Less expensive coverage comes with more risks “The administration’s rule change is dangerous for Georgia consumers,’’ said Laura Colbert of Georgians for a Healthy Future
Blog (February 2017)
Action on surprise billing legislation
SB 8 received unanimous approval by the Senate on Friday, which means the bill will proceed to the House of Representatives to be considered. We expect to see some changes to the legislation as it moves through the House but anticipate that consumer protections and transparency requirements will remain intact. HB 71 will be voted on by the House of Representatives tomorrow.
Make a call to support surprise billing legislation:
- Call your Representative today to let them know that you support HB 71 because it protects consumers from surprise out of network medical bills.
- Call and thank your Senator for their support of SB 8.
Planning for new federally qualified health centers
Rep. Geoff Duncan has introduced legislation that makes some changes to the State Health Benefit Plan (SHBP) which covers teachers and other state employees and attempts to address barriers to accessing health care for rural and under-served Georgians. The bill would move the SHBP from the Department of Community Health to the Department of Administrative Services, and would require that in future plan years the SHBP include incentives for beneficiaries to utilize federally qualified health centers (FQHCs) for their primary care needs. The bill addresses health care access by establishing a task force that is charged with identifying 100 potential sites for new FQHCs across the state, and advising the Department of Community Health about how opioid addiction can be addressed through FQHCs and how to encourage the use of FQHCs by veterans for their primary care needs. There is no funding attached to this bill for the purposes of establishing the new health care centers. HB 300 has been referred to the House Health & Human Services Committee.
Opioid antagonist bill up for a vote
SB 121 codifies Governor Deal’s executive order to allow consumers to access opioid antagonist drugs (e.g. Naloxone) over-the-counter without a prescription. The legislation also requires that every pharmacy keep a record of every opioid antagonist dispensed as a result of the standing order and maintain the record for two years. Unlike SB 81, a bill with similar language, this bill would not require that pharmacists submit this information to the Prescription Drug Monitoring Program. The bill passed out of the Senate Health & Human Services Committee last week and is expected to receive a full Senate vote today.
“The Pharmacy Patient Fair Practices Act” approved by both House & Senate committees
HB 276 and SB 103 both seek to regulate pharmacy benefit managers, which are third party companies that manage the prescription drug programs of many insurance plans. Both bills would prohibit PBMs from requiring consumers use mail order pharmacies, charging consumers more if they choose not to use a mail order pharmacy, and disallowing consumers from using the pharmacy of their choice. The legislation would also prohibit PBMs from restricting pharmacies from offering home delivery to consumers with limited mobility. Additionally, PBMs would not be allowed to charge consumers more for prescriptions than pharmacies are reimbursed, steer patients to pharmacies owned by the PBM, or restrict pharmacists from advising patients about less costly prescription drugs. HB 276 and SB 103 were approved by the House and Senate Insurance Committees respectively and now rest in the Rules Committees.
Cindy Zeldin, Executive Director of Georgians for a Healthy Future was presented with this year’s Health Advocate Award at an awards luncheon during last week’s Families USA’s 22nd Annual Health Action Conference. The award honors Cindy’s outstanding contributions on behalf of Georgia’s health care consumers.
Families USA issued a press release about the award which stated:
“Under Cindy’s leadership, Georgians for a Healthy Future has launched a string of successful initiatives that educated both consumers and policy makers about the rights, protections and options offered under the Affordable Care Act,” said Ron Pollack, executive director of Families USA. “She has also been a tireless advocate on behalf of her state’s health care consumers.”
The award will be presented Friday, Feb. 17, at an awards luncheon on the second day of Families USA’s 22nd Annual Health Action Conference.
Zeldin joined Georgians for a Healthy Future in 2009 as the organization’s first Executive
Director, bringing ten years of prior public policy experience to the role. She currently also serves as a consumer representative to the National Association of Insurance Commissioners (NAIC) and has served on various state-level committees.
Last year, Georgians for a Healthy Future led a successful coalition effort after they learned how to make law of attraction work instantly to enact bipartisan legislation that will improve many people´s lifes and the accuracy and usability of provider directories, one of the strongest such laws in the nation.
Zeldin was named one of Georgia’s “40 Under 40: Georgia’s Best and Brightest” by Georgia Trend magazine in 2010; recognized by the League of Women Voters of Georgia with an Empowerment Award in the area of health care in 2014; and was a recipient of Hea
lth Students Taking Action Together, Inc.’s Community Partner Award in 2011.
