2005 California Business and Professions Code Sections 800-809.9 Article 11. Professional Reporting

800.  (a) The Medical Board of California, the Board of Psychology,
the Dental Board of California, the Osteopathic Medical Board of
California, the State Board of Chiropractic Examiners, the Board of
Registered Nursing, the Board of Vocational Nursing and Psychiatric
Technicians, the State Board of Optometry, the Veterinary Medical
Board, the Board of Behavioral Sciences, the Physical Therapy Board
of California, and the California State Board of Pharmacy shall each
separately create and maintain a central file of the names of all
persons who hold a license, certificate, or similar authority from
that board.  Each central file shall be created and maintained to
provide an individual historical record for each licensee with
respect to the following information:
   (1) Any conviction of a crime in this or any other state that
constitutes unprofessional conduct pursuant to the reporting
requirements of Section 803.
   (2) Any judgment or settlement requiring the licensee or his or
her insurer to pay any amount of damages in excess of three thousand
dollars ($3,000) for any claim that injury or death was proximately
caused by the licensee's negligence, error or omission in practice,
or by rendering unauthorized professional services, pursuant to the
reporting requirements of Section 801 or 802.
   (3) Any public complaints for which provision is made pursuant to
subdivision (b).
   (4) Disciplinary information reported pursuant to Section 805.
   (b) Each board shall prescribe and promulgate forms on which
members of the public and other licensees or certificate holders may
file written complaints to the board alleging any act of misconduct
in, or connected with, the performance of professional services by
the licensee.
   If a board, or division thereof, a committee, or a panel has
failed to act upon a complaint or report within five years, or has
found that the complaint or report is without merit, the central file
shall be purged of information relating to the complaint or report.
   Notwithstanding this subdivision, the Board of Psychology, the
Board of Behavioral Sciences, and the Respiratory Care Board of
California shall maintain complaints or reports as long as each board
deems necessary.
   (c) The contents of any central file that are not public records
under any other provision of law shall be confidential except that
the licensee involved, or his or her counsel or representative, shall
have the right to inspect and have copies made of his or her
complete file except for the provision that may disclose the identity
of an information source.  For the purposes of this section, a board
may protect an information source by providing a copy of the
material with only those deletions necessary to protect the identity
of the source or by providing a comprehensive summary of the
substance of the material.  Whichever method is used, the board shall
ensure that full disclosure is made to the subject of any personal
information that could reasonably in any way reflect or convey
anything detrimental, disparaging, or threatening to a licensee's
reputation, rights, benefits, privileges, or qualifications, or be
used by a board to make a determination that would affect a licensee'
s rights, benefits, privileges, or qualifications.  The information
required to be disclosed pursuant to Section 803.1 shall not be
considered among the contents of a central file for the purposes of
this subdivision.
   The licensee may, but is not required to, submit any additional
exculpatory or explanatory statement or other information that the
board shall include in the central file.
   Each board may permit any law enforcement or regulatory agency
when required for an investigation of unlawful activity or for
licensing, certification, or regulatory purposes to inspect and have
copies made of that licensee's file, unless the disclosure is
otherwise prohibited by law.
   These disclosures shall effect no change in the confidential
status of these records.
801.  (a) Every insurer providing professional liability insurance
to a person who holds a license, certificate, or similar authority
from or under any agency mentioned in subdivision (a) of Section 800
(except as provided in subdivisions (b), (c), (d), and (e)) shall
send a complete report to that agency as to any settlement or
arbitration award over three thousand dollars ($3,000) of a claim or
action for damages for death or personal injury caused by that person'
s negligence, error, or omission in practice, or by his or her
rendering of unauthorized professional services.  The report shall be
sent within 30 days after the written settlement agreement has been
reduced to writing and signed by all parties thereto or within 30
days after service of the arbitration award on the parties.
   (b) Every insurer providing professional liability insurance to a
physician and surgeon licensed pursuant to Chapter 5 (commencing with
Section 2000) or the Osteopathic Initiative Act shall send a
complete report to the Medical Board of California or the Osteopathic
Medical Board of California, as appropriate, as to any settlement
over thirty thousand dollars ($30,000); or arbitration award of any
amount; or civil judgment of any amount, whether or not vacated by a
settlement after entry of the judgment, that was not reversed on
appeal; of a claim or action for damages for death or personal injury
caused by that person's negligence, error, or omission in practice,
or by his or her rendering of unauthorized professional services.  A
settlement over thirty thousand dollars ($30,000) shall also be
reported if the settlement is based on the licensee's negligence,
error, or omission in practice, or by the licensee's rendering of
unauthorized professional services, and a party to the settlement is
a corporation, medical group, partnership, or other corporate entity
in which the licensee has an ownership interest or that employs or
contracts with the licensee.  The report shall be sent within 30 days
after the written settlement agreement has been reduced to writing
and signed by all parties thereto, within 30 days after service of
the arbitration award on the parties, or within 30 days after the
date of entry of the civil judgment.
   (c) Every insurer providing professional liability insurance to a
person licensed pursuant to Chapter 13 (commencing with Section 4980)
or Chapter 14 (commencing with Section 4990) shall send a complete
report to the Board of Behavioral Science Examiners as to any
settlement or arbitration award over ten thousand dollars ($10,000)
of a claim or action for damages for death or personal injury caused
by that person's negligence, error, or omission in practice, or by
his or her rendering of unauthorized professional services.  The
report shall be sent within 30 days after the written settlement
agreement has been reduced to writing and signed by all parties
thereto or within 30 days after service of the arbitration award on
the parties.
   (d) Every insurer providing professional liability insurance to a
dentist licensed pursuant to Chapter 4 (commencing with Section 1600)
shall send a complete report to the Dental Board of California as to
any settlement or arbitration award over ten thousand dollars
($10,000) of a claim or action for damages for death or personal
injury caused by that person's negligence, error, or omission in
practice, or rendering of unauthorized professional services.  The
report shall be sent within 30 days after the written settlement
agreement has been reduced to writing and signed by all parties
thereto or within 30 days after service of the arbitration award on
the parties.
   (e) Every insurer providing liability insurance to a veterinarian
licensed pursuant to Chapter 60 (commencing with Section 4825) shall
send a complete report to the Veterinary Medical Board of any
settlement or arbitration award over ten thousand dollars ($10,000)
of a claim or action for damages for death or injury caused by that
person's negligence, error, or omission in practice, or rendering of
unauthorized professional service.  The report shall be sent within
30 days after the written settlement agreement has been reduced to
writing and signed by all parties thereto or within 30 days after
service of the arbitration award on the parties.
   (f) The insurer shall notify the claimant, or if the claimant is
represented by counsel, the insurer shall notify the claimant's
attorney, that the report required by subdivision (a), (b), (c), or
(d) has been sent to the agency.  If the attorney has not received
this notice within 45 days after the settlement was reduced to
writing and signed by all of the parties, the arbitration award was
served on the parties, or the date of entry of the civil judgment,
the attorney shall make the report to the agency.
   (g) Notwithstanding any other provision of law, no insurer shall
enter into a settlement without the written consent of the insured,
except that this prohibition shall not void any settlement entered
into without that written consent.  The requirement of written
consent shall only be waived by both the insured and the insurer.
This section shall only apply to a settlement on a policy of
insurance executed or renewed on or after January 1, 1971.
801.1.  (a) Every state or local governmental agency that self
insures a person who holds a license, certificate or similar
authority from or under any agency mentioned in subdivision (a) of
Section 800 (except a person licensed pursuant to Chapter 3
(commencing with Section 1200) or Chapter 5 (commencing with Section
2000) of Division 2 or the Osteopathic Initiative Act) shall send a
complete report to that agency as to any settlement or arbitration
award over three thousand dollars ($3,000) of a claim or action for
damages for death or personal injury caused by that person's
negligence, error or omission in practice, or rendering of
unauthorized professional services.  The report shall be sent within
30 days after the written settlement agreement has been reduced to
writing and signed by all parties thereto or within 30 days after
service of the arbitration award on the parties.
