Monday, May 20, 2019


Current Threats

Table of Contents:

MICRA Attacks

On May 2, 2013, a coalition — including the Consumer Attorneys of California and the trial lawyer-funded Consumer Watchdog group — announced intentions to seek to overturn MICRA through legislation or, failing that, a ballot initiative.

Consumer Attorneys of California recently paid $6,635 to install a billboard in Sacramento featuring an infant who died from whooping cough in 2010, with text that reads, “Medical Negligence Kills,” and then beneath it, “But a 38-year-old law says Mia’s life was worth only $250,000. Call your legislator.” The coalition pushing to eliminate the $250,000 cap is committed to spending $1 million to do so.

The group has until September to submit a proposed initiative to qualify for the November 2014 general election ballot. If successful, the trial attorney’s efforts will cause malpractice rates to skyrocket and recreate the same conditions that threatened to throw California’s healthcare system into crisis during the early 1970s. Increasing the amount of noneconomic damages allowed under MICRA from $250,000 to $500,000 would raise healthcare costs in California by at least $9.5 billion annually, according to the State’s former nonpartisan legislative analyst; that translates into approximately $1,000 annually for a family of four.


Medi-Cal Reimbursement Rate Cuts

CMA held off the 10% Medi-Cal cut in the courts for several years, but the judicial process is now exhausted. We are now working to solve this problem through the legislative budget process. Our biggest concern is that the Medi-Cal reimbursement clawback, i.e., the state’s asking for 10% of past Medi-Cal reimbursements back, be limited or eliminated.


Allied Health Professional Scope of Practice Expansions

SB 491 would expand the scope of practice for California’s nurse practitioners, allowing them to establish independent practices without the supervision of a physician partner.

SB 492 initially sought to dramatically expand the scope of practice for California’s optometrists. Through amendments, all of the surgical procedures and most of the treatments generally reserved for ophthalmologists have been removed from the bill.

SB 493 initially sought to expand the scope of practice of California’s pharmacists to allow them to prescribe a wide variety of drugs without physician supervision. Following a round of amendments, much of the prescribing authority has been removed from the bill, but CMA continues to have major concerns.

Allied health professional scope of practice expansion bills that are a threat to patient safety are introduced in the California Assembly and Senate every year.


Bar to the Corporate Practice of Medicine Challenges

(No specific challenges at this time.)


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