Under existing law, the State Department of Health Care Services is responsible for administering prevention, treatment, and recovery services for alcohol and drug abuse and problem gambling. Existing law defines "alcohol and other drug services" as a service that is designed to encourage recovery from the abuse of alcohol and other drugs, and "alcohol and other drug abuse program" as a collection of alcohol and other drug services that are coordinated to achieve specified objectives. Existing law also provides for the licensure and regulation of adult alcoholism or drug abuse recovery and treatment facilities by the department and authorizes the department to enforce those provisions. This bill, the Body Brokering and Patient Referral Integrity Act, would prohibit any person from offering, paying, soliciting, or receiving a commission, benefit, bonus, or other form of remuneration or from engaging in a split-fee arrangement to induce a referral to a residential treatment facility or in return for acceptance of an individual into a residential treatment facility. The bill would make a violation of that provision a misdemeanor. The bill would define a "residential treatment facility" to include any sober living home, group home, recovery residence, residential care facility, or similar facility providing housing or residential services, in connection with alcohol or substance use disorder treatment or behavioral health recovery. By creating a new 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.
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 sets forth requirements by which a health care service plan or health insurer reimburses a provider for health care services. This bill would require a determination to downcode a claim, which is the unilateral alteration by a payer of the service or procedure code submitted on a claim resulting in a lower payment, to include a documented review of the clinical information supporting the billed service. The bill would set forth requirements for and limitations of downcoding decisions, and, if a claim is downcoded, would require a plan or insurer to provide a billing provider with specified information and a clear and accessible process for disputing downcoded claims. The bill would prohibit a plan or insurer from using downcoding practices in a targeted or discriminatory manner against physicians or other health care providers who routinely treat patients with high acuity, complex, or chronic conditions, and would authorize the departments to take action against a plan or insurer that engages in a pattern or practice of discriminatory downcoding or that otherwise violates these provisions. 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 bill would require the departments to collect data on coding and claims adjustment practices, evaluate the information, and submit a report with specified information to the Legislature. 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 Vocational Nursing Practice Act, establishes the Board of Vocational Nursing and Psychiatric Technicians of the State of California to license and regulate vocational nurses and psychiatric technicians. Chapter 624 of the Statutes of 2022 (SB 1436) limited the respiratory tasks and services that a licensed vocational nurse may perform to basic respiratory tasks and services that do not require a respiratory assessment and only require manual, technical skills, or data collection, as identified by the Respiratory Care Board of California, as specified. SB 1436 and subsequent legislation have created exemptions for a licensed vocational nurse to perform respiratory tasks and services under specified circumstances that vary depending on the task or service, the nurse's training, demonstrated competency, and employer, and the setting in which the task or service is performed, as provided. SB 1436 became effective on January 1, 2023. This bill, instead, would authorize a licensed vocational nurse to perform respiratory tasks and services consistent with the scope of practice of a licensed vocational nurse, as it existed on December 31, 2022. The bill would make various conforming changes, including removal of the above-described exemptions.
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 requires a health care service plan's assets to be invested in a prudent manner and requires the director of the department to determine the acceptability of a health care service plan's investments, as specified. This bill would state the intent of the Legislature to enact legislation to require the public disclosure of material investment holdings of nonprofit organizations providing integrated health care service plans.
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 requires a full service health care service plan, excluding a Medi-Cal managed care plan, or its delegate, to subscribe to and use the Council for Affordable Quality Healthcare credentialing form on and after January 1, 2028. On and after January 1, 2027, existing law requires a health care service plan, excluding a Medi-Cal managed care plan, or its delegate, that credentials health care providers for its networks to make a determination regarding the credentials of a provider within 90 days after receiving a completed provider credentialing application. This bill would extend the application of the above-described requirements to Medi-Cal managed care plans. Because a willful violation of these requirements by a Medi-Cal managed care 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 provides for the licensure of alcohol or other drug recovery or treatment facilities, and the certification of alcohol or other drug programs, by the State Department of Health Care Services. Existing law requires the department to develop and maintain a centralized indicator data collection system that gathers and obtains information on the status of alcohol and other drug problems in the state, and requires the information to include, among other things, the number and characteristics of persons receiving recovery or treatment services from alcohol and other drug programs providing publicly funded services or services licensed by the state. Existing data collection systems developed by the department, known as the California Outcomes Measurement System Treatment and Drug and the Alcohol Treatment Access Report, collect data for substance use disorder (SUD) treatment services and SUD treatment capacity from specified treatment providers. This bill would require the above-described facilities and programs, commencing on January 1, 2028, to submit to the department certain data, including, treatment and outcome information and treatment availability information consistent with the requirements of the California Outcomes Measurement System Treatment and the Drug and the Alcohol Treatment Access Report. The bill would not apply to an entity that is contracted to provide Medi-Cal treatment services or contracted with the department, among others, and would clarify that these provisions do not impose additional or new reporting requirements on an entity that reports data to the department through the California Outcomes Measurement System Treatment and the Drug and Alcohol Treatment Access Report.