   (b) Every state or local governmental agency that self-insures a
physician and surgeon licensed pursuant to Chapter 5 (commencing with
Section 2000) of Division 2 or the Osteopathic Initiative Act shall
send a complete report to the Medical Board of California or the
Osteopathic Medical Board of California, as appropriate, as to any
settlement or arbitration award over thirty thousand dollars
($30,000) of a claim or action for damages for death or personal
injury caused by that person's negligence, error or omission in
practice, or rendering of unauthorized professional services.  A
settlement over thirty thousand dollars ($30,000) shall also be
reported if the settlement is based on the licensee's negligence,
error, or omission in practice or by his or her rendering of
unauthorized professional services, and a party to the settlement is
a corporation, medical group, partnership, or other corporate entity
in which the licensee has an ownership interest or that employs or
contracts with the licensee.  The report shall be sent within 30 days
after the written settlement agreement has been reduced to writing
and signed by all parties thereto or within 30 days after service of
the arbitration award on the parties.
   (c) Every state or local governmental agency that self-insures a
person licensed pursuant to Chapter 13 (commencing with Section 4980)
or Chapter 14 (commencing with Section 4990) shall send a complete
report to the Board of Behavioral Science Examiners as to any
settlement or arbitration award over ten thousand dollars ($10,000)
of a claim or action for damages for death or personal injury caused
by that person's negligence, error, or omission in practice, or
rendering of unauthorized professional services.  The report shall be
sent within 30 days after the written settlement agreement has been
reduced to writing and signed by all parties thereto or within 30
days after service of the arbitration award on the parties.
802.  (a) Every settlement, judgment, or arbitration award over
three thousand dollars ($3,000) of a claim or action for damages for
death or personal injury caused by negligence, error or omission in
practice, or by the unauthorized rendering of professional services,
by a person who holds a license, certificate, or other similar
authority from an agency mentioned in subdivision (a) of Section 800
(except a person licensed pursuant to Chapter 3 (commencing with
Section 1200) or Chapter 5 (commencing with Section 2000) of Division
2) or the Osteopathic Initiative Act who does not possess
professional liability insurance as to that claim shall, within 30
days after the written settlement agreement has been reduced to
writing and signed by all the parties thereto or 30 days after
service of the judgment or arbitration award on the parties, be
reported to the agency that issued the license, certificate, or
similar authority. A complete report shall be made by appropriate
means by the person or his or her counsel, with a copy of the
communication to be sent to the claimant through his or her counsel
if the person is so represented, or directly if he or she is not. If,
within 45 days of the conclusion of the written settlement agreement
or service of the judgment or arbitration award on the parties,
counsel for the claimant (or if the claimant is not represented by
counsel, the claimant himself or herself) has not received a copy of
the report, he or she shall himself or herself make the complete
report. Failure of the licensee or claimant (or, if represented by
counsel, their counsel) to comply with this section is a public
offense punishable by a fine of not less than fifty dollars ($50) or
more than five hundred dollars ($500). Knowing and intentional
failure to comply with this section or conspiracy or collusion not to
comply with this section, or to hinder or impede any other person in
the compliance, is a public offense punishable by a fine of not less
than five thousand dollars ($5,000) nor more than fifty thousand
dollars ($50,000).
   (b) Every settlement over thirty thousand dollars ($30,000), or
judgment or arbitration award of any amount, of a claim or action for
damages for death or personal injury caused by negligence, error or
omission in practice, or by the unauthorized rendering of
professional services, by a physician and surgeon licensed pursuant
to Chapter 5 (commencing with Section 2000) of Division 2, or the
Osteopathic Initiative Act, who does not possess professional
liability insurance as to the claim shall, within 30 days after the
written settlement agreement has been reduced to writing and signed
by all the parties thereto or 30 days after service of the judgment
or arbitration award on the parties, be reported to the agency that
issued the license, certificate, or similar authority. A settlement
over thirty thousand dollars ($30,000) shall also be reported if the
settlement is based on the licensee's negligence, error, or omission
in practice or his or her rendering of unauthorized professional
services, and a party to the settlement is a corporation, medical
group, partnership, or other corporate entity in which the licensee
has an ownership interest or that employs or contracts with the
licensee. A complete report including the name and license number of
the physician and surgeon shall be made by appropriate means by the
person or his or her counsel, with a copy of the communication to be
sent to the claimant through his or her counsel if he or she is so
represented, or directly if he or she is not. If, within 45 days of
the conclusion of the written settlement agreement or service of the
judgment or arbitration award on the parties, counsel for the
claimant (or if the claimant is not represented by counsel, the
claimant himself or herself) has not received a copy of the report,
he or she shall himself or herself make the complete report. Failure
of the physician and surgeon or claimant (or, if represented by
counsel, their counsel) to comply with this section is a public
offense punishable by a fine of not less than fifty dollars ($50) nor
more than five hundred dollars ($500).  Knowing and intentional
failure to comply with this section or conspiracy or collusion not to
comply with this section, or to hinder or impede any other person in
the compliance, is a public offense punishable by a fine of not less
than five thousand dollars ($5,000) nor more than fifty thousand
dollars ($50,000).
   (c) Every settlement, judgment, or arbitration award over ten
thousand dollars ($10,000) of a claim or action for damages for death
or personal injury caused by negligence, error, or omission in
practice, or by the unauthorized rendering of professional services,
by a marriage and family therapist or clinical social worker licensed
pursuant to Chapter 13 (commencing with Section 4980) or Chapter 14
(commencing with Section 4990) who does not possess professional
liability insurance as to that claim shall within 30 days after the
written settlement agreement has been reduced to writing and signed
by all the parties thereto or 30 days after service of the judgment
or arbitration award on the parties be reported to the agency that
issued the license, certificate, or similar authority. A complete
report shall be made by appropriate means by the person or his or her
counsel, with a copy of the communication to be sent to the claimant
through his or her counsel if he or she is so represented, or
directly if he or she is not. If, within 45 days of the conclusion of
the written settlement agreement or service of the judgment or
arbitration award on the parties, counsel for the claimant (or if he
or she is not represented by counsel, the claimant himself or
herself) has not received a copy of the report, he or she shall
himself or herself make a complete report. Failure of the marriage
and family therapist or clinical social worker or claimant (or, if
represented by counsel, their counsel) to comply with this section is
a public offense punishable by a fine of not less than fifty dollars
($50) nor more than five hundred dollars ($500). Knowing and
intentional failure to comply with this section, or conspiracy or
collusion not to comply with this section or to hinder or impede any
other person in that compliance, is a public offense punishable by a
fine of not less than five thousand dollars ($5,000) nor more than
fifty thousand dollars ($50,000).
802.1.  (a) A physician and surgeon shall report either of the
following to the Medical Board of California in writing within 30
days:
   (1) The bringing of an indictment or information charging a felony
against the physician and surgeon.
   (2) The conviction of the physician and surgeon, including any
verdict of guilty, or plea of guilty or no contest, of any felony or
misdemeanor. A physician and surgeon shall report only those
misdemeanors that are substantially related to the qualifications,
functions, or duties of a physician and surgeon defined or identified
by the Legislature pursuant to subdivision (d) of Section 2027.
   (b) Failure to make a report required by this section shall be a
public offense punishable by a fine not to exceed five thousand
dollars ($5,000).
802.3.  Every report of a settlement required by Sections 801,
801.1, and 802 shall specify the specialty or subspecialty of the
physician and surgeon involved.
