Monthly Archives: November 2013

New Ability to Prescribe

This is third in a series of new 2024 laws affecting healthcare in California. 
SB 670: Physicians and Surgeons: Drug Prescribing Privileges

This new law wades into the increasing regulation over physicians for prescriptions, especially pain killers. The Medical Board of California has increased investigations in this area. One hurdle to such investigations has been getting access to patient records without the consent of the patient or the patient’s family.

SB 670 permits the Medical Board to inspect and copy a deceased patient’s medical records without authorization or court order solely for the purpose of determining whether death was in violation of MPA. The Medical Board must declare in writing that it has been unsuccessful in locating or contacting the deceased patient’s representative after reasonable efforts.

The legislation met with quite a few reservations and is watered down from the original version. The Medical Board still may not see the records when the representative refuses to allow access. It also has a provision that refusal of a physician to participate in a Medical Board interview can be deemed “unprofessional conduct.”


This is second in a series of new 2024 laws affecting healthcare in California. 

SB 493: New Authority to Pharmacists

One of the key goals of the Accountable Care Act was to to increase utilization of professionals other than doctors.  One way to do that is to expand the authority of pharmacists to perform certain tests and to administer drugs.

This new law gives pharmacists new clout as “health care providers” who can now administer drugs by injection, provide training on drug therapy and disease management and prevention, furnish contraceptives, nicotine replacement products, medications recommended for travel outside the US, order certain tests, and initiate, adjust or discontinue drug therapy (but may not interfere with “as written”).

Devolving  physician authority to other professionals, including nurse practitioners, physician assistants and pharmacists, is an experiment with some risk.  It is clear that these professionals will be able to fill some gaps left by overly busy physicians.  However, there is likely to be less quality and the overall effectiveness of healthcare may follow.  The provision regarding the administration of international travel drugs will likely the pocket books of those physicians who derive economic benefit from this part of their practice.



This is the first in a series of posts about new laws for 2014 affecting healthcare.

AB 460: Non-Discrimination for Homosexuals and Lesbians


This law requires coverage under the Knox-Keene Health Care Service Plan Act and a under a policy of health insurance that provides for coverage for the treatment of infertility.   If such coverage is offered and purchased, it must be provided without discrimination on the basis of age, ancestry, color, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex or sexual orientation.

AB 460 extended the idea of “non-discrimination” in this context to homosexuals and lesbians regarding fertility. If a health insurance plan is purchased that contains coverage for infertility, then the plan must not discriminate.  This statute is meant to help all people access to treatment of infertility.

Insurance plans are not required to carry such coverage.  There will be a violation of the statute only if the plan does offer such coverage and they attempt discrimination in the utilization of the coverage.

The law makes homosexuals and lesbians eligible for insurance coverage for “treatment of infertility, except in vitro fertilization, under those terms and conditions as may be agreed upon between the group subscriber or the group policyholder and the plan or the insurer.”

An interesting issue arises when the definition of infertility is considered. Under the new law, homosexuals and lesbians will be classified as “infertile” if they are unable “to conceive a pregnancy or to carry a pregnancy to a live birth after a year or more of regular sexual relations without contraception.” Since most sexual relations in a homosexual and lesbian relationship do not result in pregnancy, the law effectively defines all homosexuals and lesbians as “infertile.” Surely this is an unintended result and new legislation will need to be considered in the near future.