AB 2386

AB2386:v96#DOCUMENT

Bill Start

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

Assembly Bill

No. 2386

An act to add Section 2126.1 to, and to add Article 6.2 (commencing with Section 2128) to Chapter 5 of Division 2 of, the Business and Professions Code, relating to healing arts.

LEGISLATIVE COUNSEL'S DIGEST

AB 2386, as amended, Alvarez. License to practice medicine: Licensed Physicians from Mexico Program and California Physician Expansion Act.

Existing law, the Medical Practice Act, establishes the Medical Board of California to license and regulate the practice of medicine. Former law, repealed as of January 1, 2025, established the Licensed Physicians and Dentists from Mexico Pilot Program, which allowed up to 30 licensed physicians and up to 30 licensed dentists from Mexico to practice medicine or dentistry in California for a period not to exceed 3 years, in accordance with certain requirements. Existing law, operative January 1, 2025, instead, establishes within the act the Licensed Physicians from Mexico Program, which authorizes the board to issue a limited number of nonrenewable 3-year physician’s and surgeon’s licenses to licensed physicians from Mexico who meet specified criteria.

This bill would require the board to issue a full and unrestricted physician’s and surgeon’s license to a person who has completed the 2 3-year term terms of the Licensed Physicians from Mexico Program or the former Licensed Physicians and Dentists from Mexico Pilot Program in good standing upon satisfaction of specified requirements, including having an offer of continued employment from a health care facility or practice in California.

This bill would establish the California Physician Expansion Act, which would require the board to issue a provisional license to an applicant who holds a full and unrestricted license to practice medicine in another country who meets specified requirements, including that the applicant has not committed any acts or crimes constituting grounds for denial of a certificate, as specified. In this regard, the bill would require the board to submit to the Department of Justice fingerprint images and related information required by the department of all applicants for a provisional license to determine whether the applicant has a criminal conviction record, as specified, and would require the department to provide a state- and federal-level response pursuant to specified provisions for the board to determine whether the applicant is subject to denial of licensure, as specified.

The bill would make the provisional license valid for 3 years and would authorize the board to grant a one-time extension renewal for an additional period of up to 3 years, as specified. The bill would require a provisional licensee to, among other things, be employed by, and practice medicine only within, a sponsoring entity that is approved by the board, entity, as specified. The bill would authorize the board to revoke a provisional license or take any other disciplinary action deemed appropriate by the board, as specified. The bill would deem a provisional licensee applicant who meets specified requirements, including having completed at least 36 months of practice under the provisional license without any disciplinary actions, to meet the professional instruction, preliminary education, and postgraduate training requirements for a certificate under the Medical Practice Act. The bill would require the board to establish application, initial licensure, renewal, and conversion fees for the provisional license, as specified. The bill would make findings and declarations relating to its provisions.

Digest Key

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

(a) The Legislature finds and declares all of the following:

(1) California faces a severe and growing shortage of physicians, particularly in primary care specialties and in federally designated health professional shortage areas and medically underserved areas.

(2) The state’s diverse population, including large Spanish-speaking communities, requires culturally and linguistically competent physicians to ensure health equity and positive outcomes.

(3) The Licensed Physicians and Dentist from Mexico Pilot Program, which was originally enacted by Assembly Bill 1045 of the 2001–02 Regular Session, and recasted as the Licensed Physicians from Mexico Program by Assembly Bill 2860 of the 2023–24 Regular Session, has demonstrated success in placing qualified Mexican physicians in underserved settings but currently offers no pathway for these physicians to continue serving California communities beyond the three-year nonrenewable term.

(4) California has untapped resources of medical talent, including recent medical school graduates who have been unable to secure residency positions and experienced internationally trained physicians who seek to practice in areas of need.

(5) It is in the public interest to create additional supervised pathways to practice medicine that maintain rigorous standards for patient safety while expanding access to care in communities throughout the state.

(b) Therefore, it is the intent of the Legislature to expand access to care while maintaining appropriate standards for patient safety and professional accountability.

SEC. 2.

Section 2126.1 is added to the Business and Professions Code, to read:

2126.1.

