Healthcare providers inside California may be asking themselves a simple question: “Will SB 623 stay limited to rideshare car crash lien cases?”

Healthcare providers outside California may be asking themselves a different question: “I’m Not in California — Why should I care about SB 623?”

Those are each great questions. Let’s address both and expand on the second even more.

The Likely Expansion of SB 623 to All California Personal Injury Cases

If you look at legislation enacted through the U.S., you will find one thing in common: laws get expanded.

Political agendas follow political elections. And tort reform is a popular political subject to spin.

SB 623 by its own wording is currently limited to rideshare car crash cases on lien.

Why is that? Why is it limited?

Because limiting it allowed that bill to get initially passed without hearings, without discussion, without scrutiny, and without the voices at the table of those affected — medical professionals or consumers.

The Legislature will assert they act on behalf of business and consumers. That’s spin. They act for themselves when it involves tricks like stripping out a planned Veteran’s bill, replacing it with tort reform, and getting it passed and signed in about a week.

The spin doctors (pun intended) will talk about how it’s limited, how it’s needed, and how it will be effective.

Then, smart legislators and their staff and experts and industry lobbyists who didn’t even participate in the review this go-around will be asked: If this is being applied to rideshare cases, why wouldn’t all these limitations be applied to all personal injury cases, car crash or otherwise?

Good question. Actually, it’s a great question.

Because starting January 1 of 2027, courts presiding over newly filed personal injury cases, as soon as they apply SB 623’s requirements will be asking themselves: Why am I having to apply two different standards when the only difference is that it involved a rideshare app company?

The answer is: there should be only one standard.

Dual standards lead to inequitable results, one way or the other.

SB 623 is begging for expansion efforts.

I can refer to Florida’s 2023 Tort Reform which started framed in the area of property claim reform because of abuses with insurance resulting from Hurricane damage claims. At the 11^th hour, that bill expanded into full out personal injury tort reform for another Governor seeking a Presidential run at the time.

See a pattern?

So, if you like SB 623 after I’ve laid out the provisions and truth in this article series, super. Sit back and enjoy the ride.

But if you find problems with it, you need to sound an alarm, spread the word, and get your organizations and lobbyists to pay attention and have the important discussions I’m challenging you all to have take place.

What Were the Medical Donations from Medical Professionals Used For?

I have one other suggestion to all California physicians and medical providers: Has the money the medical industry contributed to help the Legal Lobby, from their urging as they shouted the sky is falling on medical professionals and legal professionals alike because of the Uber initiative, been used to help or hurt you?

The Legal Lobby made a call out to medical providers when the Uber initiative was rolled out. They had conference calls run by attorneys and some of their key doctor contacts and professed how the Uber initiative would lower their fees and harm medical practices.

The medical industry was lied to by not just the state Legal Lobby, but by at least one other national medical lobbying group who used the occasion to raise more donated funds.

You see, fear raises money. The more fear, the more money raised. And the Legal Lobby went on a campaign to scare the hell out of medical professionals to get them to open their pocketbooks and help in a grassroots campaign for a “no vote” on Uber’s ballot initiative.

They were wrong and no one bothered to read closely the Uber initiative or understand the ballot’s provisions didn’t have much of an effect on medical professionals – it was the lawyers and their cases being impacted. But the medical professionals who didn’t know any better sucked up the fear mongering. Drank the Legal Lobby Kool-Aid.

Now, that same Legal Lobby behind closed doors without your participation has impacted your profession to save the things that mattered most to them … their fees.

One thing I suggest you all do is go to the medical and legal PACs that raised funds and ask for a full accounting of how every dollar was used, by who, when, and for what. Don’t accept general statements. Don’t accept oral accounting. Get it in detail, and in writing.

Especially look at what money was used, if any, for the period of June 2026.

Transparency matters. Integrity matters. And the truth will set you free.

You can then learn if any of your money was used to help throw you under the bus.

And if not, here’s something else to consider.

All those millions raised still exist. With the Uber ballot initiative gone, what are those funds to be used for?