802.5.  (a) When a coroner receives information that is based on
findings that were reached by, or documented and approved by a
board-certified or board-eligible pathologist indicating that a death
may be the result of a physician's or podiatrist's gross negligence
or incompetence, a report shall be filed with the Medical Board of
California, the Osteopathic Medical Board of California, or the
California Board of Podiatric Medicine. The initial report shall
include the name of the decedent, date and place of death, attending
physicians or podiatrists, and all other relevant information
available. The initial report shall be followed, within 90 days, by
copies of the coroner's report, autopsy protocol, and all other
relevant information.
   (b) The report required by this section shall be confidential. No
coroner, physician and surgeon, or medical examiner, nor any
authorized agent, shall be liable for damages in any civil action as
a result of his or her acting in compliance with this section. No
board-certified or board-eligible pathologist, nor any authorized
agent, shall be liable for damages in any civil action as a result of
his or her providing information under subdivision (a).
803.  (a) (1) Except as provided in paragraph (2), within 10 days
after a judgment by a court of this state that a person who holds a
license, certificate, or other similar authority from the Board of
Behavioral Science Examiners or from an agency mentioned in
subdivision (a) of Section 800 (except a person licensed pursuant to
Chapter 3 (commencing with Section 1200)) has committed a crime, or
is liable for any death or personal injury resulting in a judgment
for an amount in excess of thirty thousand dollars ($30,000) caused
by his or her negligence, error or omission in practice, or his or
her rendering unauthorized professional services, the clerk of the
court that rendered the judgment shall report that fact to the agency
that issued the license, certificate, or other similar authority.
   (2) For purposes of a physician and surgeon who has committed a
crime, or is liable for any death or personal injury resulting in a
judgment of any amount caused by his or her negligence, error or
omission in practice, or his or her rendering unauthorized
professional services, the clerk of the court that rendered the
judgment shall report that fact to the agency that issued the
license.
   (b) Every insurer providing professional liability insurance to a
physician and surgeon licensed pursuant to Chapter 5 (commencing with
Section 2000) shall send a complete report including the name and
license number of the physician and surgeon to the Medical Board of
California or the Osteopathic Medical Board of California as to any
judgment of a claim for damages for death or personal injury caused
by that licensee's negligence, error, or omission in practice, or
rendering of unauthorized professional services. The report shall be
sent within 30 calendar days after entry of judgment.
   (c) Notwithstanding any other provision of law, the Medical Board
of California, the Osteopathic Medical Board of California, and the
California Board of Podiatric Medicine shall disclose to an inquiring
member of the public information received pursuant to subdivision
(a) regarding felony convictions of, and judgments against, a
physician and surgeon or doctor of podiatric medicine. The Division
of Medical Quality, the Osteopathic Medical Board of California, and
the California Board of Podiatric Medicine may formulate appropriate
disclaimers or explanatory statements to be included with any
information released, and may, by regulation, establish categories of
information that need not be disclosed to the public because that
information is unreliable or not sufficiently related to the licensee'
s professional practice.
803.1.  (a) Notwithstanding any other provision of law,  the Medical
Board of California, the Osteopathic Medical Board of California,
and the California Board of Podiatric Medicine shall disclose to an
inquiring member of the public information regarding any enforcement
actions taken against a licensee by either board or by another state
or jurisdiction, including all of the following:
   (1) Temporary restraining orders issued.
   (2) Interim suspension orders issued.
   (3) Revocations, suspensions, probations, or limitations on
practice ordered by the board, including those made part of a
probationary order or stipulated agreement.
   (4) Public letters of reprimand issued.
   (5) Infractions, citations, or fines imposed.
   (b) Notwithstanding any other provision of law, in addition to the
information provided in subdivision (a), the Medical Board of
California, the Osteopathic Medical Board of California, and the
California Board of Podiatric Medicine shall disclose to an inquiring
member of the public all of the following:
   (1) Civil judgments in any amount, whether or not vacated by a
settlement after entry of the judgment, that were not reversed on
appeal and arbitration awards in any amount of a claim or action for
damages for death or personal injury caused by the physician and
surgeon's negligence, error, or omission in practice, or by his or
her rendering of unauthorized professional services.
   (2) (A) All settlements in the possession, custody, or control of
the board shall be disclosed for a licensee in the low-risk category
if there are three or more settlements for that licensee within the
last 10 years, except for settlements by a licensee regardless of the
amount paid where (i) the settlement is made as a part of the
settlement of a class claim, (ii) the licensee paid in settlement of
the class claim the same amount as the other licensees in the same
class or similarly situated licensees in the same class, and (iii)
the settlement was paid in the context of a case where the complaint
that alleged class liability on behalf of the licensee also alleged a
products liability class action cause of action.  All settlements in
the possession, custody, or control of the board shall be disclosed
for a licensee in the high-risk category if there are four or more
settlements for that licensee within the last 10 years except for
settlements by a licensee regardless of the amount paid where (i) the
settlement is made as a part of the settlement of a class claim,
(ii) the licensee paid in settlement of the class claim the same
amount as the other licensees in the same class or similarly situated
licensees in the same class, and (iii) the settlement was paid in
the context of a case where the complaint that alleged class
liability on behalf of the licensee also alleged a products liability
class action cause of action.  Classification of a licensee in
either a "high-risk category" or a "low-risk category" depends upon
the specialty or subspecialty practiced by the licensee and the
designation assigned to that specialty or subspecialty by the Medical
Board of California, as described in subdivision (e).  For the
purposes of this paragraph, "settlement" means a settlement of an
action described in paragraph (1) entered into by the licensee on or
after January 1, 2003, in an amount of thirty thousand dollars
($30,000) or more.
   (B) The board shall not disclose the actual dollar amount of a
settlement but shall put the number and amount of the settlement in
context by doing the following:
   (i) Comparing the settlement amount to the experience of other
licensees within the same specialty or subspecialty, indicating if it
is below average, average, or above average for the most recent
10-year period.
   (ii) Reporting the number of years the licensee has been in
practice.
   (iii) Reporting the total number of licensees in that specialty or
subspecialty, the number of those who have entered into a settlement
agreement, and the percentage that number represents of the total
number of licensees in the specialty or subspecialty.
   (3) Current American Board of Medical  Specialty certification or
board equivalent as certified by the Medical Board of California, the
Osteopathic Medical Board of California, or the California Board of
Podiatric Medicine.
   (4) Approved postgraduate training.
   (5) Status of the license of a licensee.  By January 1, 2004, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
adopt regulations defining the status of a licensee.  The board shall
employ this definition when disclosing the status of a licensee
pursuant to Section 2027.
   (6) Any summaries of hospital disciplinary actions that result in
the termination or revocation of a licensee's staff privileges for
medical disciplinary cause or reason.
   (c) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine may
formulate appropriate disclaimers or explanatory statements to be
included with any information released, and may by regulation
establish categories of information that need not be disclosed to an
inquiring member of the public because that information is unreliable
or not sufficiently related to the licensee's professional practice.
  The Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
include the following statement when disclosing information
concerning a settlement:
   "Some studies have shown that there is no significant correlation
between malpractice history and a doctor's competence.  At the same
time, the State of California believes that consumers should have
access to malpractice information.  In these profiles, the State of
California has given you information about both the malpractice
settlement history for the doctor's specialty and the doctor's
history of settlement payments only if in the last 10 years, the
doctor, if in a low-risk specialty, has three or more settlements or
the doctor, if in a high-risk specialty, has four or more
settlements.  The State of California has excluded some class action
lawsuits because those cases are commonly related to systems issues
such as product liability, rather than questions of individual
professional competence and because they are brought on a class basis
where the economic incentive for settlement is great.  The State of
California has placed payment amounts into three statistical
categories:  below average, average, and above average compared to
others in the doctor's specialty.  To make the best health care
decisions, you should view this information in perspective.  You
could miss an opportunity for high-quality care by selecting a doctor
based solely on malpractice history.
