(1) Existing law governs professions and vocations that are regulated by various boards within the Department of Consumer Affairs, including the Medical Board of California and the Dental Board of California. Existing law requires those boards to require a licensee, at the time of issuance of a license, to provide specified federal taxpayer information, including the applicant's social security number or individual taxpayer identification number. Existing law prohibits a licensing board from processing an application for an initial license unless the applicant provides that information where requested on the application. Existing law, the Licensed Physicians and Dentists from Mexico Pilot Program, allows licensed physicians and dentists from Mexico to be issued a license by the Medical Board of California or a permit by the Dental Board of California to practice medicine or dentistry in California for a period not to exceed 3 years and establishes requirements for the participants in the program, as specified. This bill, for purposes of the pilot program, notwithstanding the above-described requirements to provide specified federal taxpayer information, would require the Medical Board of California (board) to issue a 3-year nonrenewable license to an applicant who has not provided an individual taxpayer identification number or social security number if the applicant meets specified conditions. The bill would require the applicant to immediately seek an appropriate 3-year visa and social security number from the federal government within 14 days of being issued the medical license and immediately provide the board with their social security number within 10 days of issuance of that card by the federal government. The bill would prohibit the applicant from engaging in the practice of medicine until the board determines that these conditions have been met. The bill would require the board to notify the applicant of their eligibility to practice medicine if the board determines the applicant has met these conditions. The bill would permit the board to extend the 3-year nonrenewable license period, as specified. The bill would require, for a licensee to be eligible for an extension, certain documents to be submitted to the board no later than January 30, 2024, including a declaration signed by the licensee under penalty of perjury that the licensee meets the requirements for an extension. By expanding the crime of perjury, the bill would impose a state-mandated local program. The bill would prohibit an extension from extending the license period beyond September 30, 2026, and would make an extension dependent upon the program having sufficient funding appropriated in the annual Budget Act. (2) Existing law, the Medical Practice Act, establishes the Medical Board of California within the Department of Consumer Affairs for the licensure, regulation, and discipline of physicians and surgeons. Under existing law, the board consists of 15 members, 7 of whom are public members. Existing law requires the Senate Committee on Rules and the Speaker of the Assembly to each appoint one public member. Existing law repeals these provisions on January 1, 2024. This bill would extend that date to January 1, 2028. (3) Existing law requires members of the Medical Board of California to only be appointed from persons who have been citizens of this state for at least 5 years next preceding their appointment. This bill would instead require members of the board to only be appointed from persons who have been residents of this state for at least the 5-year period preceding their appointment. The bill would also make conforming changes. (4) Existing law requires legal proceedings against the Medical Board of California to be instituted in the City of Sacramento, Los Angeles, San Diego, or San Francisco. This bill would make a technical, nonsubstantive change to these provisions. (5) Existing law authorizes the Medical Board of California to employ and fix the compensation of an executive director, and other specified staff, as provided. Existing law authorizes the Attorney General to act as legal counsel for the board for any judicial and administrative proceedings. Existing law repeals these provisions on January 1, 2022. This bill would extend that date to January 1, 2028. The bill would also establish a Complainant Liaison Unit comprised of board staff responsible for, among other things, responding to communications from the public about the complaint review and enforcement process. The bill would condition the implementation of the unit on allocation of positions in the annual Budget Act, as specified. (6) Existing law requires medical school graduates to obtain a physician's and surgeon's postgraduate training license within 180 days after enrollment in a board-approved training program, as specified. Existing law establishes that the physician's and surgeon's postgraduate training license shall be valid until 90 days after the holder has received 12 months' credit of board-approved postgraduate training for graduates of medical schools in the United States and Canada or 24 months of board-approved postgraduate training for graduates of foreign medical schools approved by the Medical Board of California, as specified. This bill would instead require a medical school graduate to obtain a physician's and surgeon's postgraduate training license within 180 days after beginning a board-approved postgraduate program. The bill would instead establish that any physician's and surgeon's postgraduate training license in an active status issued on or after January 1, 2020, shall be valid for a period of 36 months. (7) Existing law prohibits a postgraduate training licensee, intern, resident, postdoctoral fellow, or instructor from engaging in the practice of medicine, or receiving compensation for that practice, unless they hold a valid, unrevoked, and unsuspended physician's and surgeon's certificate issued by the Medical Board of California, except as provided. Existing law authorizes a graduate who has completed the first year of postgraduate training, in an approved residency or fellowship, to engage in the practice of medicine as part of that residency or fellowship, and to receive compensation for that practice. If the resident or fellow fails to receive a license to practice medicine within 27 months from the commencement of the residency or fellowship, except as otherwise specified, or if the board denies their application for licensure, existing law