New Bill on Clinical Lab Unlicensed Personnel

We wanted to alert you to the introduction of AB 1741 (Waldron) that proposes a new solution to the lab workforce issue. It is sponsored by Quest Labs and supported by the California Clinical Laboratory Association. According to the sponsor it would update the California personnel licensure requirements, the proposal would expand the activities that an unlicensed person can perform under the direct and constant supervision of a licensed person, physician or surgeon, including conducting waived tests and assisting with moderate and high complexity testing. It would also allow unlicensed personnel to assist licensed a licensed person, physician and surgeon with tests that involve the quantitative measurement of the specimen or test reagent or any mathematical calculation relative to determining the results or validity of a test procedure. Unlicensed personnel would not be permitted to release waived, moderate or high complexity testing.

Here is a link to the background sheet issued by Assemblywoman Waldron. The CSP Board has reviewed the proposed bill and has mixed reactions to the wisdom of this approach. Clearly there are lab workforce issues and a primary cause is insufficient training programs in California that are hampered by lack of clinical training sites. It is also well known that the scope of duties for unlicensed personnel has not been updated since the early 1970’s and technology has evolved. Other states abide by the CLIA standards, which are not as strict as California standards.

We would welcome your thoughts/comments about AB 1741. The bill will likely face opposition from some lab personnel unions. We might also want to focus on expanded duties for histotechnologists.

Bill on Reforming Plan Prior Authorization

The CSP supported SB 250 (Pan) last year that would have instituted a Texas like Gold Card program for physicians who has an 80% approval rate on health plan prior authorization over the prior year. The CSP advocated for and achieved an amendment to also protect the actual performing physician, pathologist or other specialist, who received the referral from a physician for a prior authorized service which was now exempt from that requirement. The pathologist could not be penalized and would be assured of reimbursement. After passing the Senate the bill was held in the Assembly Appropriations Committee and did not get to the Governor. Plans continued to raise concerns.

SB 598 (Skinner) is sponsored again by the CMA and would continue the effort to reform the prior authorization process to reduce the burden on physicians. The CSP will again support that effort.

Bill on Patient Access to Biomarkers

We will support SB 496 (Limon) a reintroduction of a bill vetoed by the Governor last year that would expand patient access to biomarkers for diagnosis and ongoing evaluation according to current recognized clinical studies without prior authorization. It would also require Medi-Cal coverage to be the same.