   When considering malpractice data, please keep in mind:
   Malpractice histories tend to vary by specialty.  Some specialties
are more likely than others to be the subject of litigation.  This
report compares doctors only to the members of their specialty, not
to all doctors, in order to make an individual doctor's history more
meaningful.
   This report reflects data only for settlements made on or after
January 1, 2003.  Moreover, it includes information concerning those
settlements for a 10-year period only.  Therefore, you should know
that a doctor may have made settlements in the 10 years immediately
preceding January 1, 2003, that are not included in this report.
After January 1, 2013, for doctors practicing less than 10 years, the
data covers their total years of practice.  You should take into
account the effective date of settlement disclosure as well as how
long the doctor has been in practice when considering malpractice
averages.
   The incident causing the malpractice claim may have happened years
before a payment is finally made.  Sometimes, it takes a long time
for a malpractice lawsuit to settle.  Some doctors work primarily
with high-risk patients.  These doctors may have malpractice
settlement histories that are higher than average because they
specialize in cases or patients who are at very high risk for
problems.
   Settlement of a claim may occur for a variety of reasons that do
not necessarily reflect negatively on the professional competence or
conduct of the doctor.  A payment in settlement of a medical
malpractice action or claim should not be construed as creating a
presumption that medical malpractice has occurred.
   You may wish to discuss information in this report and the general
issue of malpractice with your doctor."
   (d) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine shall,
by regulation, develop standard terminology that accurately
describes the different types of disciplinary filings and actions to
take against a licensee as described in paragraphs (1) to (5),
inclusive, of subdivision (a).  In providing the public with
information about a licensee via the Internet pursuant to Section
2027, the Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine shall
not use the terms "enforcement," "discipline," or similar language
implying a sanction unless the physician and surgeon has been the
subject of one of the actions described in paragraphs (1) to (5),
inclusive, of subdivision (a).
   (e) The Medical Board of California shall adopt regulations no
later than July 1, 2003, designating each specialty and subspecialty
practice area as either high risk or low risk.  In promulgating these
regulations, the board shall consult with commercial underwriters of
medical malpractice insurance companies, health care systems that
self-insure physicians and surgeons, and representatives of the
California medical specialty societies.  The board shall utilize the
carriers' statewide data to establish the two risk categories and the
averages required by subparagraph (B) of paragraph (2) of
subdivision (b).  Prior to issuing regulations, the board shall
convene public meetings with the medical malpractice carriers,
self-insurers, and specialty representatives.
   (f) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of Podiatric Medicine shall
provide each licensee with a copy of the text of any proposed public
disclosure authorized by this section prior to release of the
disclosure to the public.  The licensee  shall have 10 working days
from the date the board provides the copy of the proposed public
disclosure to propose corrections of factual inaccuracies.  Nothing
in this section shall prevent the board from disclosing information
to the public prior to the expiration of the 10-day period.
   (g) Pursuant to subparagraph (A) of paragraph (2) of subdivision
(b), the specialty or subspecialty information required by this
section shall group physicians by specialty board recognized pursuant
to paragraph (5) of subdivision (h) of Section 651 unless a
different grouping would be more valid and the board, in its
statement of reasons for its regulations, explains why the validity
of the grouping would be more valid.
803.2.  Every entry of settlement agreement over thirty thousand
dollars ($30,000), or judgment or arbitration award of any amount, of
a claim or action for damages for death or personal injury caused
by, or alleging, the negligence, error, or omission in practice, or
the unauthorized rendering of professional services, by a physician
and surgeon or doctor of podiatric medicine licensed pursuant to
Chapter 5 (commencing with Section 2000) or the Osteopathic
Initiative Act, when that judgment, settlement agreement, or
arbitration award is entered against, or paid by, the employer of
that licensee and not the licensee himself or herself, shall be
reported to the appropriate board by the entity required to report
the information in accordance with Sections 801, 801.1, 802, and 803
as an entry of judgment, settlement, or arbitration award against the
negligent licensee.  This report shall include the name and license
number of the physician and surgeon.
   "Employer" as used in this section means a professional
corporation, a group practice, a health care facility or clinic
licensed or exempt from licensure under the Health and Safety Code, a
licensed health care service plan, a medical care foundation, an
educational institution, a professional institution, a professional
school or college, a general law corporation, a public entity, or a
nonprofit organization that employs, retains, or contracts with a
licensee referred to in this section.  Nothing in this section shall
be construed to authorize the employment of, or contracting with, any
licensee in violation of Section 2400.
803.3.  Any arbitration under a health care service plan contract
for any death or personal injury resulting in an award for an amount
in excess of thirty thousand dollars ($30,000) shall be a judgment
for purposes of subdivision (b) of Section 803.
803.5.  (a) The district attorney, city attorney, or other
prosecuting agency shall notify the Medical Board of California, the
Osteopathic Medical Board of California, the California Board of
Podiatric Medicine, the State Board of Chiropractic Examiners, or
other appropriate allied health board, and the clerk of the court in
which the charges have been filed, of any filings against a licensee
of that board charging a felony immediately upon obtaining
information that the defendant is a licensee of the board. The notice
shall identify the licensee and describe the crimes charged and the
facts alleged. The prosecuting agency shall also notify the clerk of
the court in which the action is pending that the defendant is a
licensee, and the clerk shall record prominently in the file that the
defendant holds a license from one of the boards described above.
   (b) The clerk of the court in which a licensee of one of the
boards is convicted of a crime shall, within 48 hours after the
conviction, transmit a certified copy of the record of conviction to
the applicable board. Where the licensee is regulated by an allied
health board, the record of conviction shall be transmitted to that
allied health board and the Medical Board of California.
803.6.  (a) The clerk of the court shall transmit any felony
preliminary hearing transcript concerning a defendant licensee to the
Medical Board of California, the Osteopathic Medical Board of
California, the California Board of Podiatric Medicine, or other
appropriate allied health board, as applicable, where the total
length of the transcript is under 800 pages and shall notify the
appropriate board of any proceeding where the transcript exceeds that
length.
   (b) In any case where a probation report on a licensee is prepared
for a court pursuant to Section 1203 of the Penal Code, a copy of
that report shall be transmitted by the probation officer to the
board.
804.  (a) Any agency to whom reports are to be sent under Section
801, 801.1, 802, or 803, may develop a prescribed form for the making
of the reports, usage of which it may, but need not, by regulation,
require in all cases.
   (b) A report required to be made by Sections 801, 801.1, or 802
shall be deemed complete only if it includes the following
information:  (1) the name and last known business and residential
addresses of every plaintiff or claimant involved in the matter,
whether or not each plaintiff or claimant recovered anything; (2) the
name and last known business and residential addresses of every
physician or provider of health care services who was claimed or
alleged to have acted improperly, whether or not that person was a
named defendant and whether or not any recovery or judgment was had
against that person; (3) the name, address, and principal place of
business of every insurer providing professional liability insurance
as to any person named in (2), and the insured's policy number; (4)
the name of the court in which the action or any part of the action
was filed along with the date of filing and docket number of each
action; (5) a brief description or summary of the facts upon which
each claim, charge or judgment rested including the date of
occurrence; (6) the names and last known business and residential
addresses of every person who acted as counsel for any party in the
litigation or negotiations, along with an identification of the party
whom said person represented; (7) the date and amount of final
judgment or settlement; and (8) any other information the agency to
whom the reports are to be sent may, by regulation, require.
   (c) Every person named in the report, who is notified by the board
within 60 days of the filing of the report, shall maintain for the
period of three years from the filing of the report any records he or
she has as to the matter in question and shall make those available
upon request to the agency with which the report was filed.
