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CANA GOVERNMENT RELATIONS Welcome to the Government Relations Page for CANA. The Government Relations Committee of CANA is responsible for monitoring legislative and regulatory activities in California that impact healthcare policy, particularly as it relates to Certified Registered Nurse Anesthetists. The committee works closely with our legislative advocate, Governmental Advocates Inc. to be “part of the solution for a healthier California”.
State Government Relations (GRC) Committee
Report
State Government Relations Committee Watch List 2009 Some
of the bills, regulations and rule changes introduced that the State GRC
is monitoring this year include, but are not limited to the following: CA AB-23 PDF Document Link was introduced by Assembly Member Jones on 12/1/08 into the CA State Regular session for 2009-2010. This bill declares the intent of the CA legislature to set a goal of universal health care coverage for Californians within 5 years as specified. CA AB 2 PDF Document Link was introduced by Assembly Member De La Torre on 12/1/08 into the CA State Regular session for 2009-2010. The bill requires the Department of Managed Health Care (DMHC) and the Department of Insurance (DOI) to jointly establish standard information and health history questions to be used on applications. AB 2 also requires all plans to complete medical underwriting (health background check) prior to issuing a contract. It is co-sponsored by the CMA and is a reincarnation of AB 1945 from last year which had bipartisan support but was vetoed by the governor. Part of the purpose of the bill is to protect patients from getting their health coverage rescinded by the insurers when they get ill. There are reports that several insurers support external review of rescinded or cancelled policies and since this process started last year over 1000 patients have had their cancelled coverage restored. SBX4 2 PDF Document Link which was introduced by Senator Cox in the 4th Extraordinary Session on 11/7/08.The bill essentially eliminates percentages for allocations to various monies related to the California Children and Families Act of 1998 and instead has those funds with specific exceptions transferred to the General Fund. The General Fund supports programs related to those that the original act was suppose to support. The thought is then to re-route the money to the General Fund so that it could recoup and support the programs of the original bill and alleviate some of the budget shortfall. CA SB 58 PDF Document Link ()was introduced by Senator Aanestad on 1/20/09 into the CA State Regular session for 2009-2010. This bill would require the Medical Board of California to conduct a pilot program to redesign the peer review process applicable to physicians and surgeons to ensure the quality and safety of medical care in California based on the July 2008 Report entitled, "Comprehensive Study of Peer Review in California: Final Report" which can be viewed here http://www.medbd.ca.gov/publications/peer_review.pdf CA AB 29 PDF Document Link was introduced by Senator Alquist on 1/20/09 into the CA State Regular session for 2009-2010. This bill would make legislative findings and declarations regarding health care coverage and would declare the intent of the Legislature to enact and implement comprehensive reforms in the state's health care delivery system, as specified by 2010 and 2012. CA SB 57 PDF Document Link was introduced by Senator Aanestad on 1/20/08 into the CA State Regular session for 2009-2010. This is an act to amend California Major Risk Medical Insurance Program. CA SB 56 PDF Document Link was introduced by Senator Alquist on 1/20/09 into the CA State Regular session for 2009-2010. This bill would make legislative findings and declarations regarding health care coverage and would declare the intent of the Legislature to enact and implement comprehensive reforms in the state's health care delivery system, as specified by 2010 and 2012. Amended 4/1/09 to create the California Health Benefits Service Program within the State Department of Health Care Services for the purpose of expanding cost-effective public health coverage options to the uninsured and purchasers of health insurance. The bill would require the department to perform various duties, subject to the availability of sufficient private donations, as determined by the Department of Finance, relative to creation of joint ventures between certain county-organized health plans and various other entities. The bill would require these joint ventures to be licensed as health care service plans and, subject to the availability of sufficient private donations, as determined by the Department of Finance, would create a stakeholder committee, as specified. The bill would also authorize the Director of Managed Health Care to provide regulatory and program flexibilities to facilitate licensing of specified entities providing coverage pursuant to the bill.Update 4/22/09 Passed Senate Committee.Amended 5/5/09 to eliminate the joint venture component between county-organized health plans and other entities. CA AB 259 PDF Document Link was introduced by Assembly Member Skinner on 2/11/09 into the CA State Legislature 2009-10 Regular session. AB 259 amend Section 1367.695 of the Health and Safety Code,and to amend Section 10123.84 of the Insurance Code, which would require a health care service plan contractor health insurance policy to allow an enrollee or policy holder the option to seek obstetrical and gynecological services from a certified nurse-midwife, as specified. The bill would specify that a violation of this requirement with respect to health care service plans shall not be a crime. The bill would also make other conforming changes and would delete certain obsolete language. CA AB 245 PDF Document Link was introduced by Assembly Member Ma on 2/10/09 into the CA State Legislature 2009-10 Regular session. AB 245 amends Section 2027 of the Business and Professions Code, relating to physicians and surgeons and requires the medical board to post on the Internet the following information in its possession, custody, regarding licensed physicians and surgeons specifically the status of the license, whether or not the licensee is in good standing, subject to a temporary restraining order, an interim suspension order, or enforcement actions. Additionally if the licensee has been subject to board discipline, has felony convictions, accusations filed by the Attorney General, malpractice judgement, arbitration awards, hospital disciplinary actions, terminations or misdemeanor convictions for the period of ten years from the date the board has it in such possession.Amended 4/27/09 adds a requirement that the board to verify the information posted pursuant to those provisions, as specified, and would require the board to immediately remove information discovered to be false and to remove expunged misdemeanor or felony convictions within a specified period of time. The bill would also require the board to ensure that the biographical information posted on its Internet Web site regarding licensees is accurate. The bill would also require the board to establish a process for addressing complaints from licensees regarding the posting of inappropriate information. Amended 6/1/09 to require the board to remove expunged misdemeanor or felony convictions posted pursuant to those provisions, within 90 days of receiving notice of the expungement. Update passed Assembly Floor vote on 6/2/09 CA AB 252 PDF Document Link was introduced by Assembly Member Carter with principal coauthor Senator Correa on 2/11/09 into the CA State Legislature 2009-10 Regular session. AB 252 seeks to add Section 2417.5 to the Business and Professions Code, relating to the practice of medicine which would make a physician and surgeon who practices medicine with a business organization that offers to provide, or provides, outpatient elective cosmetic medical procedures or treatments, knowing that the organization is owned or operated in violation of Section 2400, may have his or her license to practice revoked.Update Passed Assembly Floor on 5/4/09. CA AB 356 PDF Document Link was introduced by Assembly Member Fletcher on 2/19/09 into the CA State Legislature 2009-10 Regular Session. Under existing law, licentiates of the healing arts in the operation of x-ray equipment is defined to include any person licensed under the Medical Practice Act, the Osteopathic Act, or a specified initiative act that created the State Board of Chiropractic Examiners, as provided. AB 356 will revised the definition to include