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's requirements a crime. Existing law requires a health care service plan to notify an enrollee by United States mail at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending that notice, existing law requires the plan to offer each affected enrollee the option to return to that provider and to reassign the enrollee to another provider if the enrollee does not exercise that option. This bill would additionally require a health care service plan to notify an enrollee by email or text message, as specified and only if the enrollee has opted in and provided their contact information, at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminating or terminated provider after sending the notice of termination, the bill would require the health care service plan to send written notice by United States mail and by email or text message, as specified and only if the enrollee has opted in and provided their contact information, to affected enrollees no later than 10 business days after department approval of the notice. If the agreement is to renew, enter into a new contract, or to not terminate their contract before the termination date in the notice of termination, the bill would require the health care service plan to notify enrollees that they will remain assigned to the provider. If the agreement is to renew, enter into a new contract, or to not terminate their contract after the termination date in the notice of termination, the bill would require the health care service plan to notify and offer each affected enrollee the option to return to that provider. The bill would require a health care service plan to submit these notices to the department for approval within 5 business days of reaching an agreement. Because a willful violation of these provisions 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.
Existing law establishes, within the California Health and Human Services Agency, the State Department of Public Health, which has authority over various programs promoting public health, including the California Tobacco Control Program. Existing law requires the department to, among other things, establish a program on tobacco use and health to reduce tobacco use in California by conducting health education interventions and behavior change programs at the state level, in the community, and other nonschool settings. Existing law also requires the department to conduct statewide surveillance of tobacco-related behaviors, knowledge, and attitudes and evaluate the department's local and state tobacco control programs. Under existing law, the department funds the Kick It California program, which is a tobacco cessation program. Existing law, the California Cigarette and Tobacco Products Licensing Act of 2003, provides for the licensure by the California Department of Tax and Fee Administration of manufacturers, distributors, wholesalers, importers, and retailers of cigarette or tobacco products that are engaged in business in California. The act authorizes the department to suspend or revoke a retailer's license or impose a civil penalty for a violation of the act's provisions and requires all moneys collected under the act to be deposited in the Cigarette and Tobacco Products Compliance Fund to be available for expenditure, upon appropriation by the Legislature, for specified uses. Existing law requires a retailer to conspicuously display its license to engage in the sale of cigarettes or tobacco products at each retail location in a manner visible to the public. This bill would require the State Department of Public Health, no later than July 1, 2027, to make available signage to raise lung cancer screening awareness, as specified, which would include, among other things, eligibility criteria for lung cancer screening and the toll-free telephone number of the Kick It California tobacco cessation program. The bill would require the sign to be available at no cost on the department's internet website. The bill would require, beginning January 1, 2028, a retailer, as defined, to conspicuously display the signage at each retail location. The bill would make a retailer who violates that requirement liable for a civil penalty of $500 for each offense at a retail location and would require those penalties to be deposited into the Cigarette and Tobacco Products Compliance Fund.
Existing law establishes various healing arts boards within the Department of Consumer Affairs, including the Medical Board of California and the Dental Board of California, that license and regulate various healing arts licensees. Existing law, including the Medical Practice Act and the Dental Practice Act, deem certain violations by licensees to be unprofessional conduct subject to discipline by the licensee's licensing board. Existing law requires a physician and surgeon or dentist to refund to a patient any amount paid by the patient for services rendered that was subsequently paid to the physician and surgeon or dentist by a third-party payor and that constitutes a duplicate payment, as prescribed. Existing law requires that the above-described duplicate payment refund be paid, if requested by the patient, either within 30 days of that request or, if the duplicate payment has not been received, within 30 days of receipt of the duplicate payment by the physician and surgeon or dentist. Existing law requires, if the patient does not request a refund, a physician and surgeon or dentist who knows, or should have known, of the receipt of the duplicate payment to notify the patient, as prescribed, and to refund the payment within 30 days of that notification, except as specified. Existing law makes a violation of the above requirements unprofessional conduct subject to disciplinary proceedings as described above. This bill would reduce the duration for a physician and surgeon or dentist to refund a duplicate payment following patient request or patient notification to 21 days.