   (d) Every professional liability insurer that makes a report under
Section 801, or self-insured governmental agency that makes a report
pursuant to Section 801.1, and has received a copy of any written
patient medical or hospital records prepared by the treating
physician or the staff of the treating physician or hospital,
describing the medical condition, history, care, or treatment of the
person whose death or injury is the subject of the claim prompting
the Section 801 or 801.1 report, or a copy of any depositions in the
matter that discuss the care, treatment, or medical condition of the
person, shall provide with the report copies of the records and
depositions, subject to reasonable costs to be paid by the Medical
Board of California to the insurer, except when confidentiality is
required by court order.  If confidentiality is required by court
order and, as a result, the insurer is unable to provide the records
and depositions, documentation to that effect shall accompany the
original report.  The applicable board may, upon prior notification
of the parties to the action, petition the appropriate court for
modification of any protective order to permit disclosure to the
board.  A professional liability insurer or self-insured governmental
agency shall maintain the records and depositions referred to in
this subdivision for at least one year from the date of the Section
801 or 801.1 report.
804.5.  The Medical Board of California may request a licensee,
health care facility, self-insured governmental agency, or
professional liability insurer that is required pursuant to Section
804 to comply with a request for medical records of a patient, or a
copy of any depositions in a case that discusses the care, treatment,
or medical condition of a person, to permit representatives of the
board to obtain copies of these records from the custodians of these
records subject to reasonable costs to be paid by the Medical Board
of California.
805.  (a) As used in this section, the following terms have the
following definitions:
   (1) "Peer review body" includes:
   (A) A medical or professional staff of any health care facility or
clinic licensed under Division 2 (commencing with Section 1200) of
the Health and Safety Code or of a facility certified to participate
in the federal Medicare program as an ambulatory surgical center.
   (B) A health care service plan registered under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that contracts with licentiates to
provide services at alternative rates of payment pursuant to Section
10133 of the Insurance Code.
   (C) Any medical, psychological, marriage and family therapy,
social work, dental, or podiatric professional society having as
members at least 25 percent of the eligible licentiates in the area
in which it functions (which must include at least one county), which
is not organized for profit and which has been determined to be
exempt from taxes pursuant to Section 23701 of the Revenue and
Taxation Code.
   (D) A committee organized by any entity consisting of or employing
more than 25 licentiates of the same class that functions for the
purpose of reviewing the quality of professional care provided by
members or employees of that entity.
   (2) "Licentiate" means a physician and surgeon, podiatrist,
clinical psychologist, marriage and family therapist, clinical social
worker, or dentist.  "Licentiate" also includes a person authorized
to practice medicine pursuant to Section 2113.
   (3) "Agency" means the relevant state licensing agency having
regulatory jurisdiction over the licentiates listed in paragraph (2).
   (4) "Staff privileges" means any arrangement under which a
licentiate is allowed to practice in or provide care for patients in
a health facility.  Those arrangements shall include, but are not
limited to, full staff privileges, active staff privileges, limited
staff privileges, auxiliary staff privileges, provisional staff
privileges, temporary staff privileges, courtesy staff privileges,
locum tenens arrangements, and contractual arrangements to provide
professional services, including, but not limited to, arrangements to
provide outpatient services.
   (5) "Denial or termination of staff privileges, membership, or
employment" includes failure or refusal to renew a contract or to
renew, extend, or reestablish any staff privileges, if the action is
based on medical disciplinary cause or reason.
   (6) "Medical disciplinary cause or reason" means that aspect of a
licentiate's competence or professional conduct that is reasonably
likely to be detrimental to patient safety or to the delivery of
patient care.
   (7) "805 report" means the written report required under
subdivision (b).
   (b) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after the effective date of
any of the following that occur as a result of an action of a peer
review body:
   (1) A licentiate's application for staff privileges or membership
is denied or rejected for a medical disciplinary cause or reason.
   (2) A licentiate's membership, staff privileges, or employment is
terminated or revoked for a medical disciplinary cause or reason.
   (3) Restrictions are imposed, or voluntarily accepted, on staff
privileges, membership, or employment for a cumulative total of 30
days or more for any 12-month period, for a medical disciplinary
cause or reason.
   (c) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after any of the following
occur after notice of either an impending investigation or the denial
or rejection of the application for a medical disciplinary cause or
reason:
   (1) Resignation or leave of absence from membership, staff, or
employment.
   (2) The withdrawal or abandonment of a licentiate's application
for staff privileges or membership.
   (3) The request for renewal of those privileges or membership is
withdrawn or abandoned.
   (d) For purposes of filing an 805 report, the signature of at
least one of the individuals indicated in subdivision (b) or (c) on
the completed form shall constitute compliance with the requirement
to file the report.
   (e) An 805 report shall also be filed within 15 days following the
imposition of summary suspension of staff privileges, membership, or
employment, if the summary suspension remains in effect for a period
in excess of 14 days.
   (f) A copy of the 805 report, and a notice advising the licentiate
of his or her right to submit additional statements or other
information pursuant to Section 800, shall be sent by the peer review
body to the licentiate named in the report.
   The information to be reported in an 805 report shall include the
name and license number of the licentiate involved, a description of
the facts and circumstances of the medical disciplinary cause or
reason, and any other relevant information deemed appropriate by the
reporter.
   A supplemental report shall also be made within 30 days following
the date the licentiate is deemed to have satisfied any terms,
conditions, or sanctions imposed as disciplinary action by the
reporting peer review body.  In performing its dissemination
functions required by Section 805.5, the agency shall include a copy
of a supplemental report, if any, whenever it furnishes a copy of the
original 805 report.
   If another peer review body is required to file an 805 report, a
health care service plan is not required to file a separate report
with respect to action attributable to the same medical disciplinary
cause or reason.  If the Medical Board of California or a licensing
agency of another state revokes or suspends, without a stay, the
license of a physician, a peer review body is not required to file an
805 report when it takes an action as a result of the revocation or
suspension.
   (g) The reporting required by this section shall not act as a
waiver of confidentiality of medical records and committee reports.
The information reported or disclosed shall be kept confidential
except as provided in subdivision (c) of Section 800 and Sections
803.1 and 2027, provided that a copy of the report containing the
information required by this section may be disclosed as required by
Section 805.5 with respect to reports received on or after January 1,
1976.
   (h) The Medical Board of California, the Osteopathic Medical Board
of California, and the Dental Board of California shall disclose
reports as required by Section 805.5.
   (i) An 805 report shall be maintained by an agency for
dissemination purposes for a period of three years after receipt.
   (j) No person shall incur any civil or criminal liability as the
result of making any report required by this section.
   (k) A willful failure to file an 805 report by any person who is
designated or otherwise required by law to file an 805 report is
punishable by a fine not to exceed one hundred thousand dollars
($100,000) per violation.  The fine may be imposed in any civil or
administrative action or proceeding brought by or on behalf of any
agency having regulatory jurisdiction over the person regarding whom
the report was or should have been filed.  If the person who is
designated or otherwise required to file an 805 report is a licensed
physician and surgeon, the action or proceeding shall be brought by
the Medical Board of California.  The fine shall be paid to that
agency but not expended until appropriated by the Legislature.  A
violation of this subdivision may constitute unprofessional conduct
by the licentiate.  A person who is alleged to have violated this
subdivision may assert any defense available at law.  As used in this
subdivision, "willful" means a voluntary and intentional violation
of a known legal duty.