physician assistants and require supervising physicians to have or be exempt of holding a permit or certificate to perform the functions he or she is supervising. Amended 4/23/09 and now reads this bill would revise the definition of licentiates of the healing arts to also include a physician assistant who is licensed pursuant to the Physician Assistant Practice Act and who practices under the supervision of a qualified physician and surgeon, as provided. The bill would require a physician assistant who is issued a licentiate fluoroscopy permit to meet specified continuing education requirements. The bill would also require the supervising physician and surgeon to have, or be exempt from having a licentiate fluoroscopy permit to perform the functions that he or she is supervising, as provided. This bill would also allow a physician and surgeon to delegate to a licensed physician assistant procedures using ionizing fluoroscopy. The bill would commencing specify training requirements and continuing education credits that must be met in order for a physician assistant to be delegated this task.Update Passed Assembly Committee on 4/28/09 and Assembly Floor on 5/21/09. CA AB 326 PDF Document Link was introduced by Assembly Member Garrick on 2/18/09 into the CA State Legislature 2009-10 Regular Session. This bill would for taxable years beginning on and after January 1, 2010 allow a deduction in connection with health savings accounts in conformity with federal law to act as an immediate tax levy and shall remain in effect until January 1, 2015. CA AB 830 PDF Document Link was introduced by Assembly Member Cook and principal co-author Assembly member Krekorian on 2/26/09 into the CA State Legislature 2009-2010 Regular session. Existing law references various drug compendia, including the United States Pharmacopoeia, in various health care provisions.This bill would include within these references or any other similar drug compendium, as determined annually by the State Department of Health Care Services on the basis of factors, including, but not limited to, the breadth of listings, use of prespecified published criteria for weighing evidence, and inclusion on a list of compendia approved by the federal Centers for Medicare and Medicaid Services. Amended 4/1/09 to include replacement of these references with compendia a compendium approved by the Federal Centers for Medicare and Medicaid Services. Existing law makes it a crime to knowingly sell, or keep or offer for sale, or otherwise dispose of any drug or medicine, knowing that it is adulterated. A drug is deemed to be adulterated based upon the standard of strength, quality, or purity in the United States Pharmacopoeia. This bill would replace the above drug compendia compendium’s with any compendia or compendium approved by the Federal Centers for Medicare and Medicaid Services. Update Passed Assembly Committee 4/14/09. Amended 4/23/09 with non substantive language changes. Update Passed Assembly Floor 5/21/09. CA AB 834 PDF Document Link was introduced by Assembly Member Solorio on 2/26/09 into the CA State Legislature 2009-2010 Regular session. This bill would declare the Legislature’s intent to enact legislation revising the health care practitioner peer review process in California to improve patient safety and care. Amended 4/14/2009 to reflect that this bill would provide an alternative to the requirement to file a report of voluntary acceptance of these restrictions, by authorizing a peer review body to impose, and a practitioner to accept, voluntary remediation which may include mandatory proctoring, consultation, education, and retraining. The bill would also authorize the peer review body to limit the practitioner’s staff privileges, and prohibit a practitioner from seeking new staff privileges, during the pendency of the voluntary remediation. The bill would also require the reporting person, as defined, to file a report, as specified, with the applicable agency within 15 days following the commencement date of a voluntary remediation, to immediately file a supplementary report if the practitioner fails to fulfill the terms of the remediation, and to file another report within 30 days following completion of a remediation. The bill would require the reporting person to provide the subject practitioner with all reports it files and with a notice of the practitioner’s right to submit additional statements or other information. Within 15 days following the commencement of a voluntary remediation, the reporting person would be required to provide a notice of remediation to each facility where the practitioner then has staff privileges. The bill would provide that a practitioner who accepts a voluntary remediation is not entitled to a hearing with respect to the remediation, and would specify that a practitioner who rejects the remediation would be entitled to a hearing concerning any proposed final action for which a reporting person is required to file a report pursuant to existing law. The bill would prohibit a lawyer who has represented the applicable peer review body or licensed health care facility or clinic within the prior 2 years from serving as a hearing officer, and would prohibit any hearing officer from gaining any benefit from the outcome. CA AB 867 PDF Document Link was introduced by Assembly Members Nava and Arambula with 20 + co-authors on 2/26/09 into the CA State Legislature 2009-2010 Regular session. This bill would authorize the California State University to award the Doctor of Nursing Practice degree. The bill would distinguish the Doctor of Nursing Practice degree from research-based doctoral degrees offered at the University of California. The bill would require the programs to be designed to enable professionals to earn the degree while working full time, train nurses for advanced practice, and prepare faculty to teach in post secondary nursing programs. Amended 4/14/2009 with technical not substantive language and also amened to require California State University to annually report the status of the Doctor of Nursing Practice degree program. Update Passed Assembly Floor Vote 6/3/09. CA AB 877 PDF Document Link was introduced by Assembly Member Emerson on 2/26/09 into the CA State Legislature 2009-2010 Regular session. Existing law provides for the licensure and regulation of various healing arts practitioners by boards within the Department of Consumer Affairs and the department is under the control of the Director of Consumer Affairs. This bill would declare the intent of the Legislature to enact legislation authorizing the Director of Consumer Affairs to appoint a specified committee of 7 members to perform occupational analysis, as specified, and to prepare written reports on any bill that seeks to expand the scope of a healing arts practice. Amended 4/14/09 and now reads that this bill would require the Director of Consumer Affairs to appoint a scope of practice committee of 5 members, as specified, to perform occupational analysis and prepare written reports, as specified, on any bills seeking to substantively expand the scope of a healing arts practice. The bill would require that the reasonable cost of an analysis and report be paid by the affected licensing board, as specified. Update referred to suspense file 5/20/09 CA AB 1070 PDF Document Link was introduced by Assembly Member Hill on 2/27/09 into the CA State Legislature 2009-2010 Regular session. Existing law, the Medical Practice Act, provides for the licensure and regulation of physicians and surgeons and other healing arts practitioners, including doctors of podiatric medicine. Existing law prescribes the disciplinary action that may be taken against a physician and surgeon or podiatrist. Among other things, existing law authorizes the licensee to be publicly reprimanded. This bill would authorize the public reprimand to include a requirement that the licensee complete educational courses selected by the board. Amended 4/22/09 to Consolidate reporting requirements to specify that the entity, person, or licensee required to report send a copy of the report to the claimant or to his or her counsel if the claimant is represented by counsel. Increases the minimum fine for failure to comply with the reporting requirements from $50 to $500 and the maximum from $500 to $5,000. Deletes the fines related to a knowing and intentional failure to comply with the reporting requirements, or conspiracy collusion not to comply, or hindering or impeding another's compliance with the reporting requirements. Requires a report to include the date of the alleged occurrence and the licensee's role in the care or