California Legislature—2015–16 Regular Session

Assembly BillNo. 502


Introduced by Assembly Member Chau

February 23, 2015


An act to amend Sections 1924, 1926, and 1931 of the Business and Professions Code, to amend Sections 13401 and 13401.5 of the Corporations Code, to add Section 1374.196 to the Health and Safety Code, and to add Section 10120.4 to the Insurance Code, relating to dental hygiene.

LEGISLATIVE COUNSEL’S DIGEST

AB 502, as introduced, Chau. Dental hygiene.

(1) Existing law, the Dental Practice Act, provides for the licensure and regulation of registered dental hygienists, registered dental hygienists in extended functions, and registered dental hygienists in alternative practice by the Dental Hygiene Committee of California.

Existing law authorizes a registered dental hygienist in alternative practice to perform various duties in specified settings, including dental health professional shortage areas, as certified by the Office of Statewide Health Planning and Development.

This bill would require an alternative dental hygiene practice established within a certified shortage area to continue regardless of certification.

Existing law authorizes a registered dental hygienist in alternative practice to provide services to a patient without obtaining written verification that the patient has been examined by a dentist or physician and surgeon licensed to practice in this state. However, under existing law, if the registered dental hygienist in alternative practice provides services to a patient 18 months or more after the first date that he or she provides services to a patient, he or she is required to obtain written verification, including a prescription for dental hygiene services, that the patient has been examined by a dentist or physician and surgeon licensed to practice in this state.

This bill would delete that written verification and prescription requirement.

(2) Existing law, the Moscone-Knox Professional Corporation Act, prohibits a professional corporation from rendering professional services in this state without a currently effective certificate of registration issued by the governmental agency regulating the profession in which the corporation is or proposes to be engaged and excepts any professional corporation rendering professional services by persons duly licensed by specified state entities from that requirement. Existing law authorizes specified healing arts practitioners to be shareholders, officers, directors, or professional employees of a designated professional corporation, subject to certain limitations relating to ownership of shares.

This bill would additionally except any professional corporation rendering professional services by persons duly licensed by the Dental Hygiene Committee of California from the certificate of registration requirement. The bill would authorize dental assistants and licensed dentists to be shareholders, officers, directors, or professional employees of a registered dental hygienist in alternative practice corporation.

(3) Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law provides certain standards that govern health care service plan contracts covering dental services, health insurance policies covering dental services, specialized health care service plan contracts covering dental services, and specialized health insurance policies covering dental services.

This bill would require health care service plan contracts covering dental services, health insurance policies covering dental services, specialized health care service plan contracts covering dental services, and specialized health insurance policies covering dental services issued, amended, or renewed on or after January 1, 2016, to reimburse registered dental hygienists in alternative practice for performing dental hygiene services that may lawfully be performed by registered dental hygienists and that are reimbursable under the contracts or policies. The bill would also require the plan or insurer to use the same fee schedule for reimbursing both registered dental hygienists and registered dental hygienists in alternative practice. Because a willful violation of the bill’s provisions by a health care service plan covering dental services or a specialized health care service plan covering dental services would be a crime, it would impose a state-mandated local program.

(4) 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.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Section 1924 of the Business and Professions
2Code
is amended to read:

3

1924.  

A person licensed as a registered dental hygienist who
4has completed the prescribed classes through the Health Manpower
5Pilot Project (HMPP) and who has established an independent
6practice under the HMPP by June 30, 1997, shall be deemed to
7have satisfied the licensing requirements under Section 1922, and
8shall be authorized to continue to operate the practice he or she
9presently operates, so long as he or she follows thebegin delete requirements
10for prescription andend delete
functions as specified in Sections 1922, 1925,
111926, 1927, 1928,begin insert andend insert 1930,begin delete and 1931,end delete and subdivision (b) of
12Section 1929, and as long as he or she continues to personally
13practice and operate the practice or until he or she sells the practice
14to a licensed dentist.

15

SEC. 2.  

Section 1926 of the Business and Professions Code is
16amended to read:

17

1926.  

A registered dental hygienist in alternative practice may
18perform the duties authorized pursuant to subdivision (a) of Section
191907, subdivision (a) of Section 1908, and subdivisions (a) and
20(b) of Section 1910 in the following settings:

21(a) Residences of the homebound.

22(b) Schools.

23(c) Residential facilities and other institutions.

24(d) Dental health professional shortage areas, as certified by the
25Office of Statewide Health Planning and Development in
P4    1accordance with existing office guidelines.begin insert An alternative dental
2hygiene practice established within a certified shortage area shall
3continue regardless of certification.end insert

4

SEC. 3.  