   (l) Except as otherwise provided in subdivision (k), any failure
by the administrator of any peer review body, the chief executive
officer or administrator of any health care facility, or any person
who is designated or otherwise required by law to file an 805 report,
shall be punishable by a fine that under no circumstances shall
exceed fifty thousand dollars ($50,000) per violation.  The fine may
be imposed in any civil or administrative action or proceeding
brought by or on behalf of any agency having regulatory jurisdiction
over the person regarding whom the report was or should have been
filed.  If the person who is designated or otherwise required to file
an 805 report is a licensed physician and surgeon, the action or
proceeding shall be brought by the Medical Board of California.  The
fine shall be paid to that agency but not expended until appropriated
by the Legislature.  The amount of the fine imposed, not exceeding
fifty thousand dollars ($50,000) per violation, shall be proportional
to the severity of the failure to report and shall differ based upon
written findings, including whether the failure to file caused harm
to a patient or created a risk to patient safety; whether the
administrator of any peer review body, the chief executive officer or
administrator of any health care facility, or any person who is
designated or otherwise required by law to file an 805 report
exercised due diligence despite the failure to file or whether they
knew or should have known that an 805 report would not be filed; and
whether there has been a prior failure to file an 805 report.  The
amount of the fine imposed may also differ based on whether a health
care facility is a small or rural hospital as defined in Section
124840 of the Health and Safety Code.
   (m) A health care service plan registered under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that negotiates and enters into a
contract with licentiates to provide services at alternative rates of
payment pursuant to Section 10133 of the Insurance Code, when
determining participation with the plan or insurer, shall evaluate,
on a case-by-case basis, licentiates who are the subject of an 805
report, and not automatically exclude or deselect these licentiates.
805.1.  (a) The Medical Board of California, the Osteopathic Medical
Board of California, and the Dental Board of California shall be
entitled to inspect and copy the following documents in the record of
any disciplinary proceeding resulting in action that is required to
be reported pursuant to Section 805:
   (1) Any statement of charges.
   (2) Any document, medical chart, or exhibits in evidence.
   (3) Any opinion, findings, or conclusions.
   (b) The information so disclosed shall be kept confidential and
not subject to discovery, in accordance with Section 800, except that
it may be reviewed, as provided in subdivision (c) of Section 800,
and may be disclosed in any subsequent disciplinary hearing conducted
pursuant to the Administrative Procedure Act (Chapter 5 (commencing
with Section 11500) of Part 1 of Division 3 of Title 2 of the
Government Code).
805.2.  (a) It is the intent of the Legislature to provide for a
comprehensive study of the peer review process as it is conducted by
peer review bodies defined in paragraph (1) of subdivision (a) of
Section 805, in order to evaluate the continuing validity of Section
805 and Sections 809 to 809.8, inclusive, and their relevance to the
conduct of peer review in California.
   (b) The Medical Board of California shall contract with an
independent entity to conduct this study that is fair, objective, and
free from bias that is directly familiar with the peer review
process and does not advocate regularly before the board on peer
review matters or on physician and surgeon disciplinary matters.
   (c) The study by the independent entity shall include, but not be
limited to, the following components:
   (1) A comprehensive description of the various steps of and
decisionmakers in the peer review process as it is conducted by peer
review bodies throughout the state, including the role of other
related committees of acute care health facilities and clinics
involved in the peer review process.
   (2) A survey of peer review cases to determine the incidence of
peer review by peer review bodies, and whether they are complying
with the reporting requirement in Section 805.
   (3) A description and evaluation of the roles and performance of
various state agencies, including the State Department of Health
Services and occupational licensing agencies that regulate healing
arts professionals, in receiving, reviewing, investigating, and
disclosing peer review actions, and in sanctioning peer review bodies
for failure to comply with Section 805.
   (4) An assessment of the cost of peer review to licentiates and
the facilities which employ them.
   (5) An assessment of the time consumed by the average peer review
proceeding, including the hearing provided pursuant to Section 809.2,
and a description of any difficulties encountered by either
licentiates or facilities in assembling peer review bodies or panels
to participate in peer review decisionmaking.
   (6) An assessment of the need to amend Section 805 and Sections
809 to 809.8, inclusive, to ensure that they continue to be relevant
to the actual conduct of peer review as described in paragraph (1),
and to evaluate whether the current reporting requirement is yielding
timely and accurate information to aid licensing boards in their
responsibility to regulate and discipline healing arts practitioners
when necessary, and to assure that peer review bodies function in the
best interest of patient care.
   (7) Recommendations of additional mechanisms to stimulate the
appropriate reporting of peer review actions under Section 805.
   (8) Recommendations regarding the Section 809 hearing process to
improve its overall effectiveness and efficiency.
   (9) An assessment of the role of medical professionals, using
professionals who are experts and are actively practicing medicine in
this state, to review and investigate for the protection of
consumers, allegations of substandard practice or professional
misconduct.
   (10) An assessment of the process to identify and retain a medical
professional with sufficient expertise to review allegations of
substandard practice or professional misconduct by a physician and
surgeon, if the peer review process is discontinued.
   (d) The independent entity shall exercise no authority over the
peer review processes of peer review bodies.  However, peer review
bodies, health care facilities, health care clinics, and health care
service plans shall cooperate with the independent entity and provide
data, information, and case files as requested in the timeframes
specified by the independent entity.
   (e) The independent entity shall work in cooperation with and
under the general oversight of the Executive Director of the Medical
Board of California and shall submit a written report with its
findings and recommendations to the board and the Legislature no
later than July 31, 2007.
   (f) Completion of the peer review study pursuant to this section
shall be among the highest priorities of the Medical Board of
California, and the board shall ensure that it is completed no later
than July 31, 2007.
805.5.  (a) Prior to granting or renewing staff privileges for any
physician and surgeon, psychologist, podiatrist, or dentist, any
health facility licensed pursuant to Division 2 (commencing with
Section 1200) of the Health and Safety Code, or any health care
service plan or medical care foundation, or the medical staff of the
institution shall request a report from the Medical Board of
California, the Board of Psychology, the Osteopathic Medical Board of
California, or the Dental Board of California to determine if any
report has been made pursuant to Section 805 indicating that the
applying physician and surgeon, psychologist, podiatrist, or dentist
has been denied staff privileges, been removed from a medical staff,
or had his or her staff privileges restricted as provided in Section
805.  The request shall include the name and California license
number of the physician and surgeon, psychologist, podiatrist, or
dentist.  Furnishing of a copy of the 805 report shall not cause the
805 report to be a public record.
   (b) Upon a request made by, or on behalf of, an institution
described in subdivision (a) or its medical staff, which is received
on or after January 1, 1980, the board shall furnish a copy of any
report made pursuant to Section 805.  However, the board shall not
send a copy of a report (1) if the denial, removal, or restriction
was imposed solely because of the failure to complete medical
records, (2) if the board has found the information reported is
without merit, or (3) if a period of three years has elapsed since
the report was submitted.  This three-year period shall be tolled
during any period the licentiate has obtained a judicial order
precluding disclosure of the report, unless the board is finally and
permanently precluded by judicial order from disclosing the report.
In the event a request is received by the board while the board is
subject to a judicial order limiting or precluding disclosure, the
board shall provide a disclosure to any qualified requesting party as
soon as practicable after the judicial order is no longer in force.
   In the event that the board fails to advise the institution within
30 working days following its request for a report required by this
section, the institution may grant or renew staff privileges for the
physician and surgeon, psychologist, podiatrist, or dentist.
   (c) Any institution described in subdivision (a) or its medical
staff that violates subdivision (a) is guilty of a misdemeanor and
shall be punished by a fine of not less than two hundred dollars
($200) nor more than one thousand two hundred dollars ($1,200).
805.6.  (a) The Medical Board of California, the Osteopathic Medical
Board, and the Dental Board of California shall establish a system
of electronic notification that is either initiated by the board or
can be accessed by qualified subscribers, and that is designed to
achieve early notification to qualified recipients of the existence
of new reports that are filed pursuant to Section 805.
   (b) The State Department of Health Services shall notify the
appropriate licensing agency of any reporting violations pursuant to
Section 805.