Existing law, the Speech-Language Pathologists and Audiologists and Hearing Aid Dispensers Licensure Act, until January 1, 2027, establishes the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board within the Department of Consumer Affairs for the licensure and regulation of speech-language pathologists, speech-language pathology aides, speech-language pathology assistants, audiologists, dispensing audiologists, and hearing aid dispensers. Existing law, until January 1, 2027, authorizes the board to appoint a person designated as the executive officer to perform duties delegated by the board and vested in them in the act. Existing law makes a violation of the act a misdemeanor. This bill would extend the operation of the board and authorization to appoint an executive officer until January 1, 2031. Existing law specifies that a person holds themselves out to the public as a speech-language pathologist or audiologist by using specified titles. This bill would specify a person also holds themselves out to the public as a speech-language pathologist or audiologist by using a business name with those titles. Existing law requires a supervising speech-language pathologist or supervising audiologist to submit to the board a description of the proposed professional responsibilities of an applicant who is issued a temporary license as a speech-language pathologist or audiologist, as applicable, working under their supervision. This bill would delete that requirement. Existing law requires a speech-language pathologist or audiologist supervising speech-language pathology or audiology aides to register with the board the name of each aide working under their supervision. This bill would prohibit a speech-language pathology or audiology aide from advertising or representing that they hold a license as a speech-language pathologist, speech-language pathology assistant, or audiologist. The bill would prohibit a speech-language pathology or audiology aide, a professional experience license holder, or a speech-language pathology assistant from being the sole proprietor of, or managing or independently operating, a business that engages in the practice of speech-language pathology or audiology. Existing law grants to the board the full authority to investigate and evaluate each applicant applying for a license to practice speech-language pathology or audiology, to determine the admission of the applicant to the examination, or to issue a license. Existing law requires the board to perform all examination functions, to determine the subject matter and scope of the examinations, and to keep recordings of any oral examination for at least 2 years. This bill would delete those provisions and would instead require an applicant to pass an examination approved by the board, which may be conducted by the board or by an organization specified by the board. Existing law requires the board to issue, suspend, and revoke licenses and approvals to practice speech-language pathology and audiology. This bill would also require the board to issue, suspend, and revoke registrations, and would make various provisions in the act applicable to registrants, including requiring registrants to pay a fee not to exceed $25 for issuance of a registration status. Existing law establishes requirements for licensure as a speech-language pathologist or audiologist, including possession of at least a master's degree in speech-language pathology or audiology from an educational institution approved by the board or qualifications deemed equivalent by the board. This bill would expand the list of degrees that would satisfy that requirement to include at least a master's degree in communication disorders, communication sciences and disorders, communicative disorders, or speech, language, or hearing sciences. Existing law, until January 1, 2027, deems a person who holds one of specified clinical competence certificates issued by certain entities to have met certain educational and experience requirements for licensure as a speech-language pathologist or audiologist, as specified. This bill would extend the operation of that provision until January 1, 2031. Existing law establishes continuing education requirements for licensees and requires continuing professional development services to be obtained from accredited institutions of higher learning or organizations approved as continuing education providers, as specified. This bill would revise the list of authorized continuing education providers to include organizations approved as continuing education providers by the California Academy of Audiology, the California Speech-Language-Hearing Association, or the American Medical Association, and continuing professional development services obtained by a federal, state, or local governmental entity. This bill would require the board, upon payment of a $75 fee, to issue a retired license to a licensed speech-language pathologist, speech-language pathology assistant, audiologist, hearing aid dispenser, or dispensing audiologist who holds a license that is current and active or a license that is inactive, and the license is not suspended, revoked, surrendered, or subject to disciplinary action, as specified, subject to satisfaction of specified requirements. Existing law authorizes the board to suspend, revoke, or impose terms and conditions upon the license of any licensee for specified acts, including violating or attempting to violate any provisions of the act. This bill would make those provisions applicable to registrants. 