I will address this aspect more in the last article. So, let’s move on to the question from providers and physicians in other states.

Will SB 623 Matter if You Don’t Live or Practice in California?

It’s a fair question.

After all, the law currently applies only to a specific category of California personal injury cases involving app-based rideshare car crash lien cases.

If you practice in Texas… Florida… Arizona… Ohio… Or virtually anywhere else… Why spend time learning about a California statute?

The answer isn’t because SB 623 necessarily predicts what your legislature will do.

The answer is because public policy often travels.

Ideas that prove politically workable in one jurisdiction are frequently studied, debated, modified, and sometimes adopted elsewhere.

Not always, but often enough that healthcare providers should pay attention.

Public Policy Rarely Begins Everywhere

Throughout American history, many legal and regulatory changes have followed a familiar pattern.

One jurisdiction adopts a new approach. Other states watch. Researchers study the results.

Interest groups evaluate the political response. Supporters point to perceived successes. Critics identify unintended consequences.

Over time, similar proposals appear elsewhere, sometimes nearly identical, sometimes substantially revised.

This is how public policy evolves.

Healthcare providers have seen it happen repeatedly.

Electronic health records. Price transparency initiatives. Telehealth expansion. Scope-of-practice debates. No Surprises Act implementation. Workers’ compensation reforms. Medical malpractice reforms. State Tort reforms in many states have taken place.

Ideas often begin somewhere before becoming part of a broader national conversation.

You see that with Florida’s Tort Reform from 2023. Already several states like Georgia and New York have referred to Florida’s reform – which was also rushed through by their Governor though not nearly as fast – as the example.

Whether SB 623 ultimately follows that path remains unknown.

But the possibility alone makes it worthy of attention.

Why California Matters

California has long served as a policy laboratory.

Because of its size, economic influence, and legislative activity, developments in California often receive national attention and are at some point adopted elsewhere if not nationally.

That does not mean other states automatically follow California’s lead.

Many do not. Some adopt modified versions. Others reject California’s approach entirely.

Still, policymakers, professional associations, insurers, employers, healthcare organizations, and advocacy groups routinely monitor significant California legislation because it often influences future discussions elsewhere.

And make no mistake about it, you have a deep pocket company, Uber, ready to shell out tens of millions, if not hundreds of millions, to lessen their litigation loss prospects.

So, SB 623 may indeed become one of those laws. Or it may remain unique.

Either way, understanding it provides valuable insight into the issues being debated.

The Larger Questions Extend Beyond California

Even if your state never adopts legislation resembling SB 623, the broader questions raised by the bill are already national questions.

For example:

How should medical liens be regulated?

How much transparency should exist between attorneys and healthcare providers?

Should external databases influence recoverable medical expenses?

How should medical funding be treated?

How do we discourage abuse while preserving patient access to timely medically necessary care?

Those debates should be occurring across the country whenever personal injury tort reform is brought up.

SB 623 represents one legislative response.

It is not the only possible response. But it is one that deserves careful study.

Why Healthcare Providers Should Watch Trends, Not Just Laws

One mistake many professionals make is focusing only on laws after they are enacted.

By then, adaptation becomes reactive.

A better approach is to watch trends.

Ask: What issues are legislators discussing? What concerns are insurers raising? What reforms are provider organizations proposing? What questions are courts beginning to address?

Understanding trends allows practices to prepare before change arrives.

Preparation is almost always less disruptive than reaction.

Could Similar Ideas Appear Elsewhere?

No one can answer that question with certainty.

Different states have different political climates. Different healthcare systems. Different insurance markets. Different legal traditions.

Some legislatures may view SB 623 favorably. Others may reject it entirely.

Still others may borrow selected concepts while discarding others.

For example, one state might consider enhanced transparency requirements. Another might focus on lien financing. Another might examine referral disclosures. Another might study FAIR Health benchmarks.

Legislation rarely travels intact.

Ideas evolve.