professional services provided to the patient with respect to those services at issue in the claim or action; and, a copy of the judgment. Requires any entity making a report to, within 15 days after filing the report, notify the licensee that the report was filed with the appropriate licensing board. Prohibits any entity that provides early intervention, patient safety, or risk management programs to patients, or contracts for those programs for patients, from including, as part of any of those programs or contracts, any of the following. A provision that prohibits a patient or patients from contacting or cooperating with the board; a provision that prohibits a patient or patients from filing a complaint with the board; or, a provision that requires a patient or patients to withdraw a complaint that has been filed with the board. Permits the president of the Medical Board of California (MBC) to be a member of any panels necessary to carry out the work of the MBC if there is a vacancy in the membership of the MBC Requires all medical records requested by the MBC to be certified. Places a cap of $10,000 on the penalty that can be assessed on a physician for not complying with the MBC's request for certified medical records. Permits an administrative law judge to recommend the issuance of a public reprimand that includes additional education and training in a proposed decision. Specifies that licensees must report to the MBC, both at the time of renewal and upon initial licensure information regarding any specialty board certifications he or she holds that is issued by a member of the Board of American Specialties or approved by the MBC,his or her practice status; and, if desired, his or her cultural background and foreign language proficiency. Update Passed Assembly Floor vote 5/28/09 CA AB 1083 PDF Document Link was introduced by Assembly Member Perez on 2/27/09 into the CA State Legislature 2009-2010 Regular session. This bill would require hospitals to annually review and update the security and safety assessment and plan and to include information regarding aggressive or violent behavior at other facilities. The bill would also suggest that the plan include security considerations relating to efforts to cooperate with local law enforcement regarding violent acts in the facility and would require the hospital to consult with affected employees, including the recognized collective bargaining agent or agents, if any, and, upon request, to make the plan and assessment available to any employee or to the recognized bargaining agent of any employee. Because this bill expands the definition of a crime, it would impose a state-mandated local program. Amended 5/6/09 to eliminate information related to aggressive and/or violent acts. Amended 5/26/09 to include all medical staff. Update Passed Assembly floor vote 5/28/09. CA AB 1092 PDF Document Link was introduced by Assembly Member Fong on 2/27/09 into the CA State Legislature 2009-2010 Regular session. Existing law provides for the creation of various programs to provide health care coverage to persons who have limited incomes and meet various eligibility requirements. This bill would state the intent of the Legislature to enact legislation that would encourage the development and utilization of personalized health medicine in order to increase positive health outcomes for patients and to provide overall savings to the health care system. CA AB 1126 PDF Document Link was introduced by Assembly Member Hernandez on 2/27/09 into the CA State Legislature 2009-2010 Regular session. This bill would prohibit a health care provider giving emergency services and care, as defined, from seeking reimbursement or attempting to obtain payment for any covered services provided to an employee or annuitant other than from the participating health benefit plan covering that employee or annuitant. The bill would specify that provision would not apply to any co-payments, coinsurance, or deductibles required for the covered services provided to that employee or annuitant other than from the participating health plan covering that employee or annuitant. CA AB 1140 PDF Document Link was introduced by Assembly Member Niello on 2/27/09 into the CA State Legislature 2009-2010 Regular session. Except as otherwise provided in this section, a health care practitioner shall disclose, while working, his or her name and practitioner’s license status, as granted by this state, on a name tag in at least 18-point type. A health care practitioner in a practice or an office, whose license is prominently displayed, may opt to not wear a name tag. If a health care practitioner or a licensed clinical social worker is working in a psychiatric setting or in a setting that is not licensed by the state, the employing entity or agency shall have the discretion to make an exception from the name tag requirement for individual safety or therapeutic concerns. In the interest of public safety and consumer awareness, it shall be unlawful for any person to use the title “nurse” in reference to himself or herself and in any capacity, except for an individual who is a registered nurse or a licensed vocational nurse, or as otherwise provided in Section 2800. Nothing in this section shall prohibit a certified nurse assistant from using his or her title. Major amendments 4/14/09 to include Diagnostic imaging services and eliminates majority of original bill. Specifies that existing law prohibits a healing arts practitioner from charging, billing, or soliciting payment from any patient, client, customer, or 3rd-party payer for performance of the technical component of specified diagnostic imaging services not rendered by the practitioner or a person under the practitioner’s supervision, as defined. Existing law also defines a 3rd-party payer as any person or entity who is responsible to pay for CT, PET, or MRI services provided to a patient. This bill would specify that a 3rd-party payer includes, but is not limited to, a person or entity who contracts with insurance carriers, self-insured employers, 3rd-party administrators, or any other person or entity who, pursuant to a contract, is responsible to pay for CT, PET, or MRI services. Update Passed Assembly floor vote 5/28/09. CA AB 1142 PDF Document Link was introduced by Assembly Member Price on 2/27/09 into the CA State Legislature 2009-2010 Regular session. This bill would provide that it is the responsibility of a hospital, as soon as proof of Medi-Cal eligibility is supplied by a person presenting himself or herself as a Medi-Cal beneficiary, to provide all information regarding that person’s Medi-Cal eligibility to all other providers that bill separately for services rendered to that person during the same time period for which the hospital is submitting a claim. Amended 4/14/09 in addition to existing language the following was added to the bill: Existing law provides that it is the responsibility of the provider prior to rendering Medi-Cal reimbursable services to persons presenting themselves as Medi-Cal beneficiaries to make a good faith effort to verify the person’s identity, if the person is not known to the provider, otherwise payment for those services may later be disallowed by the department. This bill would provide that it is the responsibility of a hospital, as soon as proof of Medi-Cal eligibility is supplied by a person presenting himself or herself as a Medi-Cal beneficiary, to provide all information regarding that person’s Medi-Cal eligibility to certain providers that bill separately for services rendered to that person during the same time period for which the hospital is submitting a claim. Existing law, the Consumer Credit Reporting Agencies Act, governs the disclosure of consumer credit reports. Existing law prohibits a person furnishing information on a specific transaction or experience to any consumer credit reporting agency if the person knows or should know the information is incomplete or inaccurate. This bill would provide that if a Medi-Cal provider or 3rd-party collection agency receives proof of Medi-Cal coverage for services rendered and then reports the services rendered to a consumer credit reporting agency or fails to correct a negative credit report regarding the services rendered, the provider or agency shall be deemed to be in violation of the above-described provisions. This bill would require each Medi-Cal provider to ensure that patient debts that are sold or assigned to a 3rd-party collection agency can and will be recalled by the provider in the event that the services were covered by the Medi-Cal program and that evidence of Medi-Cal coverage could