Bill protecting physician autonomy stalls after tied committee vote

Senate Bill 450, a measure aimed at limiting the degree to which health care entities can direct or interfere with clinicians' professional judgment, did not advance from the Senate Health and Public Affairs Committee after a tie vote.

Sponsor Senator Samuel Lopez said the measure seeks to protect physicians' clinical autonomy where corporate ownership or cost-cutting practices were perceived to have interfered with medical judgment. "The point of this bill is to empower doctors," the sponsor told the committee, saying physicians reported situations in which corporate policies limited referrals or imposed clinical practices that they viewed as interfering with patient care.

The committee substitute removed certain prescriptive language after discussions with clinicians and added a carve-out for actions "required by licensing and accreditation" so hospitals could comply with accreditation standards. The substitute also changed an ownership definition from "entirely" to "majority" to address stakeholder feedback.

The bill includes two enforcement mechanisms: a private right of action allowing clinicians to sue to stop policies that interfere with professional judgment, and discretionary authority for the attorney general to bring suits where there is evidence of a pattern or practice affecting the public interest. Supporters said the attorney general would act only when there is evidence of a broader pattern; sponsor testimony included a hypothetical example of a hospital policy that limited out-of-area referrals and could be blocked by injunctive relief.

Opponents and some committee members raised concerns about vague standards, broad enforcement authority, the potential for increased litigation and the practical effect on hospital operations. Sponsor and witnesses said some physicians declined to testify publicly out of concern about employer retaliation, and supporters argued the bill addresses physician burnout and provider departures caused by corporate constraints.

The committee vote was tied 5 to 5; under committee rules the tied vote meant the measure did not advance out of committee. The sponsor said he will continue work to seek compromise language.