Section 1931 of the Business and Professions Code is
5amended to read:

6

1931.  

begin delete(a)end deletebegin deleteend deletebegin delete(1)end deletebegin deleteend deleteAbegin insert registeredend insert dental hygienist in alternative
7practice may provide services to a patient without obtaining written
8verification that the patient has been examined by a dentist or
9physician and surgeon licensed to practice in this state.

begin delete

10(2) If the dental hygienist in alternative practice provides
11services to a patient 18 months or more after the first date that he
12or she provides services to a patient, he or she shall obtain written
13verification that the patient has been examined by a dentist or
14physician and surgeon licensed to practice in this state. The
15verification shall include a prescription for dental hygiene services
16as described in subdivision (b).

17(b) A registered dental hygienist in alternative practice may
18provide dental hygiene services for a patient who presents to the
19registered dental hygienist in alternative practice a written
20prescription for dental hygiene services issued by a dentist or
21physician and surgeon licensed to practice in this state. The
22prescription shall be valid for a time period based on the dentist’s
23or physician and surgeon’s professional judgment, but not to exceed
24two years from the date it was issued.

25(c) (1) The committee may seek to obtain an injunction against
26any registered dental hygienist in alternative practice who provides
27services pursuant to this section, if the committee has reasonable
28cause to believe that the services are being provided to a patient
29who has not received a prescription for those services from a dentist
30or physician and surgeon licensed to practice in this state.

31(2) Providing services pursuant to this section without obtaining
32a prescription in accordance with subdivision (b) shall constitute
33unprofessional conduct on the part of the registered dental hygienist
34in alternative practice, and reason for the committee to revoke or
35suspend the license of the registered dental hygienist in alternative
36practice pursuant to Section 1947.

end delete
37

SEC. 4.  

Section 13401 of the Corporations Code is amended
38to read:

39

13401.  

As used in this part:

P5    1(a) “Professional services” means any type of professional
2services that may be lawfully rendered only pursuant to a license,
3certification, or registration authorized by the Business and
4Professions Code, the Chiropractic Act, or the Osteopathic Act.

5(b) “Professional corporation” means a corporation organized
6under the General Corporation Law or pursuant to subdivision (b)
7of Section 13406 that is engaged in rendering professional services
8in a single profession, except as otherwise authorized in Section
913401.5, pursuant to a certificate of registration issued by the
10governmental agency regulating the profession as herein provided
11and that in its practice or business designates itself as a professional
12or other corporation as may be required by statute. However, any
13professional corporation or foreign professional corporation
14rendering professional services by persons duly licensed by the
15Medical Board of California or any examining committee under
16the jurisdiction of the board, the Osteopathic Medical Board of
17California, the Dental Board of California,begin insert the Dental Hygiene
18Committee of California,end insert
the California State Board of Pharmacy,
19the Veterinary Medical Board, the California Architects Board,
20the Court Reporters Board of California, the Board of Behavioral
21Sciences, the Speech-Language Pathology and Audiology Board,
22the Board of Registered Nursing, or the State Board of Optometry
23shall not be required to obtain a certificate of registration in order
24to render those professional services.

25(c) “Foreign professional corporation” means a corporation
26organized under the laws of a state of the United States other than
27this state that is engaged in a profession of a type for which there
28is authorization in the Business and Professions Code for the
29performance of professional services by a foreign professional
30corporation.

31(d) “Licensed person” means any natural person who is duly
32licensed under the provisions of the Business and Professions
33Code, the Chiropractic Act, or the Osteopathic Act to render the
34same professional services as are or will be rendered by the
35professional corporation or foreign professional corporation of
36which he or she is or intends to become, an officer, director,
37shareholder, or employee.

38(e) “Disqualified person” means a licensed person who for any
39reason becomes legally disqualified (temporarily or permanently)
40to render the professional services that the particular professional
P6    1corporation or foreign professional corporation of which he or she
2is an officer, director, shareholder, or employee is or was rendering.

3

SEC. 5.  

Section 13401.5 of the Corporations Code is amended
4to read:

5

13401.5.  

Notwithstanding subdivision (d) of Section 13401
6and any other provision of law, the following licensed persons
7may be shareholders, officers, directors, or professional employees
8of the professional corporations designated in this section so long
9as the sum of all shares owned by those licensed persons does not
10exceed 49 percent of the total number of shares of the professional
11corporation so designated herein, and so long as the number of
12those licensed persons owning shares in the professional
13corporation so designated herein does not exceed the number of
14persons licensed by the governmental agency regulating the
15designated professional corporation. This section does not limit
16employment by a professional corporation designated in this section
17begin delete ofend deletebegin insert toend insert only those licensed professionals listed under each
18subdivision. Any person duly licensed under Division 2
19(commencing with Section 500) of the Business and Professions
20Code, the Chiropractic Act, or the Osteopathic Act may be
21employed to render professional services by a professional
22corporation designated in this section.

