Health Care

CMS Recently Introduced New Interoperability Mandates for Health Plans That Must be Implemented by July 1, 2021 The CMS Interoperability and Patient Access Rule (“Interoperability Rule”) requires payors to permit third-party applications to retrieve, with the approval and at the direction of a current enrollee certain health care data.  42 C.F.R. §§ 422.119(a), 431.60(a), 457.730(a); 45 C.F.R. § 156.221(a).  The Interoperability Rule does not alter covered entities’ or business associates’ responsibilities to protect PHI under HIPAA, however, once a member selects a third-party application and authorizes access of their data to the application, the covered entity and business associate are…
On September 30, 2018, the Governor signed Assembly Bill 2138, which primarily helps many license applicants with criminal records get professional licenses.  AB 2138 took effect on July 1, 2020. After the change in the law, a plea of guilty or a verdict of guilty can only be used against a licensee or license applicant as a conviction once a judgment has been entered.  (Business and Professions Code section 7.5)   This is an important change for defendants who get deferred entry of judgment, for example.  In criminal courts, individuals granted deferred entry of judgment enter a plea…
New U.S. Supreme Court Decision May Expand Health Plans’ Ability to Text Members Under the TCPA The Telephone Consumer Protection Act of 1991 (TCPA) has restricted health plans’ ability to call or send text messages to cell phone numbers.  The U.S. Supreme Court’s recent decision in Facebook, Inc. v. Duguid, 141 S. Ct. 1163 (2021) (“Facebook”) eases those restrictions by clarifying and narrowing the type of dialing equipment which falls within the TCPA’s definition of an automatic telephone dialing system (“autodialer”). The TCPA generally makes it unlawful to make any call (other than a call made for emergency purposes…
California Business and Professions Code section 2310 empowers the Medical Board of California to immediately and without prior notice suspend certain California physician licenses.  Business and Professions Code section 2310 provides that if a California physician’s license in another state is suspended or revoked outright and that action is reported to the National Practitioners Data Bank, and the physician’s primary place of practice is outside of California, the physician’s California license can be immediately suspended.  The suspension stays in place unless overturned by a hearing at the Office of Administrative Hearings, if the out-of-state order of suspension or revocation…
In its first abortion-related decision with a newly cemented majority of conservative jurists, the U.S. Supreme Court in a 6-3 decision on Tuesday stayed an injunction of a Food and Drug Administration regulation requiring women seeking the abortion pill to pick up the drug in person rather than receiving it in the mail. The injunction of the rule, issued by a Maryland district court, prevented the FDA from enforcing the in-person dispensation requirement for mifepristone, used to end an early pregnancy or manage a miscarriage, for the duration of the COVID-19 public health emergency. The American College of Obstetricians and…
Mandated Reporting of Sexual Misconduct Allegations against California Licensed Physicians by Healthcare Facilities The Medical Board of California and other healthcare licensing boards hold licensed physicians and other healthcare licensees to an extremely high standard regarding sexual misconduct allegations. Every day physicians, and other healthcare licensees, who communicate with hundreds of patients each week, face the possibility of patients reporting unprofessional conduct, which can trigger a license investigation and license discipline. Existing laws require the Medical Board of California, and other licensing boards, to monitor, regulate, and discipline licensed health care practitioners. When licensed physicians face sexual or inappropriate misconduct…
More Practice-Level Guidelines for Physician Assistants The Physician Assistant Practice Act sets forth supervision requirements for licensed physician assistants (PAs) in California. These requirements set statewide standards for supervision, agreements, and protocols mostly under the delegation of physicians and surgeons. Signed by Governor Newsom on October 9, 2019, and effective January 1, 2020, Senate Bill 697 relaxes chart review and physician signature requirements allowing decisions to be made at the practice level. All references to “delegation of services agreements” have been changed to “practice agreements”, the most notable change to recognize physician assistants as independent and capable health care workers.…
The Department of Business Oversight (DBO) changed its name to the Department of Financial Protection and Innovation (DFPI) effective September 29, 2020.  Along with this name change, effective January 1, 2021, the new California Consumer Financial Protection Law (CCFPL) grants the Department of Financial Protection and Innovation new powers to investigate previously unregulated businesses, such as debt collectors, rent to own contracts and other point of sale financing, consumer credit reporting agencies and credit repair agencies. The Department of Financial Protection and Innovation’s primary role will continue to be the licensing and license regulation of California finance lender licensees (CFLs),…
Department of Health Care Services Seeks Input From Health Plans The Department of Health Care Services (DHCS) released a Request for Information (RFI) to solicit stakeholder input into the development of a forthcoming Medi-Cal Managed Care Plan Request for Proposal (RFP) and the updated Medi-Cal managed care contract. The RFI contained two parts.  The first is a set of questions to guide stakeholder input to the RFI related to the DHCS’s expressed goals for the Medi-Cal managed care delivery system.  The second is an invitation for input specifically from health plans that may be interested in submitting a proposal in…
Tweaks to C.U.R.E.S. Database Reporting and Access The Controlled Substance Utilization Review and Evaluation System (C.U.R.E.S.) is a prescription monitoring program maintained by California’s licensed physicians, licensed physician assistants, licensed pharmacies, licensed pharmacists, and any other prescribing California health care professionals. On October 2, 2018, the California Department of Justice (DOJ) certified the mandatory statewide use of the C.U.R.E.S. database, consisting of all DEA Schedule II, III, and IV controlled substance prescriptions dispensed in California.  California lawmakers amended Assembly Bill 528 to expand on California pharmacy prescription reporting requirements and to increase access to the C.U.R.E.S. database for licensed…