Yesterday SB 1215 ( Hernandez) that would have eliminated the in office exemption under the California Self referral law for advanced imaging and radiation oncology failed passage in the Senate Business and Professions Committee on a vote of 1 to 3 with 5 members of the Committee not voting. The number of members failing to cast a vote is relevant to the complexity of the issue and the intensity of the lobbying against the bill with claims that the change would interrupt continuity of care and delay timely care or diagnosis. The studies are overwhelming to show aberrant utilization but opponents claims that these are individual "bad actors" that can be dealt with through prior authorization and utilization review.

There is nothing easy about the issue and the opposition from other members of the medical community is always substantial. Since the bill was amended after being introduced and it is the second year of the two year session there is no real time to work on the specifics of the bill and have the Committee hear the bill again. The Committee members were clearly concerned with unintended consequences but saw the need for meaningful attempts to control health care costs.