The Weekly Articles

Free to register for CSHA members!  Join our esteemed panelists for a conversation about the legal landscape surrounding gender-affirming care in California. Topics will include the legal arguments, strategies, and implications of the anticipated U.S. Supreme Court decision in U.S. v. Skrmetti; the current federal administration’s policies on gender-affirming care; California’s response to ongoing national attacks on gender-affirming care access; and the on-the-ground realities for recipients and providers of gender-affirming care in California. 

Panelists:

Jessica Clarke (she/her) is the Robert C. and Nanette T. Packard Professor of Law at USC Gould School of Law.  She writes on antidiscrimination law, with a focus on sex, gender, and sexuality.  Her work has appeared in law journals including the California Law Review, Columbia Law Review, Duke Law Journal, Harvard Law Review, New York University Law Review, Northwestern University Law Review, and Yale Law Journal, as well as other outlets including the New England Journal of Medicine, Los Angeles Times and Harvard Business Review. She has twice received the Dukeminier Award for the best legal scholarship on sexual orientation and gender identity.

Pelecanos (they/them) is the Daniel H. Renberg Fellow at Lambda Legal, the nation’s oldest and largest legal organization working for full recognition of the civil rights of LGBTQ+ people and everyone living with HIV. Pelecanos’ work encompasses litigation, education, and policy advocacy. Their current litigation centers on racial and gender equity, access to gender-affirming care for minors, facilities access for transgender people, and appropriate housing in carceral settings. Presently, they serve on several boards, including the National Trans Bar Association. Pelecanos continues to build strong community relationships, both in California and nationally, to further the goal of liberation for all.

Riley Robertson (they/them) (moderator) is a Health Care & Life Sciences attorney at Jones Day and a member of the CSHA Diversity Task Force.

CSHA is pleased to provide information on the following recent actions by the Trump administration that potentially impact health care in California.  Given how rapidly events are changing at the federal level, readers are cautioned to double check the current status of any article in this feature.

If you have not responded to the survey yet, please do so!  We will keep this open a few more weeks to try and get as many responses as possible.  CSHA is committed to creating a culture that recognizes the value of individuals with diverse backgrounds, talents, experiences, and perspectives at all levels of the organization. For the first time, CSHA is conducting a voluntary and anonymous member demographic survey to understand the composition of CSHA membership and leadership. CSHA will aggregate the data and share a compilation of overall percentage by category with the entire CSHA membership (e.g., years in practice, practice area, sexuality, gender, race/ethnicity/ancestry, disability, and veteran status).  CSHA leadership will review the data to understand the diversity within the organization and measure progress on creating an inclusive environment for all members.  CSHA will not receive any identifying information along with the survey responses and therefore will not be able to tie any particular response to a specific member.  Participation is purely voluntary, but sharing this information will provide important and meaningful data regarding the diversity of CSHA’s membership. Members can indicate that they prefer not to answer any or all of the questions.  Members can also simply ignore the survey.

 To complete the survey, click here. Please only complete the survey once.

The data collected through this survey will be stored securely using Google Forms, which is part of Google Workspace. Google Workspace leverages Google Cloud Platform (GCP) infrastructure, ensuring high levels of data protection and privacy.  Key security features include:

• Encryption: All data is encrypted both in transit and at rest, providing a robust layer of security against unauthorized access.
• Regular Security Audits: Google conducts regular security audits and adheres to stringent compliance standards.
• Redundancy and Reliability: Data is stored across multiple secure data centers, ensuring redundancy and reliability.

For more information about Google’s privacy policy, click here.  CSHA is committed to safeguarding your information and ensuring that your data is handled with the utmost care and confidentiality.  CSHA will never sell or share member information to any third-party. 

Starting July 1, 2025, certain health insurance policies must provide coverage for the diagnosis and treatment of infertility and fertility services. Large group plans (cover 101 or more employees) must provide infertility treatment coverage. Small group plans (cover up to 100 employees) must offer infertility treatment coverage. Before the passage of the new law last year, California law required insurers to offer employers the option to add general infertility treatment, not including in vitro fertilization (IVF), to their policies.

With the passage of SB 729, California law now requires broader coverage of infertility treatment. Large group plans are required to cover IVF, including a maximum of three completed oocyte retrievals with unlimited embryo transfers in accordance with American Society of Reproductive Medicine Guidelines.  In the case of both large and small group plans, the policy may not include: (i) any exclusion, limitation, or other restriction on coverage of fertility medications that are different than those imposed on other prescription medications; (ii) any deductible, copayment, or other limitation on coverage for the treatment of infertility, that are different from those imposed on benefits related to services not related to infertility.

The new law does not apply to Medi-Cal managed care plans, religious employers that meet certain criteria, and certain other policies. In addition, the implementation of SB 729 is delayed until July 1, 2027 for plans for the Public Employees’ Retirement System.

If you have not responded to the survey yet, please do so!  We will keep this open a few more weeks to try and get as many responses as possible.  CSHA is committed to creating a culture that recognizes the value of individuals with diverse backgrounds, talents, experiences, and perspectives at all levels of the organization. For the first time, CSHA is conducting a voluntary and anonymous member demographic survey to understand the composition of CSHA membership and leadership. CSHA will aggregate the data and share a compilation of overall percentage by category with the entire CSHA membership (e.g., years in practice, practice area, sexuality, gender, race/ethnicity/ancestry, disability, and veteran status).  CSHA leadership will review the data to understand the diversity within the organization and measure progress on creating an inclusive environment for all members.  CSHA will not receive any identifying information along with the survey responses and therefore will not be able to tie any particular response to a specific member.  Participation is purely voluntary, but sharing this information will provide important and meaningful data regarding the diversity of CSHA’s membership. Members can indicate that they prefer not to answer any or all of the questions.  Members can also simply ignore the survey. 