have been obtained by the provider. Existing law prohibits any provider of health care services who obtains a label or copy from the Medi-Cal card or other proof of eligibility from seeking reimbursement or attempting to obtain payment for the cost of the covered health care services from the eligible applicant or recipient, or any person other than the department or a 3rd-party payor who provides a contractual or legal entitlement to health care services. This bill would provide that a provider of health care services who obtains a label or copy from the Medi-Cal card or other proof of eligibility and who attempts to seek reimbursement or to obtain payment for the cost of covered services from the eligible applicant or recipient or fails to recall a debt, as this bill would require, shall be subject to a fine not to exceed 3 times the amount the provider could otherwise have obtained had the provider of health care services billed the Medi-Cal program.Adds that bill would require a Medi-Cal provider, if the provider receives proof of a patient’s Medi-Cal eligibility and has referred an unpaid bill for services rendered to the patient to a 3rd-party collection agency, to promptly recall the matter from the 3rd-party collection agency and otherwise ensure collection efforts by the 3rd-party collection agency are halted and notify the patient accordingly. The bill would require, commencing July 1, 2010, that all contracts between a 3rd-party collection agency and a Medi-Cal provider or billing service that works on behalf of a Medi-Cal provider to include a provision allowing the Medi-Cal provider to immediately recall a debt from collection pursuant to the aforementioned provisions. Amended 4/28/09 To mention under existing law, the Consumer Credit Reporting Agencies Act, governs the disclosure of consumer credit reports and existing law prohibits a person furnishing information on a specific transaction or experience to any consumer credit reporting agency if the person knows or should know the information is incomplete or inaccurate.This bill would provide that if a Medi-Cal provider or 3rd-party collection agency receives proof of Medi-Cal coverage for services rendered and then reports the services rendered to a consumer credit reporting agency or fails to correct a negative credit report regarding the services rendered, the provider or agency shall be deemed to be in violation of the above-described provisions.Update Passed Assembly floor vote 5/26/09 CA AB 1295 PDF Document Link was introduced by Assembly Member Fuller on 2/27/09 into the CA State Legislature 2009-2010 Regular session. This bill would express the intent of the Legislature to enact legislation to create a model program that facilitates and expedites, for licensed registered nurses who have completed associate degrees in nursing, the completion of coursework necessary to earn a bachelor of science in nursing degree or a master of science in nursing degree and to create programs that facilitate the completion of master of science in nursing degrees by students with baccalaureate degrees who are enrolled in associate degree nursing programs. Amended 4/14/09 to require the commencement of such programs by the 2012-13 academic year and requires regular status updates of such program. Update Passed Assembly floor vote 5/14/09 CA AB 445 PDF Document Link was introduced by Assembly Member Salas on 2/24/09 into the CA State Legislature 2009-2010 Regular session. This bill would, in addition, exempt from this prohibition the use of a mini C-arm digital radiography device in connection with the diagnosis of bone fractures, in a licensed trauma center or an emergency department of a licensed hospital, by an orthopedic resident, an orthopedic nurse practitioner, or a physician assistant, when under the direct or indirect supervision of a certified radiological technologist. CA AB 526 PDF Document Link was introduced by Assembly Member Fuentes on 2/25/09 into the CA State Legislature 2009-2010 Regular session. This bill would enact the Public Protection and Physician Health Program Act of 2009, and create a program in California that will permit physicians and surgeons to obtain treatment and monitoring of alcohol or substance abuse or dependence or mental disorder recovery so that they do not treat patients while impaired. Amended 4/14/2009 and now would until January 1, 2021, establish within the State and Consumer Services Agency the Public Protection and Physician Health Committee, consisting of 14 members appointed by specified entities, and would require the committee to be appointed and to hold its first meeting by March 1, 2010, and would require agency adoption of related rules and regulations by June 30, 2010. The bill would require the committee to recommend to the agency one or more physician health programs, and would authorize the agency to contract, including on an interim basis, as specified, with any qualified physician health program for purposes of care and rehabilitation of physicians and surgeons with alcohol or drug abuse or dependency problems or mental disorders as specified. The bill would impose requirements on the physician health program relating to, among other things, monitoring the status and compliance of physicians and surgeons who enter treatment for a qualifying illness, as defined, pursuant to written, voluntary agreements, and would require the agency and committee to monitor compliance with these requirements. The bill would provide that a voluntary agreement to receive treatment would not be subject to public disclosure or disclosure to the Medical Board of California, except as specified. The bill would require authorize the board to increase physician and surgeon licensure and renewal fees for purposes of the act, and would establish the Public Protection and Physician Health Program Trust Fund for deposit of those funds, which would be subject to appropriation by the Legislature. The bill would also require specified performance audits.Amended 4/16/08 to require committee be appointed and meet by March 2010. Amended 6/1/09 to require the board to increase physician and surgeon licensure and renewal fees for purposes of the act. Update Passed Assembly floor vote 6/2/09. CA AB 583 PDF Document Link was introduced by Assembly Member on 2/25/09 into the CA State Legislature 2009-2010 Regular session. This bill would require those health care practitioners to display the type of license and, except for nurses, the highest level of academic degree he or she holds either on a name tag in at least 18-point type, in his or her office, or in writing given to patients disclose the name of the certifying board or association either on a name tag in at least 18-point type and conspicuously post in each office a schedule of the regular hours when he or she will be present in that office and the office hours during which he or she will not be present.Update 4/13/09 Passed Assembly floor vote. CA AB 212 PDF Document Link was introduced by Assembly Member Florez on 2/23/09 into the CA State Legislature 2009-2010 Regular session. This bill would require departments to post health care acquired infections from central lines, surgical sites and rate of MRSA, c-diff and VRE on the internet.Amended 4/15/09 with substantial changes and now states that under existing law requires the governing board of each school district maintaining a high school to provide for the annual cleaning, sterilization, and necessary repair of football equipment of their schools and requires that all football equipment actually worn by pupils to be cleaned and sterilized at least once a year. This bill would require authorize the governing board of each school district maintaining a high school to provide for the annual cleaning and sterilization of wrestling equipment and would specify that wrestling equipment used multiple years may be cleaned and sterilized as specified by the Superintendent of Public Instruction and the State Board of Education. The Superintendent and state board would be required to develop and approve, respectively, information and guidelines on the prevention of communicable diseases at schoolsites. The information and guidelines would be required to address, at a minimum, the maintenance of locker rooms, athletic equipment, and synthetic ground covers used for athletic fields and ways to minimize the spread of methicillin resistant Staphylococcus aureus and meningococcal disease. The Superintendent would be required to post the information and guidelines on the department’s Internet Web site. Amended 5/18/09: To reflect non substantive changes to language