(a) A physician from Mexico who has completed the two three-year nonrenewable license terms of a licensing program under this article or under the Licensed Physicians and Dentists from Mexico Pilot Program, as established in former Section 853, may apply for a full and unrestricted physician’s and surgeon’s license if the physician meets all of the following requirements:

(1) Has completed the two three-year term of the nonrenewable license program terms in good standing.

(2)Has obtained Educational Commission for Foreign Medical Graduates certification.

(3)Has passed Steps 1, 2, and 3 of the United States Medical Licensing Examination.

(4)

(2) Has provided evidence satisfactory to the board establishing that the physician has received positive evaluations in the peer reviews described in paragraph (5) of subdivision (e) of Section 2125 and from the federally qualified health center’s chief executive officer or chief medical officer for each year of licensure.

(5)

(3) Has an offer of continued employment from a health care facility or practice in California, including, but not limited to, a federally qualified health care center, hospital, or clinic.

(4) Has certified that the physician will practice only in the areas of family medicine, internal medicine, pediatrics, obstetrics and gynecology, or psychiatry, as appropriate based on the physician’s licensure and certification in Mexico and history of practice in California.

(6)

(5) Has completed all applicable continuing medical education requirements of Article 10 (commencing with Section 2190) during the three-year term. each year of board licensure.

(6) Has not committed any acts or crimes constituting grounds for denial of licensure pursuant to Division 1.5 (commencing with Section 475) or Article 12 (commencing with Section 2220).(7) Has no open complaints against their license and no history of enforcement action, including, but not limited to, a citation and fine or discipline, against their license.(8) Is in good standing when applying for a full and unrestricted license and applies no earlier than nine months prior to the expiration of their current license.(9) Has submitted payment of all fees for a full and unrestricted physician and surgeon license pursuant to Article 20 (commencing with Section 2435).

(b) The board shall issue a full and unrestricted physician’s and surgeon’s license to an applicant who meets the requirements of subdivision (a) and who otherwise meets all requirements for licensure under this chapter.

(c) A license issued pursuant to this section shall expire, and may be renewed, pursuant to the requirements of Article 19 (commencing with Section 2421).

SEC. 3.

Article 6.2 (commencing with Section 2128) is added to Chapter 5 of Division 2 of the Business and Professions Code, to read:

Article 6.2. California Physician Expansion Act

2128.

This article shall be known, and may be cited, as the California Physician Expansion Act.

2128.1.

For purposes of this article:

(a) “ACGME” means the Accreditation Council for Graduate Medical Education.

(b) “ECFMG” means the Educational Commission for Foreign Medical Graduates.

(c) “HPSA” means health professional shortage area as designated by the United States Department of Health and Human Services.

(d) “MUA” means medically underserved area as designated by the United States Department of Health and Human Services.

(e) “Sponsoring entity” means an entity approved by the board that is one of the following:

(1) A federally qualified health center.

(2) A primary care clinic licensed under Section 1204 of the Health and Safety Code.

(3) A primary care clinic exempt from licensure pursuant to Section 1206 of the Health and Safety Code.

(4) A clinic owned or operated by a public hospital or health system. system located in a HPSA or a MUA.

(5) A clinic owned and operated by a hospital that maintains the primary contract with a county government to fill the county’s role under Section 17000 of the Welfare and Institutions Code.

(6)Any licensed health facility located within a HPSA or MUA.

2128.2.

The board shall issue a provisional license to an applicant who meets all of the following requirements:

(a) The applicant holds a full and unrestricted license to practice medicine in another country and has been in good standing for at least four years. Any time spent by the applicant in a residency or postgraduate training program shall not be included in the calculation of this four-year period.

(b)The board determines that no disciplinary action has been taken against the applicant by any medical licensing authority and that the applicant has not been the subject of adverse judgments or settlements resulting from the practice of medicine that the board determines constitutes evidence of a pattern of negligence or incompetence.

(b) The board determines all of the following:(1) No disciplinary action has been taken against the applicant by any medical licensing authority.(2) The applicant has not been subject to adverse judgments or settlements resulting from the practice of medicine.(3) The applicant holds a license in good standing in the jurisdiction where they practiced medicine or held a license in good standing at the time they departed that jurisdiction. The board may waive this requirement if official verification of good standing is not available.

(c) (1) The applicant has not committed any acts or crimes constituting grounds for denial of a certificate under Division 1.5 (commencing with Section 475) or Article 12 (commencing with Section 2220).

