stone advocacy - orthobullets
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STONE ADVOCACY [email protected] 916-798-1878
California overview:as blue as the Pacific Ocean
Democratic Super-majorities
Every statewide office holder is a Democrat
Treasurer, AG, SOS, Insurance Commisioner – Democrat
Lt. Governor –Democrat
Governor – Democrat
80 Assembly Members: 61 Democrats/ 19 Republicans
40 Senators: 29 Democrats / 11 Republicans
Becoming increasingly Democratic --OC Register10/21/2017
Governor Newsom
AB 407 (Santiago) re Flouroscopy
� Assembly Health Committee Vote 14- 1
� Assembly Business and Professions Committee Vote 20-0
� Assembly Appropriations Committee Vote 18-0
� Next Steps: Assembly Floor, then Senate
� Opposition has not been effective
� Challenges: Radiological Health Branch, Department, Administration
Scope of Practice:
Big Fights
Scope of Practice Fights: The big one AB 890 (Wood) re Nurse Practitioners
� As introduced 2/20/2019 would have allowed very independent practice by Nurse Practitioners
� As amended 4/22: � Corporate Practice ban
� 3 years or 4,600 hours� New Board: Advanced Practice Registered Nursing Board in
Department of Consumer Affairs
� Appropriations implications
� Political considerations (NPs and SEIU vs CMA and MDs)
Scope of Practice: Physician Assistants
� SB 697 (Caballer0)
� Supported by CMA
� Flexible agreement regarding supervision terms
� MD may supervise more PAs: 6 not 4
Scope of Practice: Medical
Assistants
� AB 1490 (Carillo) expanded what medical assistants could do under “technical supportive services” to include drawing local anesthetic.
� Bill became a “two-year bill”; dead for 2019
� Eligible for a hearing in January 2020
� COA supportive of concept (maybe amend to include casts)
Pharmacy bills
AB 387 (Gabriel) requires the “purpose” of the prescription on the rx unless patient does not want. Designed for elderly patients and families who get confused with multiple medicines. On Assembly Appropriations Suspense File.
AB 714 (Wood) limiting when a MD prescribing opiods must also prescribe naloxone. Exempts inpatient facilities and hospice patients.
Medi-Cal Coverage of
Podiatric Services
� AB 678 (Flora) would restore Medi-Cal coverage of podiatric services.
� On Assembly Appropriations Committee Suspense File because $4.6 M cost.
Radiologic Assistant
Practice Act
� SB 480 (Archuleta) would have3 created Radiologist Assistant Practice Act to be administered by the medical board.
� No hearing, became a two year bill, dead for this year, eligible for a vote in January 2020.
Automatic Fee increases for medical licensing fees
AB 613 (Low) would allow licensing fees to increase by the Consumer Price Index every four years, absent showing of any need or justification.
Bill passed Assembly and in the Senate
Limitation on fees you could
charge patients to fill out forms
� AB 370 (Voepel) would have limited the amount that MDs can charge a patient for filling out forms.
� COA opposed because forms may be time consuming and expensive to complete.
� A win! Bill died in Assembly Health Committee and is done for this year.
Required new continuing education
training on maternal
mental health
� AB 845 (Mainschein) would have required all docs to take a training course on maternal mental health
� COA opposed as overbroad and unnecessary
� A win! Bill was amended to allow continuing education on the subject but not to require it.
Concussion Protocols in
kids sports
� AB 379 (Mainschein) expands youth concussion protocols from 27 designated youth sports to all youth sports
� A win! Passed Assembly and on to Senate.
Questions?
STONE ADVOCACY [email protected] 916-798-1878