California Assembly Bill AB1140 Amended / Bill

 BILL NUMBER: AB 1140AMENDED BILL TEXT AMENDED IN ASSEMBLY APRIL 14, 2009 INTRODUCED BY Assembly Member Niello FEBRUARY 27, 2009 An act to amend Section  680   655.8  of the Business and Professions Code, relating to healing arts. LEGISLATIVE COUNSEL'S DIGEST AB 1140, as amended, Niello.  Healing arts.   Diagnostic imaging services.   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.   Existing law requires a health care practitioner, as defined, to disclose, while working, his or her name and license status on a specified name tag. However, existing law exempts from this requirement a health care practitioner, in a practice or office, whose license is prominently displayed.   This bill would make a nonsubstantive, technical change to these provisions.  Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:  SECTION 1.   Section 655.8 of the   Business and Professions Code   is amended to read:  655.8. (a) It is unlawful for any person licensed under this division or under any initiative act referred to in this division to charge, bill, or otherwise solicit payment from any patient, client, customer, or third-party payer for performance of the technical component of Computerized Tomography (CT), Positron Emission Tomography (PET), or Magnetic Resonance Imaging (MRI) diagnostic imaging services if those services were not actually rendered by the licensee or a person under his or her supervision. (b) Radiological facilities or imaging centers performing the technical component of CT, PET, or MRI diagnostic imaging services shall directly bill either the patient or the responsible third-party payer for such services rendered by those facilities. Radiological facilities or imaging centers shall not bill the licensee who requests the services. (c) This section shall not apply to any of the following: (1) Any person who, or radiological facility or imaging center that, contracts directly with a health care service plan licensed pursuant to Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code. (2) Any person who, or clinic that, provides diagnostic imaging services without charge to the patient, or on a sliding scale payment basis if the patient's charge for services is determined by the patient's ability to pay. (3) Health care programs operated by public entities, including, but not limited to, colleges and universities. (4) Health care programs operated by private educational institutions to serve the health care needs of their students. (5) Any person who, or clinic that, contracts with an employer to provide medical services to employees of the employer if the diagnostic imaging services are provided under the contract. (6) Diagnostic imaging services that are performed within a physician and surgeon's office, as defined in paragraph (5) of subdivision (b) of Section 650.01, or the office of a group practice, as defined in paragraph (6) of subdivision (b) of Section 650.01. (d) Nothing in this section prohibits a licensee or a physician entity from billing globally for professional and technical components if both of the following conditions are met: (1) Neither the physician, or any member of his or her medical group, nor the physician entity has ordered the diagnostic imaging services. (2) The physician, or a member of his or her medical group, or the physician entity provides the professional interpretation of the diagnostic imaging service. (e) Nothing in subdivision (d) is intended to authorize or permit an imaging center to engage in the practice of medicine or exercise other professional rights, privileges, or powers in violation of Section 2400 of the Business and Professions Code. (f) For the purposes of this section, the following terms shall have the following meanings: (1) "Physician entity" means a professional medical corporation formed pursuant to Section 2406 or a general partnership that consists entirely of physicians and surgeons or professional medical corporations. (2) "Responsible third-party payer" means any person or entity who is responsible to pay for CT, PET, or MRI services provided to a patient  , including, but not limited to, a person or entity who contracts with insurance carriers, self-insured employers, third-party administrators, or any other person or entity who,   pursuant to a contract, is responsible to pay for CT, PET, or MRI services provided to a patient covered by that contract  . (3) "Supervision" means that the referring licensee is providing the level of supervision set forth in paragraph (3) of subsection (b) of Section 410.32 of Title 42 of the Code of Federal Regulations. (4) "Technical component" includes services other than those provided by a physician and surgeon for the CT, PET, or MRI including personnel, materials, space, equipment, and other facilities.  SECTION 1.   Section 680 of the Business and Professions Code is amended to read: 680. (a) 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. (b) Facilities licensed by the State Department of Social Services, the State Department of Mental Health, or the State Department of Public Health shall develop and implement policies to ensure that health care practitioners providing care in those facilities are in compliance with subdivision (a). The State Department of Social Services, the State Department of Mental Health, and the State Department of Public Health shall verify through periodic inspections that the policies required pursuant to subdivision (a) have been developed and implemented by the respective licensed facilities. (c) For purposes of this article, "health care practitioner" shall mean any person who engages in acts that are the subject of licensure or regulation under this division or under any initiative act referred to in this division.