to include, but not limited to, information provided to school staff, including classified employees, for training and information to minimize the spread of methicillin-resistant Staphylococcus aureus and meningococcal disease.Update Passed Senate floor vote 6/3/09. CA SB 294 PDF Document Link was introduced by Senator McLeod on 2/25/09 into the CA State Legislature 2009-2010 Regular session. This bill would authorize the implementation of standardized procedures that would expand the duties of a nurse practitioner in the scope of his or her practice, as enumerated. The bill would make specified findings and declarations in that regard. The intent of the Legislature to provide clarification that standardized procedures and protocols may include the specified services and functions set forth in this act so that health care entities may allow nurse practitioners to engage in those activities if the entities choose to do so, and that third-party payors understand that those services and functions can be performed by nurse practitioners if they are included in an entity’s standardized procedures and protocols. Admit patients to a hospital, provided all admissions policies are followed by the nurse practitioner. Order durable medical equipment, subject to any limitations set forth in the standardized procedures. Notwithstanding that authority, nothing in this paragraph shall operate to limit the ability of a third-party payor to require prior approval. After performance of a physical examination by the nurse practitioner and collaboration with a physician and surgeon, certify disability pursuant to Section 2708 of the Unemployment Insurance Code. Permit a nurse practitioner to be designated by the nurse practitioner’s supervising physician and surgeon as the primary care provider of record for an individual enrolled in a health care service plan. Notwithstanding that authority, nothing in this paragraph shall be construed to allow a nurse practitioner to operate independently of a standardized procedure. For individuals receiving home health services under Medicare or Medi-Cal, or personal care services, approve, sign, modify, or add to a plan of treatment or plan of care. Amended 3/31/2009 Which reflects the following changes for individuals receiving home health services , or personal care services, after consultation with treating physician or surgeon, approve, sign, modify, or add to a plan of treatment or plan of care. Update Passed Senate floor vote 5/11/09. CA AB 1445 PDF Document Link was introduced by Assembly Member Chesbro on 2/27/09 into the CA State Regular Legislature 2009-2010 Regular session. This bill would provide that more than one encounter between a patient and the same health care professional on the same day and at a single location may each be separately reimbursed in specified circumstances. The bill would also provide that, under specified circumstances, visits with different health care professionals on the same day of service may be billed as separate visits. The bill would require the department, by March 30, 2010, to seek all necessary federal approvals in order to implement the bill, including any necessary amendments to the state Medi-Cal plan.Amended 4/14/09 to limit the number of same day visits for reimbursement to 2. Amended 6/1/09 The amended bill would require an federally qualified health center (FQHC) services and rural health clinic (RHC) services that currently includes the cost of encounters with more than one health professional that take place on the same day at a single location as constituting a single visit for purposes of establishing its FQHC or RHC rate to, by January 1, 2011, apply for an adjustment to its per-visit rate, and, after the rate adjustment has been approved by the department, require the FQHC or RHC to bill a medical visit and another health visit that take place on the same day at a single location as separate visits. The bill would make other conforming changes. This bill would require the department, by January 15, 2010, to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services reflecting the changes described above. Update Passed Assembly floor vote 6/2/09. CA SB 395 PDF Document Link was introduced by Senator Wyland on 2/26/09 into the CA State Legislature 2009-2010 Regular Session. This bill makes nonsubstantive and technical changes to B & P code 2000. It is likely a shell bill and will be monitored closely. CA SB 482 PDF Document Link was introduced by Senator Padilla on 2/26/09 into the CA State Legislature 2009-2010 Regular Session. This bill makes nonsubstantive and technical changes to B & P code 2000. It is likely a shell bill and will be monitored closely.Amended 4/14/09 to become a highly technical biological data analysis services regulations bill specifically genetic material. CA SB 486 PDF Document Link was introduced by Senator Simitian on 2/26/09 into the CA State Legislature 2009-2010 Regular Session. This bill makes non substantive and technical changes to the Medical Waste Management Act. Amended 4/2/2009 The California Integrated Waste Management Act of 1989 requires a city’s or a county’s household hazardous waste element to include a program containing specified components for the safe collection, treatment, and disposal of sharps waste generated by households. The act requires the Integrated Waste Management Board, in consultation with specified entities, to develop model programs for the collection and proper disposal of drug waste. This bill would require, on or before July 1, 2010, and annually thereafter, a pharmaceutical manufacturer that sells or distributes medication that is self-injected at home through the use of hypodermic needles and other similar devices to submit to the board a plan for the safe collection and destruction of home-generated sharps waste containing specified elements. The bill would require the manufacturer and the board to post and maintain the plan on their respective Internet Web sites. Update Passed Senate floor vote 5/14/09. CA SB 599 PDF Document Link was introduced by Senator McLeod on 2/27/09 into the CA State Legislature 2009-2010 Regular Session. This bill would require every board, as defined, to post each accusation, statement of issues, or disciplinary action taken by the board on that board’s Internet Web site within 10 days of the filing date of the accusation or statement of issues, or the effective date of the disciplinary action. Major amendments 4/30/09 to include workforce initiatives specifically transferring remaining funding for dental school repayment for those working in under served areas to have money left over from previous program rolled over onto the succeeding program. Amended 5/13/09 to include the successor agency to the former Bureau for Private Postsecondary and Vocational Education in the Department.of Consumer Affairs to transmit any available data regarding school performance, as prescribed, it receives from any schools under its jurisdiction to the California Postsecondary Education Commission. However the bill would make this provision operative only if AB 48 of the 2009–10 Regular Session is enacted and becomes effective on or before January 1, 2010. Also for purposes of disbursing economic recovery funds recently made available as part of the American Recovery and Reinvestment Act of 2009 to workforce development programs, would provide that local workforce investment boards may work directly with institutions of higher education and other training providers, including accredited private postsecondary institutions, to quickly design education and training to fit the needs of the job seekers and employers they are serving and would extend the distribution of the remaining California Dental Corps Loan Repayment Program till 2012. Update Passed Senate floor vote 6/3/09. CA SB 774 PDF Document Link was introduced by Senator Ashburn on 2/27/09 into the CA State Legislature 2009-2010 Regular Session This bill would provide that it is the intent of the Legislature to enact legislation to define the scope of practice for nurse practitioners. SB 774, was amended 4/27/09, and now focuses on social workers Social workers and their criminal history. Existing law requires the counties, with the assistance of the State Department of Social Services, to provide child welfare services, including emergency response, foster care placement, adoption services, and family maintenance and reunification.Commencing January 1, 2010, this bill would require a county, before hiring an applicant for a position as a county child protective service social worker who will be assigned emergency response, family