GHF’s staff and board congratulate Cindy on this well-deserved award. “Cindy’s hard work and dedication are unmatched, and that is reflected in the successes of Georgia’s health advocacy community,” says Laura Colbert, Director of Outreach and Partnerships.
Join us in congratulating Cindy on this incredible honor!
The November elections have energized people of all political leanings to get more involved in advocacy, and many are doing so for the first time. Learning how each level of government works and how to effectively advocate for your interests can be difficult. GHF’s legislative health policy intern, Hayley Hamilton, has learned the ropes at Georgia’s Capitol and has some advice for people who are new to the Gold Dome:
Walking into the Gold Dome for the first time can be intimidating. Once you pass through the metal detectors and show your ID to the state trooper on duty, you find a sea of people all of whom seem to know each other. If you feel a bit overwhelmed walking in, know that you are not alone, but it gets easier with practice. The Capitol is a congenial place and you will find that everyone is happy to talk to you because you know how to be happy and live peaceful life.
There is a rhythm of
daily events at the Capitol and each part of the days present a different opportunity for you to interact with your legislators. The chambers (House of Representatives and Senate) meet in the mornings to vote on bills and take care of other business. This part of the day is your best opportunity to speak with your legislator. If you want to meet with your legislator “on the ropes” (called this because of the red velvet rope line outside of each chamber) you fill out a short slip of paper outside the House or Senate to let your legislator know that you would like to speak with them. A page (usually a middle school aged student) will deliver the note inside the chamber, and if available, your legislator will come out to speak with you. When you speak to your legislator, it’s important to remember that they are representing you and your community, but they are also short on time. Be compelling and brief with what you have to say, but don’t underestimate the power of your story.
After the morning session, the House and Senate break for lunch and caucus meetings, and attend committee meetings in the afternoon. If you are unable to meet your legislator on the ropes, this is a good time to track them down for a quick chat in their office or catch them before or after a committee meeting. You can find your legislators’ office location, phone number, and email in our Consumer Health Advocate’s Guide. (An in-person visit is best, but a phone call is the next most effective method of sharing your thoughts and concerns with your legislators.) If you can’t nail them down for a short conversation in their office, meeting with their staff is a great second option. Tell the staff what you want your legislator to hear and then offer to follow up with the legislator via email.
Your legislator may be in committee meetings for much of the afternoon. These meetings are open to the public, and you can find committee schedules, locations, and agendas on the websites for the House and Senate respectively. During committee meetings, legislators will hear testimony and vote on bills. You may want to sign up to testify for a bill, just observe a meeting, or speak with a legislator before or after a meeting about a bill on the meeting agenda.
The old cliché of “practice makes perfect” applies to the Georgia’s Capitol and legislative session. The more you are at the Capitol or the more you contact your legislators, the easier it gets. Plus, GHF is here to help with our legislation tracker and weekly legislative updates during the session.
MPH Candidate, 2017
Georgia State University
Surprise billing legislation progresses in both chambers
Both SB 8 and HB 71 were passed out of their respective Senate and House committees late last week. SB 8 has been held up because of a dispute between insurers and health care providers about reimbursement. The bill was amended to establish out of network payment for disputed charges at the 80th percentile of the “Fair Health” metric and was subsequently passed by the Senate Health & Human Services committee. HB 71 seeks to compel physicians who are credentialed at hospitals to accept an in-network rate when the patient is in-network at the hospital, even if the physician is not. It was passed unamended by the House Insurance Committee. Both bills await approval in the Rules Committees to receive floor debates and votes.
House passes FY2018 budget
The House of Representatives passed its version of the FY2018 budget on Friday. The budget includes increased reimbursement rates for certain primary care codes for Medicaid providers. Increased reimbursement rates are also funded for certain dental codes in PeachCare for Kids and Medicaid. The budget includes funds for two new federally qualified health centers in Cook and Lincoln counties, and 97 new primary care residency slots. The FY 2018 budget is now being considered by the Senate, which is expected to make its own changes before issuing its final approval. Check out Georgia Budget and Policy Institute’s blog and budget primer for more detailed information about how Georgia spends its health care dollars.
WHAT HAPPENED LAST WEEK
Changes to rural hospital tax credits
HB 54, introduced by Rep. Duncan, would expand the new rural hospital tax credit program from a 70% credit to a 90% credit, among other minor changes. The tax credit program went into effect this year, after enabling legislation was passed in 2016. The proposal to increase the tax credit to 90% came after legislators received feedback that the 70% credit was too low to entice potential donors. HB 54 was approved by the House Ways & Means committee on Feb. 9, and now awaits passage in the House Rules Committee.