23(a) Medical corporation.

24(1) Licensed doctors of podiatric medicine.

25(2) Licensed psychologists.

26(3) Registered nurses.

27(4) Licensed optometrists.

28(5) Licensed marriage and family therapists.

29(6) Licensed clinical social workers.

30(7) Licensed physician assistants.

31(8) Licensed chiropractors.

32(9) Licensed acupuncturists.

33(10) Naturopathic doctors.

34(11) Licensed professional clinical counselors.

35(12) Licensed physical therapists.

36(b) Podiatric medical corporation.

37(1) Licensed physicians and surgeons.

38(2) Licensed psychologists.

39(3) Registered nurses.

40(4) Licensed optometrists.

P7    1(5) Licensed chiropractors.

2(6) Licensed acupuncturists.

3(7) Naturopathic doctors.

4(8) Licensed physical therapists.

5(c) Psychological corporation.

6(1) Licensed physicians and surgeons.

7(2) Licensed doctors of podiatric medicine.

8(3) Registered nurses.

9(4) Licensed optometrists.

10(5) Licensed marriage and family therapists.

11(6) Licensed clinical social workers.

12(7) Licensed chiropractors.

13(8) Licensed acupuncturists.

14(9) Naturopathic doctors.

15(10) Licensed professional clinical counselors.

16(d) Speech-language pathology corporation.

17(1) Licensed audiologists.

18(e) Audiology corporation.

19(1) Licensed speech-language pathologists.

20(f) Nursing corporation.

21(1) Licensed physicians and surgeons.

22(2) Licensed doctors of podiatric medicine.

23(3) Licensed psychologists.

24(4) Licensed optometrists.

25(5) Licensed marriage and family therapists.

26(6) Licensed clinical social workers.

27(7) Licensed physician assistants.

28(8) Licensed chiropractors.

29(9) Licensed acupuncturists.

30(10) Naturopathic doctors.

31(11) Licensed professional clinical counselors.

32(g) Marriage and family therapist corporation.

33(1) Licensed physicians and surgeons.

34(2) Licensed psychologists.

35(3) Licensed clinical social workers.

36(4) Registered nurses.

37(5) Licensed chiropractors.

38(6) Licensed acupuncturists.

39(7) Naturopathic doctors.

40(8) Licensed professional clinical counselors.

P8    1(h) Licensed clinical social worker corporation.

2(1) Licensed physicians and surgeons.

3(2) Licensed psychologists.

4(3) Licensed marriage and family therapists.

5(4) Registered nurses.

6(5) Licensed chiropractors.

7(6) Licensed acupuncturists.

8(7) Naturopathic doctors.

9(8) Licensed professional clinical counselors.

10(i) Physician assistants corporation.

11(1) Licensed physicians and surgeons.

12(2) Registered nurses.

13(3) Licensed acupuncturists.

14(4) Naturopathic doctors.

15(j) Optometric corporation.

16(1) Licensed physicians and surgeons.

17(2) Licensed doctors of podiatric medicine.

18(3) Licensed psychologists.

19(4) Registered nurses.

20(5) Licensed chiropractors.

21(6) Licensed acupuncturists.

22(7) Naturopathic doctors.

23(k) Chiropractic corporation.

24(1) Licensed physicians and surgeons.

25(2) Licensed doctors of podiatric medicine.

26(3) Licensed psychologists.

27(4) Registered nurses.

28(5) Licensed optometrists.

29(6) Licensed marriage and family therapists.

30(7) Licensed clinical social workers.

31(8) Licensed acupuncturists.

32(9) Naturopathic doctors.

33(10) Licensed professional clinical counselors.

34(l) Acupuncture corporation.

35(1) Licensed physicians and surgeons.

36(2) Licensed doctors of podiatric medicine.

37(3) Licensed psychologists.

38(4) Registered nurses.

39(5) Licensed optometrists.

40(6) Licensed marriage and family therapists.

P9    1(7) Licensed clinical social workers.

2(8) Licensed physician assistants.

3(9) Licensed chiropractors.

4(10) Naturopathic doctors.

5(11) Licensed professional clinical counselors.

6(m) Naturopathic doctor corporation.

7(1) Licensed physicians and surgeons.

8(2) Licensed psychologists.

9(3) Registered nurses.

10(4) Licensed physician assistants.

11(5) Licensed chiropractors.

12(6) Licensed acupuncturists.

13(7) Licensed physical therapists.

14(8) Licensed doctors of podiatric medicine.

15(9) Licensed marriage and family therapists.

16(10) Licensed clinical social workers.

17(11) Licensed optometrists.

18(12) Licensed professional clinical counselors.

19(n) Dental corporation.

20(1) Licensed physicians and surgeons.

