Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law, except as provided and under certain circumstances, prohibits a person who manufactures a prescription drug from offering a discount, repayment, product voucher, or other reduction in an individual's out-of-pocket expenses associated with their health insurance or health care service plan. Existing law generally imposes specified cost sharing limits on covered prescription drugs. This bill would require a health care service plan or health insurer, when calculating an enrollee's or insured's overall contribution to an out-of-pocket maximum or cost sharing requirement under the plan contract or insurance policy, to count any amount paid by the enrollee or insured or on behalf of the enrollee or insured for a covered drug toward the enrollee's or insured's cost sharing, except as provided. The bill would prescribe an administrative penalty for each violation by a health insurer that is enforceable by the Insurance Commissioner after appropriate notice and opportunity for hearing. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Naturopathic Doctors Act, which is repealed on January 1, 2027, establishes the California Board of Naturopathic Medicine within the Department of Consumer Affairs to license and regulate naturopathic doctors. The act requires the board to consist of 9 members, appointed by the Governor, Speaker of the Assembly, or the Senate Committee on Rules, as specified, and requires each member of the board be appointed to a 4-year term. This bill would instead repeal those provisions on January 1, 2031. The bill would specify that the 4-year term expires 4 years after the date of the appointment. To ensure staggered terms, the bill would require that specified members appointed by the Governor after the effective date of this bill be appointed for prescribed term lengths and thereafter would require all appointments be for four-year terms. The bill would also make nonsubstantive changes to the provisions specifying the appointment authorities for the board members. Existing law sets forth fees associated with the application and renewal of a license, including a renewal fee of $1,000 and authorizing an increase to not more than $1,200. This bill would, instead, specify that this fee range applies to the renewal of an active license and would require the renewal fee for an inactive license to be one-half of the current renewal fee for an active license. The bill would authorize the board to accept the voluntary cancellation of a naturopathic doctor's license, as prescribed, upon the written request of the licensee, provided that the cancellation is not in lieu of an administrative enforcement action. Existing law requires an applicant to have received a degree in naturopathic medicine from an approved naturopathic medical school, as specified. Existing law requires the board to approve a naturopathic medical school program that is accredited by the Council on Naturopathic Medical Education (CNME) or another federally recognized accrediting body if the program meets specified admission and program requirements. This bill would, instead, require the board to approve a program that is accredited by either the CNME or a substantially equivalent accreditor, or that is housed in an accredited institution and meets standards substantially equivalent to those required by CNME, if the program meets the above-described admission and program requirements and other specified requirements. Existing law, the Medical Practice Act, makes it a crime to practice or hold oneself out as practicing medicine, as specified, without having a certificate to do so. Under existing law, providing services other than those specified is not a violation of that crime if the person providing those services discloses that they are not a licensed physician, among other things, and obtains a written acknowledgment from the client before providing those services. The Naturopathic Doctors Act makes it a crime to claim to be a naturopathic doctor without a valid license under the act but does not restrict use of the title "naturopath." The Naturopathic Doctors Act also does not limit activity otherwise allowed by law, including the practice of naturopathy, and authorizes an unlicensed person who engages in specified activities to represent that they "practice naturopathy," if they comply with the above-described provisions of the Medical Practice Act. This bill would revise and recast those provisions. Specifically, the bill would make it a crime to practice or hold oneself out as practicing naturopathic medicine, as specified, without having a license to do so. The bill would specify that engaging in activity that is otherwise allowed by law or using the title "naturopath" is a not a violation of this crime if the person complies with the above-described provisions of the Medical Practice Act and discloses they are not a naturopathic doctor, as provided. By establishing a new crime, this bill would impose a state-mandated local program. Existing law, the Medical Practice Act, prohibits use of any fictitious, false, or assumed name by a physician and surgeon or any doctor of podiatric medicine, as specified, in any public communication, advertisement, sign, or announcement of a practice without a fictitious-name permit. Existing law requires the Medical Board of California or the Division of Licensing to issue a fictitious-name permit if the applicant for the permit satisfies certain conditions, including having a name that includes specified designations. This bill would prohibit the use of any fictitious, false, or assumed name by a naturopathic doctor, as specified, in any public communication, advertisement, sign, or announcement of a practice without a fictitious-name permit. The bill would require the California Board of Naturopathic Medicine to issue a fictitious-name permit if the applicant for the permit satisfies certain conditions. The bill would require the application fee for a fictitious name permit to be $100 and would require the renewal fee for a fictitious-name permit to be $50. The Naturopathic Doctors Act authorizes the board to grant a license to an applicant who meets specified requirements, but who graduated before 1986, and passed a state or Canadian Province naturopathic licensing examination, as specified. The act requires that applications under this provision be received no later than December 31, 2007. This bill would repeal those provisions. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law provides for the licensure and regulation of health facilities, including general acute care hospitals and skilled nursing facilities, by the State Department of Public Health. A violation of these provisions is generally a crime. Under existing law, if a person dies in a hospital, convalescent hospital, or board and care facility without known next of kin, the person in charge of the hospital or facility is required to give immediate notice of that fact to the public administrator of the county in which the hospital or facility is located, and if the person in charge fails to do so, the hospital or facility is liable for the cost of internment, as specified, and specified losses incurred by the estate or beneficiaries as a result of the failure to notify. This bill would instead require the licensee in charge of a general acute care hospital or a skilled nursing facility to make a reasonable attempt to notify any known next of kin, as specified. The bill would state that this requirement is met if a skilled nursing facility notifies the person's resident representative or has the body transferred to a hospital after death, or if the person notified the hospital or facility, prior to death and in writing, that they do not want their known next of kin to be notified of their presence or death. The bill would require, if a reasonable attempt is made or the person expressed a desire that next of kin not be notified, as specified, that the hospital or facility give notice to the public administrator as described above. The bill would make a hospital or facility that fails to notify any known next of kin liable for a continuing civil penalty of $200 per day, up to a maximum of $50,000, measured from the time it would take to make a reasonable attempt to notify the next of kin until the actual knowledge by the next of kin of the decedent's death. The bill would also make a hospital or facility that fails to notify the county public administrator, as specified, liable for a continuing civil penalty of up to $200 per day, up to a maximum of $50,000, measured from the 5th business day following a person's death until the county public administrator is notified. The bill would authorize a licensee that disputes the assessment of a civil penalty to, within 10 working days of the notification of the penalty, request a hearing pursuant to specified law.
Existing law, the Naturopathic Doctors Act, provides for the licensure and regulation of naturopathic doctors by the California Board of Naturopathic Medicine. Existing law repeals the act on January 1, 2027. This bill would extend operation of the act until an unspecified date. Existing law defines naturopathic medicine and authorizes a naturopathic doctor to perform specific health care functions. Existing law authorizes a naturopathic doctor to dispense, administer, order, prescribe, and furnish or perform, among other things, repair and care incidental to superficial lacerations and abrasions, except suturing, and the removal of foreign bodies located in the superficial tissues. This bill would, instead, authorize a naturopathic doctor to dispense, administer, order, prescribe, and furnish or perform minor office procedures, defined, in part, to mean care and operative procedures relative to lacerations, skin lesions, and abrasions, the incision and drainage of abscesses, and the trephination of subungual hematomas, among other specified procedures. Existing law authorizes a naturopathic doctor to furnish or order drugs, including Schedule III to Schedule V, inclusive, controlled substances, under specified circumstances, including, among others, that the drugs are furnished or ordered under the supervision of a physician and surgeon and in accordance with standardized procedures or protocols developed by the naturopathic doctor and their supervising physician and surgeon and that the board has certified that the naturopathic doctor has completed coursework in pharmacology, as specified. Existing law authorizes a naturopathic doctor to independently prescribe and administer other specified drugs. This bill would revise and recast the above-described authorizations to instead authorize a naturopathic doctor to furnish, order, or prescribe drugs, including, among others, Schedule II to Schedule V, inclusive, controlled substances, and would remove the supervision and standardized procedure requirements. The bill would make conforming changes.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a pharmacy benefit manager contracting with a health care service plan or health insurer to secure a license from the Department of Managed Health Care on or after January 1, 2027, or the date on which the department has established the licensure process, whichever is later. This bill would require the department to maintain a public internet website displaying specified information for each licensed pharmacy benefit manager, including, among other things, the legal name, license number, and license expiration date.