To complete the survey, click here. Please only complete the survey once.

The data collected through this survey will be stored securely using Google Forms, which is part of Google Workspace. Google Workspace leverages Google Cloud Platform (GCP) infrastructure, ensuring high levels of data protection and privacy.  Key security features include:

• Encryption: All data is encrypted both in transit and at rest, providing a robust layer of security against unauthorized access.
• Regular Security Audits: Google conducts regular security audits and adheres to stringent compliance standards.
• Redundancy and Reliability: Data is stored across multiple secure data centers, ensuring redundancy and reliability.

For more information about Google’s privacy policy, click here.  CSHA is committed to safeguarding your information and ensuring that your data is handled with the utmost care and confidentiality.  CSHA will never sell or share member information to any third-party. 

CSHA is pleased to provide information on the following recent actions by the Trump administration that potentially impact health care in California.  Given how rapidly events are changing at the federal level, readers are cautioned to double check the current status of any article in this feature.

Last month, Eli Lilly & Co. filed lawsuits in the U.S. District Court for the Northern District of California against two telehealth companies, Mochi Health and Fella Health, alleging violations of the state’s prohibition against the corporate practice of medicine. The lawsuits are part of a broader legal strategy to curb the unauthorized sale of compounded versions of Lilly’s FDA-approved weight loss drug, Zepbound. However, they focus primarily on claims that both companies unlawfully interfere in medical decision-making.

Lilly claims that Mochi Health’s CEO, a non-physician, exerts control over an affiliated medical group and has altered patient prescriptions in bulk. These changes were allegedly made without medical justification to sustain sales following FDA warnings and supply limitations.

Fella Health is similarly accused of allowing its non-physician CEO and staff to provide medical advice and modify prescriptions without appropriate physician oversight. The lawsuit also cites Fella’s promotion of an unapproved oral form of tirzepatide, which it allegedly markets as superior to Lilly’s FDA-approved injectable version.

These lawsuits highlight the growing legal scrutiny of telehealth companies that operate under "friendly PC" or MSO-PC structures. If successful, the cases could establish a significant precedent for how aggressively California’s CPOM laws are interpreted and enforced in the digital health space.

CSHA is pleased to provide information on the following recent actions by the Trump administration that potentially impact health care in California.  Given how rapidly events are changing at the federal level, readers are cautioned to double check the current status of any article in this feature.

As always, California is at the forefront of inventing new requirements for enforcing compliance with pharmacy laws. This time, the new requirement pertains to Pharmacists-In-Charge (PICs).

Effective April 1, 2025, all proposed PICs are required to complete a training course available on the California State Board of Pharmacy's website, within two years prior to the date of application to serve as a PIC.

The amended California Code of Regulations (CCR), Title 16, section 1709.1 now requires all proposed PICs to submit an attestation statement that include the following:

• The name of the proposed PIC
• The proposed PIC's license number
• A statement that the PIC has read Sections 4036.5, 4081, 4113, and 4330 of the Business and Professions Code and CCR 1709.1 (please review these sections if you are currently serving as a PIC, as they have recently been amended)
• A statement identifying the date that the proposed PIC took the Board's training course
• A declaration signed under penalty of perjury that the statement contains true information.

The training course could be accessed on the BOPI’s website and is free of charge. It provides an overview of pharmacy law related to the position and the responsibility of a PIC. The course also discusses tips on how to prepare a pharmacy for an inspection by a California State Board of Pharmacy Inspector and provide resources for the PIC to aid in their supervision and management of a pharmacy. One hour of CE will be awarded for completing this training, but does not count towards the required 2 hours of CE for Law and Ethics.

Taking this course is recommended for all PICs (even if not required). Many PICs are still confused about their responsibilities and oversight of the pharmacy. The course is beneficial to all PlCs, pharmacy owners, and pharmacists as it covers such important requirements as:

1. Legal requirements of the role of a PIC;
2. Legal prohibitions for a pharmacy owner to subvert the PIC;
3. Legal requirements/Overview of the self-assessment process;
4. How to prepare for an inspection;
5. Top violations that result in a Cite and Fine.

If you are a pharmacist who considers becoming a PIC, a pharmacy owner, or a PIC, this course is a must and not because it is now required but also because it provides a condensed version of major legal requirements that pertain to pharmacy operations.

Assembly Bill 1312, introduced by Assemblymember Pilar Schiavo on February 21, 2025, would require hospitals to prescreen patients who meet certain criteria for presumptive eligibility to participate in the hospital’s charity care and discount payment program. Under the proposed legislation, hospitals would be authorized to use third-party software tools or contract with external services to facilitate prescreening, subject to certain conditions.

AB 1312, if enacted, would represent one more change in a series of changes to California’s hospital charity care requirements over the last few years. Assembly Bill 1020, enacted in 2021, transferred enforcement authority to the Department of Health Care Access and Information (HCAI) and introduced stricter regulations on hospital pricing and financial assistance. In January 2024, new regulations required hospitals to improve signage, patient handouts, and online information about charity care.