(2) The board shall submit to the Department of Justice fingerprint images and related information required by the Department of Justice of all applicants for a provisional license to determine whether the applicant has a criminal conviction record in this state or in any other jurisdiction, including foreign countries, pursuant to Section 2042. The Department of Justice shall provide a state- and federal-level response in accordance with subdivision (p) of Section 11105 of the Penal Code for the board to determine whether the applicant is subject to denial of licensure under Division 1.5 (commencing with Section 475) and Section 2221.

(d)The applicant shows evidence satisfactory to the board that the licensee has received credit for at least 36 months of residency or postgraduate training in the other country that is substantially equivalent to an ACGME-accredited residency program, as determined by the board.

(d) The applicant has done either of the following:(1) Completed two years of postgraduate training in a graduate medical education program approved by the applicant’s country of licensure.(2) Practiced medicine in the applicant’s country of licensure for at least six years after completion of medical school.

(e) The applicant has obtained ECFMG certification.

(f) The applicant has passed Steps 1 and 2 of the United States Medical Licensing Examination. Examination or has passed any other assessments approved by the board.

(g) The applicant has proficiency in the English language as demonstrated by a passing score on the Test of English as a Foreign Language or the Occupational English Test at levels established by the board.

(h) The applicant is authorized to work in the United States.

(i) The applicant has a valid offer of employment from a sponsoring entity.

2128.3.

(a) (1) The provisional license shall be valid for a period of three years.

(2) Notwithstanding paragraph (1), the board may grant a one-time extension renewal of the provisional license for an additional period of up to three years upon demonstration of continued progress toward meeting licensure requirements.

(3) The total duration of any provisional license shall not exceed six years.

(b) (1) The provisional licensee shall be employed by, and practice medicine only within, a sponsoring entity that is approved by the board. entity.

(2) The sponsoring entity employing the provisional licensee shall do all of the following:

(A) Ensure that the provisional licensee practices under appropriate supervision.

(B) Maintain a peer review process consistent with applicable state and federal law.

(C) Be responsible for the medical services provided by the provisional licensee.

(D) Maintain a copy of the written agreement required pursuant to subparagraph (A) of paragraph (3) of subdivision (c). The sponsoring entity shall make the agreement available to the board upon request, including for purposes of complaint investigation, audit, or disciplinary review.

(3) The provisional licensee’s authority to practice shall be limited to the sponsoring entity identified in their application and approved by the board. application.

(4) If the provisional licensee ceases to be employed by the sponsoring entity, the provisional license shall no longer be valid unless the board approves a transfer to another sponsoring entity.

(c) (1) The provisional licensee shall practice under the supervision of a physician and surgeon licensed in this state and in good standing.

(2) The supervising physician and surgeon shall oversee the activities of, and accept responsibility for, the medical services rendered by the provisional licensee.

(3) (A) The supervising physician and surgeon and the provisional licensee shall enter into a written agreement that defines the medical services the provisional licensee is authorized to perform. The written agreement shall be completed and signed by the provisional licensee and the supervising physician and surgeon before the provisional licensee begins practice under the provisional license.

(B) Nothing in this section shall be construed to require the board to review, approve, or maintain a copy of the written agreement as a condition of issuing or renewing a provisional license.

(4) A supervising physician shall not supervise more than four provisional licensees at any one time.

(d) The provisional licensee shall complete all continuing medical education requirements of Article 10 (commencing with Section 2190).

(e) The board may revoke a provisional license or take any other disciplinary action deemed appropriate by the board pursuant to Article 12 (commencing with Section 2220).

2128.4.

A provisional licensee shall be deemed to meet the professional instruction, preliminary education, and postgraduate training requirements for a certificate under this chapter if the provisional licensee meets all of the following requirements:

(a) The provisional licensee has passed Step 3 of the United States Medical Licensing Examination.

(b) The provisional licensee has completed at least 36 months of practice under the provisional license without any disciplinary actions.

(c) The provisional licensee has received a positive recommendation from the supervising physician or director of the sponsoring entity’s medical staff.

2128.5.

(a)The board shall set application, initial licensure, renewal, and conversion fees for the provisional license at an amount sufficient to cover the costs of administering this article.

(b)This section does not require the board to issue a license to any applicant who does not meet the requirements established by the board.