maintenance, family reunification, permanent placement, or adoption responsibilities, to secure from the Department of Justice a criminal history to determine if the applicant has ever been convicted of specified crimes. The bill would prohibit the county from employing the applicant under prescribed circumstances. The bill would allow the county to require the applicant to pay any fees charged by the Department of Justice for the processing of the criminal history and would prohibit the county from hiring a person who had been convicted of specified crimes. This bill would exclude a person who has obtained a certificate of rehabilitation from being considered convicted for purposes of the bill. The bill would specify additional duties of the Department of Justice with respect to obtaining necessary criminal history and subsequent arrest information and responding to counties. Amended 5/28/09 to specify employee or transferring employee who has frequent and routine contact with children, if the employee will provide services to children who are alleged victims of abuse, neglect, or exploitation, and must now pay the fees related to the criminal background check. Update Passed Senate floor vote on 6/3/09. CA SB 762 PDF Document Link was introduced by Senator Aanestad on 2/27/09 into the CA State Legislature 2009-2010 Regular Session. This bill would also make it unlawful for a city, county, or city and county to prohibit a healing arts licensee from engaging in any act or performing any procedure that falls within the professionally recognized scope of practice of that licensee, but would prohibit construing this provision to prohibit the enforcement of a local ordinance effective prior to January 1, 2010, as specified. Amended 5/5/09 to prohibit the adoption or enforcement of a local ordinance governing zoning, business licensing, or reasonable health and safety requirements, as specified. Update Passed Senate floor vote 5/14/09 CA SB 700 PDF Document Link was introduced by Senator McLeod on 2/27/09 into the CA State Legislature 2009-2010 Regular Session. Existing law provides for the professional review of specified healing arts licentiates through a peer review process. Existing law defines the term “peer review body” as including a medical or professional staff of any health care facility or clinic licensed by the State Department of Public Health. This bill would define the term “peer review” and would revise the definition of the term “peer review body” to include a medical or professional staff of other specified health care facilities or clinics. Under existing law, specified persons are required to file a report, designated as an “805 report,” with a licensing board if a peer review body takes one of several specified actions against a person licensed by that board. Existing law requires the board to maintain the report for a period of 3 years after receipt. This bill would require the board to maintain the report electronically. Existing law authorizes the Medical Board of California, the Osteopathic Medical Board of California, and the Dental Board of California to inspect and copy certain documents in the record of any disciplinary proceeding resulting in action that is required to be reported in an 805 report. This bill would authorize those boards to also inspect an peer review minutes or reports in those records. Amended 4/22/09 and now reads under existing law, specified persons are required to file a report, designated as an “805 report,” with a licensing board within 15 days after a specified action is taken against a person licensed by that board. Existing law provides various due process rights for licentiates who are the subject of a final proposed disciplinary action of a peer review body, including authorizing a licentiate to request a hearing concerning that action. This bill would require the filing of the 805 report with the licensing board within 15 days of the imposition of a specified action on a licentiate regardless of whether a hearing has occurred. This bill would also require specified persons to file a report with a licensing board if a peer review body concludes, after formal investigation, that a person licensed by that board departed from the standard of care, as specified, suffered from mental illness or substance abuse, or engaged in sexual misconduct. The bill would authorize the board to inspect and copy certain documents in the record of that investigation. Existing law requires the board to maintain an 805 report for a period of 3 years after receipt. This bill would require the board to maintain the report electronically. Existing law authorizes the Medical Board of California, the Osteopathic Medical Board of California, and the Dental Board of California to inspect and copy certain documents in the record of any disciplinary proceeding resulting in action that is required to be reported in an 805 report. This bill would specify that the boards have the authority to inspect those documents in unredacted form and without a subpoena and would authorize those boards to also inspect any peer review minutes or reports in the record of the disciplinary proceeding. Existing law requires specified healing arts boards to maintain a central file of their licensees containing, among other things, disciplinary information reported through 805 reports. Under this bill, if a court finds that the peer review resulting in the 805 report was conducted in bad faith and the licensee who is the subject of the report notifies the board of that finding, the board would be required to include that finding in the licensee’s central file. Existing law requires the Medical Board of California, the Osteopathic Medical Board of California, and the California Board of Podiatric Medicine to disclose an 805 report to specified health care entities and to disclose certain hospital disciplinary actions to inquiring members of the public. Existing law also requires the Medical Board of California to post hospital disciplinary actions regarding its licensees on the Internet. This bill would prohibit those disclosures, and would require the Medical Board of California to remove certain information posted on the Internet, if a court finds that the peer review resulting in the 805 report or the hospital disciplinary action was conducted in bad faith and the licensee notifies the board of that finding. The bill would also require the Medical Board of California to post on the Internet a factsheet that explains and provides information on the 805 reporting requirements.Passed Senate Committee. Amended 5/21/09 Under existing law, specified persons are required to file a report, designated as an “805 report,” with a licensing board within 15 days after a specified action is taken against a person licensed by that board, the amendment adds the inclusion of an imposition of a summary suspension of staff privileges, membership, or employment if the summary suspension stays in effect for a period in excess of 14 days. This amended bill would require the filing of the 805 report with the licensing within 15 days of the imposition of a specified action on a licentiate the summary suspension regardless of whether a hearing has occurred. The bill would also be amended to require Medical Board of California, the Osteopathic Medical Board of California, and the California Board of Podiatric Medicine to make disclosures regarding enforcement actions taken against former licensees.Update: Passed Senate Floor 6/3/09. CA SB 638 PDF Document Link was introduced by Senator McLeod on 2/27/09 into the CA State Legislature 2009-2010 Regular Session. This bill would abolish the Joint Committee on Boards, Commissions, and Consumer Protection and would authorize the appropriate policy committees of the Legislature to carry out its duties. The bill would terminate the terms of office of each board member or bureau chief within the department on unspecified dates and would authorize successor board members and bureau chiefs to be appointed, as specified. The bill would also subject interior design organizations, the State Board of Chiropractic Examiners, the Osteopathic Medical Board of California, and the Tax Education Council to review on unspecified dates. The bill would authorize the appropriate policy committees of the Legislature to review the boards, bureaus, or entities that are scheduled to have their board membership or bureau chief so terminated or reviewed, as specified, and would authorize the appropriate policy committees of the Legislature to investigate their operations and to hold specified public hearings. The bill would require a