Existing law provides for the licensure and regulation of drug testing laboratories and adult alcoholism or drug abuse recovery or treatment facilities and provides for the certification and regulation of adult alcoholism or drug abuse recovery or treatment programs by the State Department of Health Care Services and authorizes the department to enforce those provisions. Existing law authorizes a facility described above to offer transportation services to an individual who is seeking recovery or treatment services only if specified conditions are met, including, among other things, that any air transportation provided to the individual includes a return ticket that may be used by the individual upon discharge and that a return ticket not used by an individual upon discharge is made available to the individual upon request for a period of one year following the individual's discharge. This bill would require a laboratory, facility, or program described above that provides air transportation to provide a ticket for round-trip transportation. The bill would additionally require, as conditions on the provision of transportation services, that the cost of the recovery or treatment services are prohibitive for the individual without assistance from the laboratory, facility, or program, and would require the laboratory, facility, or program to obtain written acknowledgment by the individual that the transportation is not tied to insurance benefits or program participation, to document the purpose and cost of the transportation, to compile information related to the provision of transportation, and to annually publish the compiled information on its internet website. The bill would require a laboratory, facility, or program to retain the information for a minimum of 5 years and to provide that information to the department upon request. Existing law prohibits facilities and programs described above and related persons from giving or receiving remuneration or anything of value for the referral of a person who is seeking alcohol or other drug recovery or treatment services. This bill would additionally apply the prohibition described above to the inducement of a person seeking services and would clarify that the prohibition prohibits specified practices by facilities or programs, including, among others, influencing or inducing an individual to enter or stay in a treatment or recovery program and recruiting individuals for treatment, unless otherwise specified.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law authorizes the Director of the Department of Managed Health Care to authorize a pilot program in southern California under which approved providers may undertake risk-bearing arrangements with a voluntary employees' beneficiary association with enrollment of more than 100,000 lives, as specified, beginning no earlier than January 1, 2022, to December 31, 2027, inclusive, if certain criteria are met. Existing law requires the association and each participating health care provider to report to the department information regarding cost savings and clinical patient outcomes compared to a fee-for-service payment model. Existing law requires the department to report those findings to the Legislature after the termination of the pilot program and before January 1, 2027. Existing law repeals these provisions on January 1, 2030. This bill would extend that repeal date to January 1, 2031. The bill would extend the end date of the pilot program to December 31, 2030, but would authorize the department to terminate the pilot program for specified reasons and would require the department to terminate the pilot program prior to the pilot program's end date based on any significant negative findings in any report, including if the department identifies any serious deficiencies that could cause enrollee harm. The bill would, instead of requiring the department to report findings to the Legislature after the termination of the pilot program, require the department to submit an interim report of the findings described above and policy recommendations regarding the continuation of the pilot program to the Legislature before January 1, 2029.
Existing law, the Physical Therapy Practice Act, establishes the Physical Therapy Board of California within the Department of Consumer Affairs for the licensure, approval, and regulation of physical therapists and physical therapist assistants. Existing law prescribes specified fees for licenses issued by the board. Existing law authorizes the board to decrease or increase the fee amounts, and establishes specified maximum amounts of license fees. Existing law repeals the board and its authority to employ an executive officer on January 1, 2027. This bill would extend the board's authority to enforce and administer the act and to appoint an executive officer until January 1, 2031. The bill would increase specified fees for licenses issued by the board and would increase the maximum amount to which the board may increase the fees, as specified. The bill would also make nonsubstantive changes to those fee provisions. Existing law authorizes a person whose license has been revoked or suspended, or who has been placed on probation, to petition the board for reinstatement or modification of a penalty after a specified period of time has elapsed. Existing law prohibits the board from considering a petition while the petitioner is under sentence for any criminal offense, including any period of court-imposed probation or parole, or while there is an accusation or petition to revoke probation pending against the petitioner. This bill would further prohibit the board from considering a petition if the applicant is required to register as a sex offender, as specified. The bill would except from this prohibition an applicant whose requirement to register as a sex offender is based solely on a misdemeanor conviction. The bill would also prohibit the board from considering a petition if the conduct underlying the petitioner's conviction involved certain sexual misconduct.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of disability insurers by the Department of Insurance. Existing law requires a health care service plan or disability insurer to allow an individual to enroll in or change their health benefit plan as a result of a specified triggering event. This bill would make pregnancy a triggering event for purposes of enrollment or changing a health benefit plan. Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law generally prohibits a health care service plan, excluding a Medi-Cal managed care plan, or health insurer from subjecting antiretroviral drugs that are medically necessary for the prevention of HIV/AIDS, including preexposure prophylaxis or postexposure prophylaxis, to prior authorization or step therapy. Under existing law, a health care service plan or health insurer is not required to cover all of the therapeutically equivalent versions of those drugs without prior authorization or step therapy if at least one is covered without prior authorization or step therapy. This bill would instead prohibit a health care service plan, excluding a Medi-Cal managed care plan, or health insurer from subjecting antiretroviral drugs, drug devices, or drug products that are medically necessary for the prevention of HIV/AIDS to prior authorization or step therapy. The bill would require, for a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, a non-self-administered antiretroviral drug, drug device, or drug product that is approved by the United States Food and Drug Administration for the prevention of HIV/AIDS to be covered under both the plan or policy's medical benefit and prescription drug benefit, and if obtained under the plan or policy's drug benefit, would require the drug, device, or product to be dispensed and administered by a health care provider acting within the scope of their license. Because a willful violation of these provisions by a health care service plan would be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
