SB 642

Bill Subjects

Abstract

(1) Existing law prohibits health care service plans and their contracting entities from including provisions in their contracts that interfere with the ability of a physician and surgeon or other licensed health care provider to communicate with a patient regarding their health care. This bill would prohibit a health facility from requiring a physician or surgeon, as a condition of obtaining or maintaining clinical privileges, to agree to comply with criteria, rules, regulations, or other policies or procedures that are not knowingly and explicitly ratified, issued, or promulgated by the medical staff, that directly or indirectly prohibit, limit, or restrict the ability of the physician or surgeon to provide a particular medical treatment or service that falls within the scope of their privileges, or from requiring a physician or surgeon to obtain permission from a nonphysician or nonsurgeon to perform a particular medical treatment or service for which consent has been obtained from the patient or the patient's representative, except as provided. The bill would prohibit a health facility from limiting or otherwise exercising control over the independent professional judgment of a physician or surgeon concerning the practice of medicine or the diagnosis or treatment of disease, if the physician or surgeon, exercising their independent professional judgment, determines that a particular medical service or treatment is medically appropriate, unless specified circumstances apply. This bill would authorize a superior court, upon application by a health facility's medical staff or an individual member of a facility's medical staff, to issue an injunction or other appropriate order restraining any acts or practices that could constitute a violation of these provisions. The bill would specify that its provisions cannot be construed to prohibit a health facility from establishing criteria, rules, regulations, policies, or procedures that are required by federal or state law or regulation as a condition of licensure, receipt of federal or state funds, or participation in Medicare, Medi-Cal, or other federal or state health care programs, or limit a medical staff's authority to take corrective action against medical staff members in accordance with the medical staff bylaws, except in specified circumstances. The bill would also prohibit health facility corporate bylaws, policies, rules, contracts, or other institutional requirements that conflict with these provisions from being applied to directly or indirectly affect a physician's clinical privileges or rights, or privileges of membership on the medical staff, except as required by federal or state law. (2) Existing law requires each shareholder, director, and officer of a medical or podiatry corporation, except as provided, to be a licensed person, as defined. This bill would require the shareholders, directors, and officers of a medical corporation to manage and have ultimate control, as defined, over the assets and business operations of the medical corporation and not be replaced, removed, or otherwise controlled by any lay entity or individual, as specified. (3) Existing law requires any nonprofit corporation that operates or controls a health facility or operates or controls a facility that provides similar health care, as specified, to provide written notice to, and to obtain the written consent of, the Attorney General prior to entering into any agreement or transaction to sell, transfer, lease, or exchange its assets to a for-profit corporation or entity or to a mutual benefit corporation or entity when a material amount of the assets of the nonprofit corporation are involved in the agreement or transaction, or to transfer control, responsibility, or governance of a material amount of the assets or operations of the nonprofit corporation to any for-profit corporation or entity or to any mutual benefit corporation or entity, as specified. Existing law requires any nonprofit corporation that operates or controls a health care facility, or that or operates or controls a facility that provides similar health care to provide written notice to, and to obtain the written consent of, the Attorney General prior to entering into any agreement or transaction to sell, transfer, lease, or exchange its assets to another nonprofit corporation or entity when a material amount of the assets of the nonprofit corporation are involved in the agreement or transaction, or to transfer control, responsibility, or governance of a material amount of the assets or operations of the nonprofit corporation to another nonprofit corporation or entity. Existing law gives the Attorney General discretion to consent to, give conditional consent to, or not to consent to these agreements or transactions considering any factor they determine to be relevant. This bill would include among those factors that, if applicable, may be relevant to the Attorney General in determining whether to consent whether the agreement or transaction may create a reduction of or limitation on the availability of the full range of health care services to any group of individuals based on any characteristic listed or defined in the Unruh Civil Rights Act. The bill would also include among those factors whether the agreement or transaction may result in undue interference in patients' access to medical care due to improper or unlawful motives. (4) This bill would state that its provisions are severable.