   (c) The Department of Managed Health Care shall notify the
appropriate licensing agency of any reporting violations pursuant to
Section 805.
805.7.  (a) The Medical Board of California shall work with
interested parties in the pursuit and establishment of a pilot
program, similar to those proposed by the Citizens Advocacy Center,
of early detection of potential quality problems and resolutions
through informal educational interventions.
   (b) The Medical Board of California shall report to the
Legislature its evaluation and findings and shall include
recommendations regarding the statewide implementation of this pilot
program before April 1, 2004.
806.  Each agency in the department receiving reports pursuant to
the preceding sections shall prepare a statistical report based upon
these records for presentation to the Legislature not later than 30
days after the commencement of each regular session of the
Legislature, including by the type of peer review body, and, where
applicable, type of health care facility, the number of reports
received and a summary of administrative and disciplinary action
taken with respect to these reports and any recommendations for
corrective legislation if the agency considers legislation to be
necessary.
807.  Each agency in the department shall notify every person
licensed, certified or holding similar authority issued by it, and
the department shall notify every insurance company doing business in
this state and every institution mentioned in Section 805 of the
provisions of this article.
808.  For purposes of this article, reports affecting respiratory
care practitioners required to be filed under Sections 801, 802, and
803 shall be filed with the Respiratory Care Board of California.
808.5.  For purposes of this article, reports affecting
psychologists required to be filed under Sections 801, 801.1, 802,
803, 803.5, and 803.6 shall be filed with the Board of Psychology of
the Department of Consumer Affairs.
809.  (a) The Legislature hereby finds and declares the following:
   (1) In 1986, Congress enacted the Health Care Quality Improvement
Act of 1986 (Chapter 117 (commencing with Section 11101) Title 42,
United States Code), to encourage physicians to engage in effective
professional peer review, but giving each state the opporunity to
"opt-out" of some of the provisions of the federal act.
   (2) Because of deficiencies in the federal act and the possible
adverse interpretations by the courts of the federal act, it is
preferable for California to "opt-out" of the federal act and design
its own peer review system.
   (3) Peer review, fairly conducted, is essential to preserving the
highest standards of medical practice.
   (4) Peer review which is not conducted fairly results in harm both
to patients and healing arts practitioners by limiting access to
care.
   (5) Peer review, fairly conducted, will aid the appropriate state
licensing boards in their responsibility to regulate and discipline
errant healing arts practitioners.
   (6) To protect the health and welfare of the people of California,
it is the policy of the State of California to exclude, through the
peer review mechanism as provided for by California law, those
healing arts practitioners who provide substandard care or who engage
in professional misconduct, regardless of the effect of that
exclusion on competition.
   (7) It is the intent of the Legislature that peer review of
professional health care services be done efficiently, on an ongoing
basis, with an emphasis on early detection of potential quality
problems and resolutions through informal educational interventions.
   (8) Sections 809 to 809.8, inclusive, shall not affect the
respective responsibilities of the organized medical staff or the
governing body of an acute care hospital with respect to peer review
in the acute care hospital setting.  It is the intent of the
Legislature that written provisions implementing Sections 809 to
809.8, inclusive, in the acute care hospital setting shall be
included in medical staff bylaws which shall be adopted by a vote of
the members of the organized medical staff and which shall be subject
to governing body approval, which approval shall not be withheld
unreasonably.
   (9) (A) The Legislature thus finds and declares that the laws of
this state pertaining to the peer review of healing arts
practitioners shall apply in lieu of Chapter 117 (commencing with
Section 11101) of Title 42 of the United States Code, because the
laws of this state provide a more careful articulation of the
protections for both those undertaking peer review activity and those
subject to review, and better integrates public and private systems
of peer review.  Therefore, California exercises its right to opt out
of specified provisions of the Health Care Quality Improvement Act
relating to professional review actions, pursuant to subparagraph (B)
of paragraph (2) of subdivision (c) of Section 11111 of Chapter 117
of Title 42 of the United States Code.  This election shall not
affect the availability of any immunity under California law.
   (B) The Legislature further declares that it is not the intent or
purposes of Sections 809 to 809.8, inclusive, to opt out of any
mandatory national data bank established pursuant to Subchapter II
(commencing with Section 11131) of Chapter 117 of Title 42 of the
United States Code.
   (b) For the purpose of this section and Sections 809.1 to 809.8,
inclusive, "healing arts practitioner" or "licentiate" means a
physician and surgeon, podiatrist, clinical psychologist, or dentist;
  and "peer review body" means a peer review body as specified in
paragraph (1) of subdivision (a) of Section 805, and includes any
designee of the peer review body.
809.05.  It is the policy of this state that peer review be
performed by licentiates.  This policy is subject to the following
limitations:
   (a) The governing bodies of acute care hospitals have a legitimate
function in the peer review process.  In all peer review matters,
the governing body shall give great weight to the actions of peer
review bodies and, in no event, shall act in an arbitrary or
capricious manner.
   (b) In those instances in which the peer review body's failure to
investigate, or initiate disciplinary action, is contrary to the
weight of the evidence, the governing body shall have the authority
to direct the peer review body to initiate an investigation or a
disciplinary action, but only after consultation with the peer review
body.  No such action shall be taken in an unreasonable manner.
   (c) In the event the peer review body fails to take action in
response to a direction from the governing body, the governing body
shall have the authority to take action against a licentiate.  Such
action shall only be taken after written notice to the peer review
body and shall fully comply with the procedures and rules applicable
to peer review proceedings established by Sections 809.1 to 809.6,
inclusive.
   (d) A governing body and the medical staff shall act exclusively
in the interest of maintaining and enhancing quality patient care.
   (e) It is not the intent or purpose of this section to prohibit or
discourage public members on state licensing boards and medical
quality review committees from participating in disciplinary actions
as authorized by law.
809.1.  (a) A licentiate who is the subject of a final proposed
action of a peer review body for which a report is required to be
filed under Section 805 shall be entitled to written notice as set
forth in subdivisions (b) and (c).  For the purposes of this section,
the "final proposed action" shall be the final decision or
recommendation of the peer review body after informal investigatory
activity or prehearing meetings, if any.
   (b) The peer review body shall give the licentiate written notice
of the final proposed action.  This notice shall include all the
following information:
   (1) That an action against the licentiate has been proposed by the
peer review body which, if adopted, shall be taken and reported
pursuant to Section 805.
   (2) The final proposed action.
   (3) That the licentiate has the right to request a hearing on the
final proposed action.
   (4) The time limit, within which to request such a hearing.
   (c) If a hearing is requested on a timely basis, the peer review
body shall give the licentiate a written notice stating all of the
following:
   (1) The reasons for the final proposed action taken or
recommended, including the acts or omissions with which the
licentiate is charged.
   (2) The place, time, and date of the hearing.
809.2.  If a licentiate timely requests a hearing concerning a final
proposed action for which a report is required to be filed under
Section 805, the following shall apply:
   (a) The hearing shall be held, as determined by the peer review
body, before a trier of fact, which shall be an arbitrator or
arbitrators selected by a process mutually acceptable to the
licentiate and the peer review body, or before a panel of unbiased
individuals who shall gain no direct financial benefit from the
outcome, who have not acted as an accuser, investigator, factfinder,
or initial decisionmaker in the same matter, and which shall include,
where feasible, an individual practicing the same specialty as the
licentiate.
   (b) If a hearing officer is selected to preside at a hearing held
before a panel, the hearing officer shall gain no direct financial
benefit from the outcome, shall not act as a prosecuting officer or
advocate, and shall not be entitled to vote.
   (c) The licentiate shall have the right to a reasonable
opportunity to voir dire the panel members and any hearing officer,
and the right to challenge the impartiality of any member or hearing
officer.  Challenges to the impartiality of any member or hearing
officer shall be ruled on by the presiding officer, who shall be the
hearing officer if one has been selected.