specifies that these privileges and exemptions automatically cease. Existing law establishes that all approved postgraduate training the medical school graduate has successfully completed in the United States or Canada shall count toward the 15-month license exemption for graduates of medical schools in the United States and Canada or the 27-month license exemption for graduates of board-approved foreign medical schools, except as otherwise allowed. Existing law permits the board, in its discretion and upon review of supporting documentation, to grant an extension beyond the 15 months to a postgraduate training licensee who graduated from a medical school in the United States or Canada, or beyond 27 months to a postgraduate training licensee who graduated from a foreign medical school approved by the board, as specified. This bill would delete the authorization provisions described above. The bill would instead establish that all approved postgraduate training the medical school graduate has successfully completed in the United States or Canada shall count toward the postgraduate training requirement to obtain a physician's and surgeon's license. The bill would modify requirements related to an applicant for a physician's and surgeon's license, who has either graduated from medical school in the United States or Canada to require the applicant to have received 12 months of board-approved postgraduate training in another state or in Canada, or has graduated from a foreign medical school approved by the board and has received 24 months credit of board-approved postgraduate training and who is accepted into an approved postgraduate program in California, to obtain their physician's and surgeon's license within 180 days after beginning that postgraduate program or all privileges and exemptions would automatically cease. The bill would also authorize the board, in its discretion and upon review of supporting documentation, to grant an extension beyond 36 months to a postgraduate training licensee who graduated from a medical school approved by the board, as specified. Existing law requires an applicant for a physician's and surgeon's license who received credit for 12 months of approved postgraduate training in another state or in Canada and who is accepted into an approved postgraduate training program in California to obtain their physician's and surgeon's license within 90 days after beginning that postgraduate training program. This bill would extend the period for an applicant for a physician's and surgeon's license who received credit of postgraduate training, as described above, to 180 days after beginning the postgraduate training program. (8) Existing law requires an applicant for a physician's and surgeon's license to successfully complete at least 12 months of board-approved postgraduate training for graduates of medical schools in the United States and Canada or 24 months of board-approved postgraduate training for graduates of foreign medical schools other than Canadian medical schools. Existing law requires the postgraduate training to include at least 4 months of general medicine and shall be obtained in a postgraduate training program, as specified. Existing law authorizes an applicant who has received credit for at least 12 months of board-approved postgraduate training for graduates of medical schools in the United States and Canada or 24 months of board-approved postgraduate training for graduates of foreign medical schools, as specified, and not less than 12 months of which were completed as part of an oral and maxillofacial surgery postgraduate training program as a resident after receiving a medical degree from a combined dental and medical degree program accredited by the Commission on Dental Accreditation (CODA) or approved by the board, to be eligible for licensure. This bill would delete the postrgraduate training requirement regarding the inclusion of 4 months of general training, as specified above. The bill would also delete the provision regarding eligibility for licensure for applicants who participated in an oral and maxillofacial surgery postgraduate training program. (9) For individuals issued a physician and surgeon license by the board on or after January 1, 2022, existing law requires a physician and surgeon to show satisfactory evidence to the Medical Board of California of postgraduate training, as specified, before a physician's and surgeon's license may be renewed. If a holder of a physician's and surgeon's certificate does not show evidence satisfactory to the board of the receipt of credit, as specified, of board-approved postgraduate training, as specified, existing law authorizes the board to automatically place a physician's and surgeon's certificate in delinquent status. The bill would require a physician and surgeon to show evidence satisfactory to the board of postgraduate training, as specified, before a physician's and surgeon's license may be renewed, except licensees or applicants who meet specified requirements, including among others, that the licensee or applicant holds an unlimited and unrestricted license as a physician and surgeon in another state and has held that license continuously for a minimum of 4 years prior to the date of application and meets other requirements. The bill would, in addition to the authority to automatically place a physician's and surgeon's certificate in delinquent status, authorize the board to grant an additional 60 days to the initial license expiration date, as specified. For a licensee who has received credit for at least 24 months of approved postgraduate training in an oral and maxillofacial surgery postgraduate training program, as specified, the bill would require, at the time of initial renewal, a licensee to show evidence satisfactory to the board, pursuant to the attestation of specified individuals before their physician's and surgeon's license may be renewed. For a physician whose license is canceled or who surrenders their license prior to meeting the renewal requirements described above, this bill would prohibit a physician from having their license reinstated, except as specified. Existing law authorizes the Division of Licensing to prepare and mail a questionnaire, as specified, to every licensed physician at the time of license renewal, and requires that questionnaire to include questions to establish that the physician currently has no mental, physical, or behavioral disorder that would impair the physician's ability to practice