In Brief: Nursing Scope Of Practice Bill Moves Forward; Covered California Names Health Plans

Nursing Scope Of Practice Bill Moves Forward

A bill that would expand the scope of practice for nurse practitioners has cleared an Assembly committee by a unanimous vote, just days after it failed to gain the support to move forward. It now moves to the Assembly Appropriations Committee.

Although the bill, SB 491, cleared the Assembly Business, Professions and Consumer Protection Committee by a 8-2 margin with four abstentions last Tuesday after changes were made to the bill, the California Medical Association remains opposed to the legislation, and sources are dubious it will ever reach Gov. Jerry Brown's desk for signature.

Under the current version of the bill, nurse practitioners are able to practice independently after being supervised by a physician for a minimum of 4,160 hours of work. However, they can only do so within a clinic, hospital, accountable care organization or a medical group specifically controlled by physicians. Language was also added stating that nurse practitioners cannot replace a physician or surgeon, and they must work in a collaborative setting.

The bill has been changed considerably since it was introduced by Sen. Ed Hernandez, D-West Covina. Prior versions would have allowed nurse practitioners to practice independently once properly certified for their profession, but the CMA and other physician lobbies have pushed to make extensive alterations.

Expanding the scope of practice for some medical professionals has been under debate given that few of California's counties have enough physicians to meet demand, and nearly a third of the state's physician workforce is expected to retire in the coming years.

Payers & Providers reported last week that five lawmakers who abstained on voting for SB 491 last week received significantly more campaign funds from the bill's opponents than backers. Three of the five abstained from voting Tuesday.

Observers suggest that the bill was allowed to pass out of the Business and Professions Commitee out of deference to Hernandez, who chairs the influential Senate Health Committee, but that it will either be voted down in another committee vote or fail during a Senate floor vote for the revisions.

Hernandez also pulled from consideration SB 492, which would have expanded the scope of practice for optometrists.

Covered California Officially Announces Participating Plans 

The Covered California health insurance exchange officially announced its participating health plans for 2014 on Wednesday. The list differed little from what had been originally disclosed earlier this year.

Altogether, 12 health plans will offer cover to individuals in various regions of California. They include large statewide players such as Anthem Blue Cross of California, but also regional payers such as L.A. Care Health Plan.

Six carriers will also offer coverage through the Small Business Health Options exchange.

For the individual insurance coverage, Ventura County Health Plan deferred offering coverage for one year. It is expected to offer coverage in Ventura County in 2015.

“We appreciate the executive staff of Ventura County Health Care Plan doing their homework and making a sound decision,” said Peter V. Lee, the exchange's executive director. “Covered California remains partners with Ventura County Health Care Plan and will lay the groundwork for negotiations next year.”