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 penalty, as specified. This bill would make those provisions applicable to a person whose license has been surrendered, as specified. Existing law requires the board to adopt regulations, in collaboration with the State Department of Education, the Commission on Teacher Credentialing, and the Advisory Commission on Special Education, that set forth standards and requirements for the adequate supervision of speech-language pathology assistants, including minimum continuing professional development requirements. This bill would prohibit coursework from a master's degree that would qualify an applicant for licensure as a speech-language pathologist from being used, as specified, to satisfy those continuing professional development requirements. Existing law establishes educational requirements for applicants for approval as a speech-language pathology assistant, and specifies that a person who has successfully graduated from a board-approved bachelor's degree program in speech-language pathology or communication disorders is deemed to have satisfied those requirements. This bill would expand the list of degrees that would satisfy those requirements to include a bachelor's degree in communication disorders, speech-language and hearing sciences, communication sciences and disorders, or communicative disorders. Existing law prohibits provisions regulating hearing aid dispensers from being construed to limit the use of a speech aide or other personnel employed by a public school working under the supervision of a speech-language pathologist. This bill would specify that construction applies so long as the speech aide or other personnel is not performing the responsibilities, duties, and functions of a speech-language pathology assistant. This bill would prohibit a person who is not registered as a speech-language pathology assistant from using the title "SLP assistant" or the letters "SLPA," and would prohibit a speech-language pathology assistant from advertising or otherwise representing that they hold a license as a speech-language pathologist. Existing law authorizes hearing aids to be sold by catalog or direct mail, subject to satisfaction of specified requirements. The bill would authorize hearing aids to be sold online. Existing law makes it unlawful for an individual to engage in the practice of fitting or selling hearing aids without a license, except as specified. This bill would specify that some of those provisions apply to hearing aid dispensers instead of licensees, and would change some of those provisions so they apply to an address or addresses instead of a place of business. Relative to the regulation of hearing aid dispensers, existing law requires a licensee to apply for and procure a duplicate license if the licensee maintains more than one place of business, as specified. Existing law authorizes a hearing aid dispenser to engage on a temporary basis in the practice of fitting or selling hearing aids at the primary or branch location of another licensee's business without obtaining a duplicate license if certain requirements are satisfied. This bill would instead require a hearing aid dispenser engaged in the practice of fitting or selling hearing aids at more than one place of business to apply for and procure a branch office license, as specified. The bill would define "temporary basis" for purposes of the provisions described above. Existing law imposes certain restrictions and requirements on licensed hearing aid dispensers related to the scope of their duties, including prohibiting a licensed hearing aid dispenser from selling a hearing aid to a person 16 years of age or younger, except as specified, and exempts from those restrictions and requirements a licensed dispensing audiologist, as specified. This bill would expand the list of restrictions and requirements applicable to licensed hearing aid dispensers that licensed dispensing audiologists are exempt from to include, among other things, provisions prohibiting a licensed hearing aid dispenser from making or seeking referrals for testing, fitting, or dispensing of hearing aids in connection with the conduction of hearing screenings, as specified. Existing law establishes a fee of $100 for an initial temporary license, and a fee of $100 for renewal of a temporary license for hearing aid dispensers. This bill would instead establish that fee for an initial temporary or trainee licensee, and a fee of $100 for renewal of a trainee license. The bill would revise and recast certain provisions related to temporary licenses. The bill would also change some provisions related to hearing aid dispensers so they apply to an address or addresses instead of a place of business. Existing law provides for the licensure and regulation of dispensing audiologists by the board. This bill would revise and recast certain of those provisions and would require a dispensing audiologist to submit documentation to the board that they have satisfied specified continuing education requirements. The bill would provide that a dispensing audiologist license expires on its assigned renewal date, unless licensee applies to the board for renewal, as specified, and would establish requirements for the renewal of an expired license. The bill would specify that a suspended dispensing audiologist license is subject to expiration and shall be renewed, as provided, but renewal does not entitle the holder of the license to engaging in the fitting or selling of hearing aids until it is reinstated. The bill would specify that a license that has been revoked is subject to expiration and shall not be renewed, and would establish requirements for reinstatement. Existing law prohibits a licensed audiologist from selling hearing aids to a person 16 years of age or younger, except if specified conditions are satisfied. This bill would delete that provision. Existing law defines certain terms for the purposes of the Act, including, among others, "hearing aid dispenser" to mean a person engaged in the practice of fitting or selling hearing aids to an individual with impaired hearing. The bill would make other definitional, technical, and conforming changes, including defining "hearing aid dispenser" as a person who is issued a permanent license pursuant to these provisions, revising the definitions of "license" and "licensee." By imposing additional requirements and prohibitions on persons subject to the act, a violation of which is a crime, the bill would expand the scope of a crime thereby imposing 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.