medicine safely. This bill would instead authorize the Division of Licensing to prepare and provide electronically or mail a questionnaire to every licensed physician at the time of license renewal, and would require that the questionnaire include questions to establish that the physician currently has no disorder that would impair the physician's ability to practice medicine safely. (10) Existing law requires any complaint determined to involve the quality of care rendered by a physician and surgeon, except as provided, before complaint closure or referral to a field office for further investigation, to be reviewed by one or more medical experts with the pertinent education, training, and expertise to evaluate the specific standard of care issues raised by the complaint to determine if further field investigation is required. Existing law requires that review to include specified information, as requested by the board. Before a complaint, as specified, pertaining to the quality of care that a licensee provided to their patient may be closed, this bill would require the board to conduct an interview with the complainant, patient, or the patient's representative, as specified. The bill would only make that provision operative 6 months following the allocation of positions for this purpose in the annual Budget Act. The bill would also require a complainant, patient, or patient representative to be provided with an opportunity to provide a statement relative to the harm they experienced, as specified. The bill would require the statement to be considered by the board, or a panel of the board, for the purposes of adjudicating the case to which the statement pertains. (11) Existing law authorizes the Medical Board of California to delegate its specified authority to conduct investigations and inspections and to institute proceedings to the executive director of the board or other specified personnel, but prohibits specified delegations of authority. Existing law requires the board to delegate to the executive director the authority to adopt a decision entered by default and a stipulation for surrender of a license. This bill would additionally require the board to delegate to the executive director the authority to adopt automatic revocations. (12) Existing law requires a licensee who fails or refuses to comply with a request for the certified medical records of a patient, as specified, to pay to the Medical Board of California a civil penalty, as specified. Existing law requires a licensee or health care facility to pay the board a civil penalty, as specified, if a licensee or health care facility refuses to comply with a court order, issued in the enforcement of a subpoena, mandating the release of records to the board. Existing law establishes that any statute of limitations applicable to the filing of an accusation by the board shall be tolled during the period the licensee is out of compliance with the court order and during any related appeals. This bill would require that the statute of limitations relating to the licensee as described above be tolled upon the service of an order to show cause, as specified, until such time as the subpoenaed records are produced, including any period the licensee is out of compliance with the court order and during any related appeals, or until the court declines to issue an order mandating release of the records to the board. This bill would require that the statute of limitations relating to the health care facility as described above be tolled during the period the health care facility is out of compliance with the court order and during any related appeals, or until the court declines to issue an order mandating release of records to the board. The bill would require the owner, corporate officer, or manager of an entity licensed by the Board of Pharmacy to provide the board, or its authorized representatives, records requested by an authorized officer of law or authorized representative of the board, within 3 business days of the time the request was made. The bill would permit the entity to request an extension of this timeframe, as specified. (13) Existing law requires the Medical Board of California to take action against any licensee who is charged with unprofessional conduct, defined as, among other things, including the failure of a certificate holder, who is the subject of an investigation of the board, to attend and participate in an interview by the board, as specified, and the failure of a physician and surgeon to maintain adequate and accurate records relating to the provision of services to their patients. Existing law provides that it shall constitute unprofessional conduct for a physician and surgeon to disseminate misinformation or disinformation related to COVID-19, as specified. This bill would specify the failure to attend and participate in an interview by the board no later than 30 calendar days after being notified by the board constitutes unprofessional conduct. The bill would specify that the failure of a physician and surgeon to maintain adequate and accurate records as described above for at least 7 years after the last date of service to a patient constitutes unprofessional conduct. The bill would include as unprofessional conduct any action of the licensee intended to cause their patient to rescind consent to the release of the patient's medical records to the board of the Health Quality Investigation Unit of the Department of Consumer Affairs and dissuading, intimidating, or tampering with a patient, witness, or any person in an attempt to prevent them from reporting or testifying about a licensee. This bill would require the board or its designee to automatically suspend a license following a conviction of a felony by a licensee, as specified. The bill would require the board or its designee to automatically revoke the license, as prescribed. The bill would authorize the licensee to request a hearing within 30 days of the automatic suspension order, as specified. This bill would repeal the above-described provisions that provide that it shall constitute unprofessional conduct for a physician and surgeon to disseminate misinformation or disinformation related to COVID-19, as provided. Existing law specifies the time period before a person whose certificate has been surrendered or revoked or placed on probation may petition the board for reinstatement of a license. Existing law specifies a period of 3 years for reinstatement of a license surrendered or revoked for