board, bureau, or entity, if their annual report contains certain information, to post it on its Internet Web site. The bill would make other conforming changes.Update 4/20/09 Passed Senate Committee. CA SB 810 PDF Document Link was introduced by Senator Leno with multiple principal coauthors and authors on 2/27/09 into the CA State Legislature 2009-2010 Regular Session. This bill would establish the California Health care System to be administered by the newly created California Health care Agency under the control of a Health care Commissioner appointed by the Governor and subject to confirmation by the Senate. The bill would make all California residents eligible for specified health care benefits under the California Health care System, which would, on a single-payer basis, negotiate for or set fees for health care services provided through the system and pay claims for those services. The bill would provide that a resident of the state with a household income, as specified, at or below 200% of the federal poverty level ould be eligible for the type of benefits provided under the Medi-Cal program. The bill would require the commissioner to seek all necessary waivers, exemptions, agreements, or legislation to allow various existing federal, state, and local health care payments to be paid to the California Health care System, which would then assume responsibility for all benefits and services previously paid for with those funds. The bill would create the Health care Policy Board to establish policy on medical issues and various other matters relating to the system. The bill would create the Office of Patient Advocacy within the agency to represent the interests of health care consumers relative to the system. The bill would create within the agency the Office of Health Planning to plan for the health care needs of the population, and the Office of Health Care Quality, headed by a chief medical officer, to support the delivery of high quality care and promote provider and patient satisfaction. The bill would create the Office of Inspector General for the California Health care System within the Attorney General’s office,which would have various oversight powers. The bill would prohibit health care service plan contracts or health insurance policies from being issued for services covered by the California Health care System. The bill would create the Health care Fund and the Payments Board to administer the finances of the California Health care System. The bill would create the California Health care Premium Commission (Premium Commission) to determine the cost of the California Health care System and to develop a premium structure for the system that complies with specified standards. The bill would require the Premium Commission to recommend a premium structure to the Governor and the Legislature on or before January 1, 2011, and to make a draft recommendation to the Governor, the Legislature, and the public 90 days before submitting its final premium structure recommendation. The bill would specify that only its provisions relating to the Premium Commission would become operative on January 1, 2010, with its remaining provisions becoming operative on the date the Secretary of California Health and Human Services notifies the Legislature, as specified, that sufficient funding exists to implement the California Health care System. The bill would require that system to be operative within 2 years of that date and would provide for various transition processes for that period. The bill would extend the application of certain insurance fraud laws to providers of services and products under the system, thereby imposing a state-mandated local program by revising the definition of a crime. The bill would enact other related provisions relative to budgeting, regional entities, federal preemption, subrogation, collective bargaining agreements, compensation of health care providers, conflict of interest, patient grievances, independent medical review, and associated matters. Amended 4/23/09 extending the recommendations for a premium structure until 2012 and added additional co-authors. CA AB 718 PDF Document Link was introduced by Assembly Member Emmerson on 2/26/2009 into the CA State Legislature 2009-2010 Regular Session. This bill would require every licensed prescriber, or prescriber’s authorized agent, or pharmacy operating in California to have the ability, on or before January 1, 2012, to transmit and receive prescriptions by electronic data transmission. Because a knowing violation of that provision would constitute a crime under the Pharmacy Law, the bill would impose a state-mandated local program.Amended 4/22/09 changing the original language to the intent of the Legislature to enact legislation that would create the Inland Empire Health Plan E-Prescribing Pilot Program, which would promote health care quality and the exchange of health care information, include specified components, and be administered by an entity with specified certification and at least 5 years of e-prescribing experience under the Medi-Cal program. Amended 5/27/09 To impose a requirement of a joint powers agency which imposes a state mandated program which requires the state to reimburse localities for state mandated programs. Update Passed Assembly floor vote 5/11/09. CA SB 674 PDF Document Link was introduced by Senator McLeod on 2/27/2009 into the CA State Legislature 2009-2010 Regular Session. This bill would impose specific advertising requirements on certain healing arts licensees. By changing the definition of a crime, this bill would impose a state-mandated local program. This bill would delete that exemption and would instead authorize a health care practitioner, in a practice or office, to disclose his or her name and his or her type of license verbally. This bill would require the board to adopt regulations by July 1, 2010, regarding the appropriate level of physician availability needed within clinics or other settings using certain laser or intense pulse light devices for elective cosmetic procedures. This bill would require the board to post on its internet web site an easy-to-understand fact sheet to educate the public about cosmetic surgery and procedures, as specified. This bill would include, among those specified aspects, the submission for approval by an accrediting agency at the time of accreditation, a detailed plan, standardized procedures, and protocols to be followed in the event of serious complications or side effects from surgery. The bill would also modify the definition of “outpatient setting” to include facilities that offer in vitro fertilization, as defined, and assisted reproduction technology treatments. This bill would require the board, absent inquiry, to notify the public whether a setting is accredited, certified, or licensed, or the setting’s accreditation, certification, or license has been revoked, suspended, or placed on probation, or the setting has received a reprimand by the accreditation agency. This bill would require the accrediting agency to immediately report to the Medical Board of California if the outpatient setting’s certificate for accreditation has been denied. This bill would delete the notice and identification requirements, and the bill would require that every outpatient setting that is accredited be periodically inspected by the board or the accreditation agency, as specified. This bill would make that evaluation mandatory. This bill would provide that no reimbursement is required by this act for a specified reason. Amended 4/3/2009 to include a requirement of the department when conducting an inspection of an acute care hospital, to inspect the peer review process utilized by the hospital. Amended 4/28/09 to delete the authorization of practitioners disclosing their names only verbally. Amended 5/20/09 to reflect adoption of regulations by 1/1/11 instead of 6/1/10. The bill would also now require the board to ensure that accreditation agencies inspect outpatient settings. Amended 6/1/09 To reflect non substantive changes to language in defining in vitro fertilization. Updated passed Senate Floor 6/3/09. CA SB 819 PDF Document Link was introduced by Committee on Business, Professions and Economic Development (Negrete McLeod (chair), Aanestad, Corbett, Correa, Florez, Oropeza, Romero, Walters, Wyland, and Yee) on 3/10/2009 into the 2009-2010 CA State Legislature Regular Session. This bill would require a petition by a registered nurse whose initial license application is subject to a disciplinary decision to be filed after a specified time period from the date upon which his or her initial license. Specifically