Emergency services and care.

Assembly Member Bauer-Kahan's emergency services legislation proposes substantial increases to civil penalties for California hospitals and physicians that violate state requirements for emergency care provision. The bill would raise maximum fines from $1,000 to $1 million per day for hospitals failing to maintain required non-discrimination policies and transfer protocols.

The measure eliminates the current $30,000 cumulative cap on hospital penalties and increases maximum civil penalties to $1 million per violation for hospitals and physicians found responsible for emergency care violations. Healthcare facilities and medical personnel face these enhanced penalties for discriminating in emergency services based on characteristics like ethnicity, citizenship, insurance status, or economic status, except when medically justified.

Under the legislation, hospitals must document all patient transfers and submit annual reports detailing transfer patterns by insurance status. The state health department would publish county-level statistical summaries on emergency patient transfers and violations. The bill preserves existing protections against retaliation toward physicians who report violations or refuse transfers they deem medically hazardous, while increasing the civil penalty for such retaliation to $1 million per incident.

Local district attorneys and the state Attorney General gain authority to pursue civil actions against entities violating emergency care injunctions, with courts required to award prevailing plaintiffs up to $1 million per violation plus attorney fees. The Department of Managed Health Care retains sole enforcement authority over violations by hospitals owned by health plans in their treatment of plan members.