unprofessional conduct, except that the board may, for good cause shown, specify in a revocation order that a petition for reinstatement may be filed after 2 years. This bill would update certain of those time periods, including specifying a period of 5 years for reinstatement of a license surrendered or revoked for unprofessional conduct, except that the board may, for good cause shown, specify in a revocation order that a petition for reinstatement may be filed after 3 years. The bill would require the board to automatically reject a petition for early termination of modification, as specified. The bill would authorize the board to establish a fee paid by a person seeking license reinstatement or modification of penalty, as specified. The bill would require the board to adopt regulations pursuant to the Administrative Procedure Act to implement this provision. (14) Existing law prohibits the use of expert testimony in matters brought by the Medical Board of California unless specified information, including a complete expert witness report with prescribed components, is exchanged with counsel for the other party, and requires the exchange of the information to be completed 30 calendar days prior to the commencement date of the hearing or as specified. This bill would additionally require a statement from a complainant, patient, or patient representative relative to the harm they experienced to be exchanged in written form with counsel for the other party. The bill would require the exchange of the information to be completed 90 days prior to the commencement date of the hearing or as specified. (15) Under existing law, all moneys paid to and received by the Medical Board of California are required to be paid into the State Treasury and credited to the Contingent Fund of the Medical Board of California. Under existing law, moneys in the contingent fund shall be available, upon appropriation by the Legislature, as provided. Existing law, applicable to the licensure of physicians and surgeons, requires an applicant for a certificate based upon a national board diplomate certificate, an applicant for a certificate based on reciprocity, and an applicant for a certificate based upon written examination to pay a nonrefundable application and processing fee at the time the application is filed. Existing law requires an applicant who qualifies for a certificate, as a condition precedent to its issuance, in addition to other required fees, to pay an initial license fee in an amount not to exceed $863. For licenses that expire on or after January 1, 2022, existing law requires the board to fix the biennial renewal fee not to exceed $863. This bill would instead require the initial license fee to be $1,151, and for licenses that expire on or after January 1, 2024, the biennial renewal fee to be $1,151. Beginning January 1, 2027, the bill would require the initial license fee to be $1,255, and for licenses that expire on or after January 1, 2027, the biennial renewal fee to be $1,255. The bill would require the board, if the board has unencumbered funds, as specified, to reduce license or other fees, as prescribed. Existing law, the Osteopathic Act, establishes the Board of Osteopathic Examiners of the State of California, known as the Osteopathic Medical Board of California, for the licensure, regulation, and discipline of persons holding or applying for physician's and surgeon's certificates issued by the Osteopathic Board of California. Existing law requires the powers and duties of the Osteopathic Medical Board of California to be subject to review by the appropriate policy committees of the Legislature. Existing law requires the review to be performed as if these provisions were scheduled to be repealed as of January 1, 2026. This bill would extend that date to January 1, 2028. (16) Existing law authorizes graduates of specified institutes who have completed clinical training in psychoanalysis to engage in psychoanalysis as an adjunct to teaching, training, or research and hold themselves out to the public as psychoanalysts, and authorizes students in those institutes to engage in psychoanalysis under supervision, if the students and graduates do not hold themselves out to the public by any title or description of services incorporating specified words or that they do not state or imply that they are licensed to practice psychology. Existing law requires those students and graduates seeking to engage in psychoanalysis to register with the Medical Board of California, presenting evidence of their student or graduate status. Existing law requires each person to whom registration is granted under those provisions to pay specified fees into the Contingent Fund of the Medical Board of California. Existing law, the Psychology Law, makes a violation of its provisions a crime. Commencing January 1, 2025, this bill would transfer the administration and enforcement duties of those provisions from the Medical Board of California to the Board of Psychology. The bill would require that any moneys within the Contingent Fund of the Medical Board of California collected pursuant to those provisions be deposited in the Psychology Fund, and would require a registrant to pay into the Psychology Fund those fees fixed by the Board of Psychology. The bill would authorize the Board of Psychology to employ, subject to civil service regulations, whatever additional clerical assistance is necessary for the administration of these provisions. By placing these provisions in the Psychology Law, the bill would expand the definition of a crime, thereby imposing a state-mandated local program. (17) Existing law establishes procedures for providing access to health care records or summaries of those records by patients and those persons having responsibility for decisions respecting the health care of others. Existing law entitles an adult patient of a health care provider, minor patient authorized by law to consent to medical treatment, and patient's personal representative to inspect patient records upon presenting to the health care provider a request for those records and upon payment of reasonable costs, except as specified. This bill would make technical, nonsubstantive changes to these provisions. (18) This bill would incorporate additional changes to Section 2065 of the Business and Professions Code proposed by AB 1646 to be operative only if this bill and AB 1646 are enacted and this bill is enacted last. (19) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.