a registered nurse whose license has been revoked, or suspended or who has been placed on probation may petition the board for reinstatement or modification of penalty, including reduction or termination of probation, after a period not less than the following minimum periods has elapsed from the effective date of the decision ordering that disciplinary action, or if the order of the board or any portion of it is stayed by the board itself or by the superior court, from the date the disciplinary action is actually implemented in its entirety, or for a registered nurse whose initial license application is subject to a disciplinary decision, from the date the initial license was issued was issued. Except as otherwise provided in this section, at least three years for reinstatement of a license that was revoked, except that the board may, in its sole discretion, specify in its order a lesser period of time provided that the period shall be not less than one year. At least two years for early termination of a probation period of three years or more. At least one year for modification of a condition, or reinstatement of a license revoked for mental or physical illness or termination of probation of less than three years. Amended 5/28/09 to reflect changes in Respiratory Therapist and Doctor of Osteopathy sections which are nonsubstative. Update Passed Senate floor vote 6/3/09 CA AB 1414 PDF Document Link was introduced by Senator Hill on 2/27/09 into the 2009-2010 CA State Legislature Regular Session as a transportation planning bill. It was later amended on 4/30/09 into a controlled substances bill. Specifically amending the California Uniform Controlled Substances Act, which classifies controlled substances into designated schedules and includes apomorphine within Schedule II. Under existing law, unlawful possession of apomorphine is a felony. This bill would remove apomorphine from Schedule II. Apomorphine is a type of dopaminergic agonist (agonist of the D1 and D2 type dopamine receptors). It does not actually contain morphine or its chemical skeleton, or bind to opioid receptors.Currently, apomorphine is used in the treatment of Parkinson's disease and of erectile dysfunction. CA AB 1542 PDF Document Link was introduced by the Assembly Committee on Health 3/4/2009 into the 2009-2010 CA State Legislature Regular Session with regards to Medical homes. It was later amended 5/6/2009 existing law which imposes various functions and duties on the State Department of Health Care Services with respect to the administration and oversight of various health programs and facilities, including the Medi-Cal program. This bill would establish the Patient-Centered Medical Home Act of 2009 to encourage health care providers and patients to partner in a patient-centered medical home, that promotes access to high-quality, comprehensive care. “Medical home” means a team approach to providing health care that , fosters a partnership among the patient, the personal provider, and other health care professionals, and where appropriate, the patient’s family, utilizes the partnership to access all medical and non medical health-related services needed by the patient and the patient’s family to achieve maximum health potential, maintains a, comprehensive record of all health-related services to promote continuity of care, and has all of the characteristics that qualify it as a medical home. State Board Activity Board of Chiropractic Examiners on 11/20/08 is proposing to amend rules pertaining to the care as it relates to manipulation under anesthesia (MUA), Amended 4/20/2009 - PDF Document Link Board of Registered Nursing has proposed on 11/24/08 that nursing license renewal requirements be changed to include fingerprinting - PDF Document Link. Changes to Title 16 CCR, Div 14, Sec(s) 1419, 1419.1 and 1419.3.Amends rules concerning fingerprinting and other licensing renewal requirements. Requires that, as a condition of renewal for a license that expires on or after march 1, 2009 a licensee who has never been finger printed by the Board or for whom a fingerprint record no longer exists, furnish the DOJ a fill set of fingerprints for the purpose of conducting a criminal background (federal and state) check. It also specifies conditions which this requirement may be waived. The CA Dental Board proposed on that credit be awarded for CE courses based on anesthesia or sedation for license renewal - PDF Document Link. If you have any questions about the State GRC, proposed bills or regulations please feel free to contact me at: jjjanakes@gmail.com
Federal
Political Director Report
CANA State & Federal
GRC Committee Members
Midyear Assembly:
A Student's Perspective
Every point of this timeline is critical. Language can be included, excluded or changed at any point along the way that affects CRNAs and we must be ready to catch it and respond. An important goal for national healthcare reform is that it includes non-discriminatory language that will not place artificial limits to CRNA practice and reimbursement. Thankfully the AANA has an excellent team of lobbyists in the DC office that are watching policy development to catch language or policy changes that threaten our profession. It is our responsibility to respond with letters and/or calls to our representatives when the AANA sends an alert and communicate to our representatives how they can support us. Without getting their attention, our representatives have so much going on they won’t catch the changes, even if they are supportive of CRNA practice. We were told this on more than one occasion by Health Legislative Aids and by members of Congress themselves. Furthermore, the opinion of members of a Congressperson’s constituency are important. If your representative is on one of the previously mentioned committees, your voice can have very meaningful impact. An important crossroad is coming in national health care reform. Everyone who provides and receives health care will be effected. Those who speak up will be heard. Please stay informed. Your involvement could make a significant difference in the future of our practice.
An Evening With Congresswoman Lois
Capps, RN
Update on Health Insurance Market
Reform
Presently the
committees are conducting hearings, inviting expert witness to
testify on their specific issues and recommendations for
healthcare reform. After these hearings a bill will be written
(May/June) and introduced to the House where it will go through
lots of hoops to get passed, rewritten and re-passed
(July/August) signed by President Obama and then given to CMS
(around September) who finalizes the language that dictates the
details of how it is enforced/enacted starting January 2010.
Although this is an ambitious time line, healthcare is on the
front of people’s minds and politicians are committed to the
imminent nature of this (unwritten) bill. |
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The week at Mid Year
Assembly April 19-22 in Washington D.C. carried the intensity of an
immersion course in national health policy. It appears very likely that a
substantive health care reform bill is forthcoming this year. There are
three major committees that will write and rewrite healthcare policy. The
Ways and Means Committee is responsible for Medicare issues, the
Appropriations Committee deals with the appropriation/appointment of
monies, and finally the Energy and Commerce Committee that has a
subcommittee on health. Presently the committees are conducting hearings,
inviting expert witness to testify on their specific issues and
recommendations for healthcare reform. After these hearings a bill will be
written in May or June and introduced to the houses where it will go
through lots of hoops to get passed, rewritten and re-passed likely in
July or August. The final bill is anticipated to be ready for president
Obama around September and then given to the Centers for Medicare &
Medicaid Services (CMS) who will finalize the language that dictates the
details of how it is enforced and enacted starting January 2010. Although
this is an ambitious time line, healthcare is on the front of people’s
minds and politicians are committed to the imminent nature of this
forthcoming bill.
During our morning
Midyear Assembly “board meeting” with California’s CRNA
representatives I was lucky enough to rochambeau my way into an
extra ticket to Congresswoman Lois Capps’ fundraising dinner.
Ms. Capps is an RN and represents District 23, the Central
Coast. Our monetary contribution was not only a way of saying
“thank you” to the Congresswoman, but also a way to connect with
her office and bring a face to CRNAs.