That is why providers should pay attention to concepts, not just statutes.

That is why providers should follow the money behind legislation and ballot initiatives. In California, Uber spent $70 million just on its ballot initiative. They are one of the most aggressive companies nationally, aside from auto insurers.

And the Legal Lobby just proved if you threaten their fees they will do anything to preserve the money train.

What Should Providers Be Monitoring?

Healthcare providers do not need to become legislative experts.

But they should remain informed about developments affecting their profession.

Questions worth monitoring include:

• Are medical liens becoming a legislative focus?
• Are reimbursement benchmarks changing?
• Are referral relationships receiving greater scrutiny?
• Are documentation requirements expanding?
• Are patient access issues being discussed?
• Are funding models changing?
• Are professional associations actively engaged in these conversations?

And is Uber about to take this roadmap on the road to other states, maybe adding a ballot initiative to lower attorney fees and then work a “compromise” bill with things they could never pass with a ballot initiative, as Uber did with SB 623? And leverage the Legal Lobby’s money and pull again to their advantage to help the bill pass that state’s legislature.

Knowledge allows providers to participate constructively rather than react defensively.

This Is Bigger Than Personal Injury

Perhaps the most important lesson extends beyond SB 623 itself.

Healthcare is becoming increasingly interconnected with public policy. Clinical excellence alone is no longer enough.

Today’s healthcare providers must also understand: Compliance. Documentation. Technology. Privacy. Reimbursement. Regulation. Risk management. Public policy.

No one entered healthcare wanting to become policy experts. Yet policy increasingly influences how healthcare is delivered.

Understanding that reality is part of modern healthcare practice management.

Learning Before Reacting

One reason I wrote this series is because I believe providers deserve more than headlines and political spin.

Whether you ultimately support SB 623… Oppose it… Or remain undecided… You should understand it.

Good decisions are built upon good information. Not assumptions. Not social media. Not political slogans. Not press releases. Not spun email notifications and so-called updates.

Healthcare providers are uniquely qualified to contribute practical insight because they understand what happens after legislation leaves the Capitol and enters the examination room.

That perspective matters.

The Opportunity

Every significant reform creates two opportunities.

The first is to criticize. The second is to improve.

Healthcare providers should never hesitate to identify unintended consequences.

But they should also contribute solutions.

If greater transparency is appropriate, how can it be implemented efficiently?

If patient access becomes more difficult, how can that be addressed?

If reimbursement models require refinement, what alternatives should be considered?

Those are the conversations that ultimately improve public policy.

A National Conversation Worth Having

Regardless of where future legislation goes, SB 623 has already accomplished one important thing.

It should continue a national conversation about the future of personal injury healthcare.

That conversation should include: Patients. Healthcare providers. Attorneys. Insurers. Transportation companies. Legislators. Researchers. Professional associations.

Every stakeholder has something valuable to contribute.

The best public policy is rarely created when only one perspective is heard, and where there is a closed door, rush to sign, unvetted pieces of legislation brought for political purposes.

A Closing Thought

One of the greatest mistakes healthcare providers can make is assuming public policy only affects someone else. It rarely does.

Today’s California rideshare car crash lien law may stay in that limited area of PI situations. I doubt it.

Today’s California discussion may remain uniquely Californian. I doubt that also.

My hope is that it may influence future conversations elsewhere. Only time will tell.

But informed professionals who care never wait until change reaches their own front door.

They pay attention. They learn. They engage.

And they demand their associations, organizations, and lobbying groups to act.

When appropriate, they help shape better solutions.

Because healthcare policy should never be about winning political battles.

It should always be about improving the care patients need when they need it.

Next in the Series

To Be Fair…

The Strongest Arguments Supporting SB 623—and Why Every Healthcare Provider Should Understand Them

In Part 9, we’ll step into the shoes of those who support SB 623. We’ll examine the concerns that motivated the legislation, acknowledge where meaningful reforms may have been needed, and explore why understanding the strongest arguments on both sides is essential to creating a better personal injury healthcare system.