New Healthcare Laws in 2023: Confidential Information, Gender Treatment, Telehealth & Referrals

New Healthcare Laws in 2023: Confidential Information, Gender Treatment, Telehealth & Referrals

Hopefully you received our prior newsletter. If not, you can see it here. It covered some of the new employment laws affecting California employers, including those in the healthcare industry. This edition focuses more specifically on some of the new healthcare laws in effect this year.
Future newsletters will take a look at what is moving through the legislature this year, but for now, we will simply review what already made it into law, most becoming effective on January 1, 2023.
Confidential Information
There are several new laws impacting those who are asked to provide patient information. One of those is Assembly Bill 2091. AB 2091’s purpose is to prevent California providers and insurers from giving out information about those who seek or obtain abortions. It prevents giving information, even in response to certain subpoenas, about an individual who sought an abortion if the information is to enforce another state’s anti-abortion laws. It also changes how California subpoenas issue in connection to other states’ or “foreign” subpoenas.
Another new law, AB 2089 , broadened California’s confidentiality rules to include electronically gathered information regarding mental health. It is targeted at mental-health information coming from apps and websites. It places other types of businesses under the same confidentiality rules as healthcare providers. To the extent that such providers have partnerships with the outside businesses, they will need to confirm compliance. And the law allows for a private right of action, making the likelihood of lawsuits high.
Next, SB 1419 simultaneously expanded patients’ rights to access imaging scans while restricting parent/guardians’ rights to access their children’s medical records as to sensitive services, including pregnancy, STD treatment, rape treatment, drug or alcohol treatment, and mental-health issues. Thus, providers have more to think about when providing, or not providing, information to anyone but the patient.
Last is AB 2098. It allows physicians’ and surgeons’ licenses to be disciplined for spreading “disinformation” or “misinformation” related to COVID-19. It defines “misinformation” as: “false information that is contradicted by contemporary scientific consensus contrary to the standard of care.” And it defines “disinformation” as: “misinformation that the licensee deliberately disseminated with malicious intent or an intent to mislead.” Disseminating such information would have to come in the act of treatment or giving patient advice. The law does not seem to speak to broader statements by doctors in everyday life (such as conversations or social media posts, for example). This distinction is likely intentional to protect the new law from First Amendment challenges. When it comes to COVID, what you say, why you say it, and how and where you say it now all have licensing implications.
Gender-Treatment Issues
2023 also has new laws impacting gender issues. SB 107 picks up on the confidential-information theme. It prohibits health care providers from giving medical information relating to a child receiving health, or mental health, treatment regarding gender—even in response to a subpoena for an out-of-state legal proceeding. The bill also prevents California law enforcement from helping with arrests or extraditions if it relates to another state’s law against gender-affirming health care. It also allows courts to take temporary jurisdiction of a child that could not “obtain gender-affirming health care.”
The bill was brought by Senator Scott Wiener—who serves on the Health Committee and chairs the Select Committee on Mental Health—as was another enacted bill, SB 923. It requires several Medi-Cal and insurance-related entities to complete training regarding providing “trans-inclusive health care.” It also requires the entities to monitor complaints related to such care and to publicly report the data. The law also expands the required “cultural competency” trainings for physicians to include issues impacting transgender, gender diverse, or intersex (defined as “TGI”). The regulatory system for this law is anticipated to be completed by July 1, 2027.
Telehealth & Referrals
AB 457 changes and clarifies the otherwise strict anti-fee-for-referral laws in California. Generally, a provider cannot have a financial relationship with someone they have a referral relationship with. This new law, however, allows for payment for any internet service that gives patients information about physicians. But this is limited by the rule that the internet-service company still cannot recommend or promote a specific provider to a patient. Essentially, it allows broad advertising or booking services, but not specific referrals or recommendations.
The same law also ensures payment parity for numerous telehealth services, as if they were provided in person. Previously, the payment parity only existed for newer provider contracts, but that date restriction has been eliminated.
The bill also created the Protection of Patient Choice in Telehealth Provider Act. It requires plans and insurers to provide various notices and consent forms for insureds, if those plans use a third-party telehealth provider. It contains a number of additional technical requirements as to Medi-Cal and mental health via telehealth providers.
Conclusion
To summarize, 2023 sees several new laws affecting healthcare providers and insurers regulating the information provided to or about patients—even in response to otherwise valid, legal subpoenas. It expands physician continuing-education requirements on gender topics, it limits what can be discussed with patients—especially in the COVID space, but the list will likely grow—and expands, within limits, telehealth and internet-based services.
If you need a more thorough analysis of these new laws, send us a note at info@cjattorneys.com and we will do a deep dive for you. Also, if you know of others that would like our updates, they may subscribe here: https://cjattorneys.com/news/. If you do not want to receive these client updates, simply click the “Unsubscribe” link at the bottom of this newsletter.
Best,
Keith W. Carlson and Nima A. Jalali
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