mental health conditions. CMA expressed concern that the term biological mother may exclude a population of people that may be pregnant or become pregnant. CMA’s Council on Legislation took an oppose unless amended position and sought an amendment to change the term biological mother to birthing person. Instead, the bill failed to garner a hearing in its first committee.

ACA 11 (KALRA): TAXES TO FUND HEALTH CARE COVERAGE AND COST CONTROL

Status: Held in Assembly Rules Committee.

Assembly Constitutional Amendment 11 was the companion funding mechanism for the single-payer health care system proposed under AB 1400 (Kalra, 2021), which the association took an oppose unless amended position on. ACA 11 would have raised the gross receipts tax, increased the employer and employee shares of the payroll tax, and increased the personal income tax on high earners. This bill was never referred out of the Assembly Rules Committee.

SUCCESSFULLY NEGOTIATED BILLS

AB 1704 (CHEN): LIMITED PODIATRIC RADIOGRAPHY PERMITS

Status: Signed by Governor (Chapter 580, Statutes of 2022).

Assembly Bill 1704 adds health care professionals operating leg-only podiatric radiography equipment under the supervision of a licensed podiatrist to the list of individuals exempted from the existing requirements of state law regarding who is permitted to operate radiological equipment in California. It also tried to remove the CDPH Radiologic Health Branch’s authority to determine certification and move it to the Podiatric Medical Board of California. CMA was able to retain the certification authority within CDPH and provide more specificity related to the requirements to receive this permit.

AB 1809 (AGUIAR-CURRY): NURSING FACILITY RESIDENT INFORMED CONSENT PROTECTION ACT OF 2022

Status: Vetoed by Governor.

Assembly Bill 1809 would have required informed consent be given by a skilled nursing facility resident before being prescribed and administered any psychotherapeutic medication. Additionally, the prescribing physician could be charged with criminal battery for not obtaining the consent from the resident. CMA secured amendments to narrow the drugs affected by the bill, remove the charge of criminal battery from the bill and to require only the relevant information about the prescribed medication be given to the resident for consent purposes.

AB 1896 (QUIRK): GAMETE BANKS

Status: Vetoed by Governor.

Assembly Bill 1896 would have added notification requirements to gamete banks. Specifically, this bill attempted to require gamete banks to notify clients of the risk of inbreeding and steps to mitigate that risk. In addition, the banks would have been required to implement a secure process for tracking future sperm donations and sharing that information with other gamete banks. CMA staff successfully negotiated amendments that minimized this bill to being education-based only, while reducing the administrative burdens and liability risk that were originally part of the bill.

AB 1954 (QUIRK): PHYSICIANS AND SURGEONS – TREATMENT AND MEDICATION OF PATIENTS USING CANNABIS

Status: Signed by Governor (Chapter 232, Statutes of 2022).

Assembly Bill 1954 originally would have prohibited physicians from denying treatment to a patient solely based on a positive drug test for tetrahydrocannabinol (THC). CMA successfully negotiated amendments stating that a physician shall not automatically deny treatment or medication to a qualified patient based solely on a positive drug screen for THC. This amendment restored a physician’s discretion for medical decision-making. The amendments ensure that physicians are protected from liability risk and continue to have the ability to make medical decisions for their patients.

AB 2085 (HOLDEN): CRIMES – MANDATED REPORTERS

Status: Signed by Governor (Chapter 770, Statutes of 2022).

Assembly Bill 2085 originally required mandatory reporters, including physicians, to make a determination between “severe neglect” and “general neglect,” and required that they only report neglect deemed “severe.” CMA sought amendments to clarify that health professionals must have clear standards about mandatory reporting and that making an assessment between “general” and “severe” neglect should not be a part of their role. Amendments were taken to the bill focusing the measure on the definition of “general neglect” in the law rather than on an assessment of levels of neglect by mandatory reporters.

AB 2274 (B. RUBIO): MANDATED REPORTERS – STATUTE OF LIMITATIONS

Status: Signed by Governor (Chapter 587, Statutes of 2022).

Assembly Bill 2274 would have made it a continuing crime if mandated reporters, which includes physicians, did not report child abuse regardless of whether or not the failure to report was intentional. CMA secured amendments to instead extend the statute of limitations for a person to bring a lawsuit against a mandated reporter who did not report to five years from the date of the occurrence of the offense.

AB 2338 (GIPSON): HEALTH CARE DECISIONS – DECISION MAKERS AND SURROGATES

Status: Signed by Governor (Chapter 264, Statutes of 2022).

Assembly Bill 2338 would have adopted a rigid, default hierarchy surrogate consent law in which family members and the people closest to a patient by kinship become designated surrogate decision-makers for the patient’s health care decisions, including when the patient is incapacitated or otherwise unable to personally designate a surrogate. CMA secured amendments that made the hierarchy suggestive and not mandatory, thereby addressing the liability concerns that initially existed with the bill.

SB 923 (WIENER): GENDER-AFFIRMING CARE

Status: Signed by Governor (Chapter 822, Statutes of 2022).

Senate Bill 923 initially would have required physicians and their staff to complete a one-time cultural humility course for the transgender, gender nonconforming and intersex (TGI) communities before they would be able to contract with a health plan to provide care. The provider or staff would be required to take the course again if a complaint was filed against the provider or their staff. CMA secured amendments to the bill that incorporated the TGI community into current physician continuing medical education cultural competency requirements and removed the contracting prohibitions in the bill.

SB 964 (WIENER): BEHAVIORAL HEALTH

Status: Vetoed by Governor.

Senate Bill 964 would have required the Board of Behavioral Sciences to analyze current law and provide recommendations to the legislature about actions it can take to increase the supply of behavioral health professionals and increase access to behavioral health services. The board would have to evaluate current scope of practice laws, licensing and clinical training requirements, and requirements for the renewal requirements for expired licenses. The bill ultimately would have required a report of the current behavioral health workforce and the state’s behavioral workforce needs. CMA successfully removed the review of current scope of practice laws.

AB 1375 (ATKINS): NURSING: NURSE PRACTITIONERS AND NURSE-MIDWIVES – ABORTION AND PRACTICE STANDARDS

Status: Signed by Governor (Chapter 631, Statutes of 2022).

Senate Bill 1375 is intended to increase access to abortion services by trained nurse practitioners. However, as introduced, it would also have eliminated the transition to practice for Section 103 and Section 104 nurse practitioners, which is much broader and unrelated to abortion care. At CMA’s request, a number of amendments were adopted that removed our opposition. The bill was amended to include additional training safeguards for nurse practitioners performing aspiration abortions and to remove the sections of the bill that would have eliminated the transition to practice for nurse practitioners.