   (d) The licentiate shall have the right to inspect and copy at the
licentiate's expense any documentary information relevant to the
charges which the peer review body has in its possession or under its
control, as soon as practicable after the receipt of the licentiate'
s request for a hearing.  The peer review body shall have the right
to inspect and copy at the peer review body's expense any documentary
information relevant to the charges which the licentiate has in his
or her possession or control as soon as practicable after receipt of
the peer review body's request.  The failure by either party to
provide access to this information at least 30 days before the
hearing shall constitute good cause for a continuance.  The right to
inspect and copy by either party does not extend to confidential
information referring solely to individually identifiable
licentiates, other than the licentiate under review.  The arbitrator
or presiding officer shall consider and rule upon any request for
access to information, and may impose any safeguards the protection
of the peer review process and justice requires.
   (e) When ruling upon requests for access to information and
determining the relevancy thereof, the arbitrator or presiding
officer shall, among other factors, consider the following:
   (1) Whether the information sought may be introduced to support or
defend the charges.
   (2) The exculpatory or inculpatory nature of the information
sought, if any.
   (3) The burden imposed on the party in possession of the
information sought, if access is granted.
   (4) Any previous requests for access to information submitted or
resisted by the parties to the same proceeding.
   (f) At the request of either side, the parties shall exchange
lists of witnesses expected to testify and copies of all documents
expected to be introduced at the hearing.  Failure to disclose the
identity of a witness or produce copies of all documents expected to
be produced at least 10 days before the commencement  of the hearing
shall constitute good cause for a continuance.
   (g) Continuances shall be granted upon agreement of the parties or
by the arbitrator or presiding officer on a showing of good cause.
   (h) A hearing under this section shall be commenced within 60 days
after receipt of the request for hearing, and the peer review
process shall be completed within a reasonable time, after a
licentiate receives notice of a final proposed action or an immediate
suspension or restriction of clinical privileges, unless the
arbitrator or presiding officer issues a written decision finding
that the licentiate failed to comply with subdivisions (d) and (e) in
a timely manner, or consented to the delay.
809.3.  (a) During a hearing concerning a final proposed action for
which reporting is required to be filed under Section 805, both
parties shall have all of the following rights:
   (1) To be provided with all of the information made available to
the trier of fact.
   (2) To have a record made of the proceedings, copies of which may
be obtained  by the licentiate upon payment of any reasonable charges
associated with the preparation thereof.
   (3) To call, examine, and cross-examine witnesses.
   (4) To present and rebut evidence determined by the arbitrator or
presiding officer to be relevant.
   (5) To submit a written statement at the close of the hearing.
   (b) The burden of presenting evidence and proof during the hearing
shall be as follows:
   (1) The peer review body shall have the initial duty to present
evidence which supports the charge or recommended action.
   (2) Initial applicants shall bear the burden of persuading the
trier of fact by a preponderance of the evidence of their
qualifications by producing information which allows for adequate
evaluation and resolution of reasonable doubts concerning their
current qualifications for staff privileges, membership, or
employment.  Initial applicants shall not be permitted to introduce
information not produced upon request of the peer review body during
the application process, unless the initial applicant establishes
that the information could not have been produced previously in the
exercise of reasonable diligence.
   (3) Except as provided above for initial applicants, the peer
review body shall bear the burden of persuading the trier of fact by
a preponderance of the evidence that the action or recommendation is
reasonable and warranted.
   (c) The peer review body shall adopt written provisions governing
whether a licentiate shall have the option of being represented by an
attorney at the licentiate's  expense.  No peer review body shall be
represented by an attorney if the licentiate is not so represented,
except dental professional society peer review bodies may be
represented by an attorney provided that the peer review body grants
each licentiate the option of being represented by an attorney at the
licentiate's expense, even if the licentiate declines to be
represented by an attorney.
809.4.  (a) Upon the completion of a hearing concerning a final
proposed action for which a report is required to be filed under
Section 805, the licentiate and the peer review body involved have
the right to receive all of the following:
   (1) A written decision of the trier of fact, including findings of
fact and a conclusion articulating the connection between the
evidence produced at the hearing and the decision reached.
   (2) A written explanation of the procedure for appealing the
decision, if any appellate mechanism exists.
   (b) If an appellate mechanism is provided, it need not provide for
de novo review, but it shall include the following mimimum rights
for both parties:
   (1) The right to appear and respond.
   (2) The right to be represented by an attorney or any other
representative designated by the party.
   (3) The right to receive the written decision of the appellate
body.
809.5.  (a) Notwithstanding Sections 809 to 809.4, inclusive, a peer
review body may immediately suspend or restrict clinical privileges
of a licentiate where the failure to take that action may result in
an imminent danger to the health of any individual, provided that the
licentiate is subsequently provided with the notice and hearing
rights set forth in Sections 809.1 to 809.4, inclusive, or, with
respect to organizations specified in Section 809.7, with the rights
specified in that section.
   (b) When no person authorized by the peer review body is available
to summarily suspend or restrict clinical privileges under
circumstances specified in subdivision (a), the governing body of an
acute care hospital, or its designee, may immediately suspend a
licentiate's clinical privileges if a failure to summarily suspend
those privileges is likely to result in an imminent danger to the
health of any individual, provided the governing body of the acute
care hospital has, before the suspension, made reasonable attempts to
contact the peer review body.  A suspension by the governing body of
an acute care hospital which has not been ratified by the peer
review body within two working days, excluding weekends and holidays,
after the suspension shall terminate automatically.
809.6.  (a) The parties are bound by any additional notice and
hearing provisions contained in any applicable professional society
or medical staff bylaws which are not inconsistent with Sections
809.1 to 809.4, inclusive.
   (b) The parties are bound by any additional notice and hearing
provisions contained in any applicable agreement or contract between
the licentiate and peer review body or health care entity which are
not inconsistent with Sections 809.1 to 809.4, inclusive.
   (c) The provisions of Sections 809.1 to 809.4, inclusive, may not
be waived in any instrument specified in subdivision (a) or (b) for a
final proposed action for which a report is required to be filed
under Section 805.
809.7.  Sections 809.1 to 809.4, inclusive, shall not apply to peer
review proceedings conducted in state or county  hospitals, in
hospitals owned by, operated by, or licensed to the Regents of the
University of California or any of its subsidiary corporations which
serve as a primary teaching facility, or in health facilities which
serve as the primary teaching facility for medical schools approved
pursuant to Section 2084.  In addition, Sections 809.1 to 809.4,
inclusive, shall not apply to licentiates engaged in postgraduate
medical education under the auspices of a medical school approved
pursuant to Section 2084. This section shall not affect the
obligation to afford due process of law to licentiates involved in
peer review proceedings in these hospitals.
809.8.  Nothing in Sections 809 to 809.7, inclusive, shall affect
the availability of judicial review under Section 1094.5 of the Code
of Civil Procedure nor  the provisions relating to discovery and
testimony in Section 1157 of the Evidence Code or Sections 1370 and
1370.1 of the Health and Safety Code.
809.9.  In any suit brought to challenge an action taken or a
restriction imposed which is required to be reported pursuant to
Section 805, the court shall, at the conclusion of the action, award
to a substantially prevailing party the cost of the suit, including a
reasonable attorney's fee, if the other party's conduct in bringing,
defending, or litigating the suit was frivolous, unreasonable,
without foundation, or in bad faith.  For the purposes of this
section, a defendant shall not be considered to have substantially
prevailed when the plaintiff obtains an award for damages or
permanent injunctive or declaratory relief.  For the purpose of this
section, a plaintiff shall not be considered to have substantially
prevailed when the plaintiff does not obtain an award of damages or
permanent injunctive or declaratory relief.