21(2) Dental assistants.

22(3) Registered dental assistants.

23(4) Registered dental assistants in extended functions.

24(5) Registered dental hygienists.

25(6) Registered dental hygienists in extended functions.

26(7) Registered dental hygienists in alternative practice.

27(o) Professional clinical counselor corporation.

28(1) Licensed physicians and surgeons.

29(2) Licensed psychologists.

30(3) Licensed clinical social workers.

31(4) Licensed marriage and family therapists.

32(5) Registered nurses.

33(6) Licensed chiropractors.

34(7) Licensed acupuncturists.

35(8) Naturopathic doctors.

36(p) Physical therapy corporation.

37(1) Licensed physicians and surgeons.

38(2) Licensed doctors of podiatric medicine.

39(3) Licensed acupuncturists.

40(4) Naturopathic doctors.

P10   1(5) Licensed occupational therapists.

2(6) Licensed speech-language therapists.

3(7) Licensed audiologists.

4(8) Registered nurses.

5(9) Licensed psychologists.

6(10) Licensed physician assistants.

begin insert

7(q) Registered dental hygienist in alternative practice
8corporation.

end insert
begin insert

9(1) Dental assistants.

end insert
begin insert

10(2) Licensed dentists.

end insert
11

SEC. 6.  

Section 1374.196 is added to the Health and Safety
12Code
, to read:

13

1374.196.  

(a) This section shall only apply to a health care
14service plan contract covering dental services or a specialized
15health care service plan contract covering dental services issued,
16amended, or renewed on or after January 1, 2016.

17(b) A registered dental hygienist in alternative practice, licensed
18pursuant to Section 1922 of the Business and Professions Code,
19may submit or allow to be submitted on his or her behalf any claim
20for dental hygiene services performed as authorized pursuant to
21Article 9 (commencing with Section 1900) of Chapter 4 of Division
222 of the Business and Professions Code to a health care service
23plan covering dental services or a specialized health care service
24plan covering dental services.

25(c) If a health care service plan contract covering dental services
26or a specialized health care service plan contract covering dental
27services provides reimbursement for dental hygiene services that
28may lawfully be performed by a registered dental hygienist,
29licensed pursuant to Section 1917 of the Business and Professions
30Code, reimbursement under that plan contract shall not be denied
31when the service is performed by a registered dental hygienist in
32alternative practice.

33(d) (1) Nothing in this section shall preclude a health care
34service plan contract covering dental services or a specialized
35health care service plan contract covering dental services from
36setting different fee schedules for different services provided by
37different providers.

38(2) A health care service plan contract covering dental services
39or a specialized health care service plan contract covering dental
40services shall use the same fee schedule for dental hygiene services
P11   1whether the services are performed by a registered dental hygienist
2or a registered dental hygienist in alternative practice.

3

SEC. 7.  

Section 10120.4 is added to the Insurance Code, to
4read:

5

10120.4.  

(a) This section shall only apply to a health insurance
6policy covering dental services or a specialized health insurance
7policy covering dental services issued, amended, or renewed on
8or after January 1, 2016.

9(b) A registered dental hygienist in alternative practice, licensed
10pursuant to Section 1922 of the Business and Professions Code,
11may submit or allow to be submitted on his or her behalf any claim
12for dental hygiene services performed as authorized pursuant to
13Article 9 (commencing with Section 1900) of Chapter 4 of Division
142 of the Business and Professions Code to a health insurer covering
15dental services or a specialized health insurer covering dental
16services.

17(c) If a health insurance policy covering dental services or a
18specialized health insurance policy covering dental services
19provides for reimbursement for dental hygiene services that may
20lawfully be performed by a registered dental hygienist, licensed
21pursuant to Section 1917 of the Business and Professions Code,
22reimbursement under that policy shall not be denied when the
23service is performed by a registered dental hygienist in alternative
24practice.

25(d) (1) Nothing in this section shall preclude a health insurance
26policy covering dental services or a specialized health insurance
27policy covering dental services from setting different fee schedules
28for different services provided by different providers.

29(2) A health insurance policy covering dental services or a
30specialized health insurance policy covering dental services shall
31use the same fee schedule for dental hygiene services whether the
32services are performed by a registered dental hygienist or a
33registered dental hygienist in alternative practice.

34

SEC. 8.  

No reimbursement is required by this act pursuant to
35Section 6 of Article XIII B of the California Constitution because
36the only costs that may be incurred by a local agency or school
37district will be incurred because this act creates a new crime or
38infraction, eliminates a crime or infraction, or changes the penalty
39for a crime or infraction, within the meaning of Section 17556 of
40the Government Code, or changes the definition of a crime within
P12   1the meaning of Section 6 of Article XIII B of the California
2Constitution.



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