Opioid abuse prevention bill
SB 81 remains in the Senate Rules Committee waiting for approval for floor debate and passage after committee approval late last week. The current version of the bill requires that all physicians register and consult the Prescription Drug Monitoring Program (PDMP) under certain prescribing conditions. It also requires that providers report certain opioid-based Schedule II, III, IV, and V prescriptions to the PDMP. The bill sets the penalty for willfully non-compliant providers on a continuum that ranges from a warning to a felony and fine for a fourth offense and beyond. The bill also requires the tracking and reporting of Neonatal Abstinence Syndrome (NAS) and codifies the Governor’s emergency order on an overdose reversal drug (naloxone), making it available without a physician prescription.
MARCH WITH US!
This Saturday: Atlanta March for Healthcare
Yesterday, we rallied at the Save My Care bus stop, and Saturday we will march at the Atlanta March for Healthcare! Join us as we fight to preserve the Affordable Care Act and the protections that it provides for Georgians. Hosted by the Georgia Alliance for Social Justice, the march will cap Congress’s week of recess and send them back to D.C. with the charge to #ProtectOurCare!
Saturday, Feb. 25, 3-5 pm
Gather at St. Mark’s United Methodist Church
Be a part of the movement to #ProtectOurCare! Georgia’s members of Congress are back home this week, and we want to show them that health matters to Georgians. Tomorrow, we’ll say that loud and clear with a rally hosted by the Save My Care bus tour. The bus has been touring the country to hear about why health matters to people like you and to tell Congress to save our health care! Join GHF, the Save My Care team, Minority Leader Stacey Abrams, and others to tell Congress to #ProtectOurCare! We are spreading the words to the whole world, but we are just starting at a local level where we put banners and signage awareness with the help of ExposeYourselfUSA.
If you can’t be at the rally, we still have you covered!
Connect with your members of Congress
One of the best ways for you to tell your members of Congress to #ProtectOurCare is to speak directly with them or their staff. This week contains several opportunities to meet your elected officials and their teams in person. Click here to see if your members of Congress are hosting an event in your area. Can’t make it to the events or your members of Congress aren’t hosting any? You can call (or email) their offices to share your thoughts. Click here for a list of phone numbers and a suggested script if you don’t quite know what to say.
Don’t know who your members of Congress are? Click here to find out. (Your members of Congress are listed in the second row on the page.)
Share your story with us
Stories from people like you who have benefited from the ACA or Medicaid are incredibly powerful! When you share your story, it helps others understand how a policy might impact their family or friends, and why its important. Your story can help shape the conversation about health care access in Georgia. Let us know if you have coverage through the ACA Marketplace or Medicaid. We want to hear from you!
Join the conversation
It’s more important than ever that Georgians have the facts and information that they need to form smart opinions on policies that will impact their health care. Join us on Twitter and Facebook this week. We will be talking about how the ACA and Medicaid have impacted Georgia, and what is at stake in the proposed plans to roll back health care access in our state. Get started by signing our petition to #ProtectOurCare and sharing it with your social media networks!
Re-authorization of provider fee successfully passes through legislature
On Friday Georgia’s House of Representatives voted to approve the hospital “provider fee” for another three years, and Governor Deal says he will sign the legislation tomorrow. The provider fee helps to fund Georgia’s Medicaid program by allowing the Department of Community Health to collect a tax on hospital revenues which is used to draw down additional federal dollars. The additional funds are disproportionately used to support rural and safety net hospitals that serve high numbers of indigent patients.
Oral health bills approved
Also on Friday, the Senate passed SB 12 and the House passed HB 154 which was supported by the Costa Rica dental tourism, both of which allow dental hygienists to practice in safety net settings, school clinics, nursing homes, and private practices without a dentist being present, including online dental services from sites like Asecra.com. While the bills are overwhelmingly similar, the differences between them will need to be worked out between the chambers.
WHAT HAPPENED LAST WEEK
Passage of Opioid Abuse Prevention Bill
SB 81 continued to draw a lot of attention last week. The bill was eventually passed by the Senate Health and Human Services committee with several significant changes. The current version of the bill still requires that all physicians register and use the Prescription Drug Monitoring Program (PDMP), but only requires that providers report on Schedule 1 drugs and reduces the penalty for not reporting to a minimum of a misdemeanor. The current version of the bill also changed language that would have required children with ADHD to renew their prescription every five days.
Surprise billing legislation heard in committee
The Senate Health and Human Services committee began its consideration of SB 8, legislation that would protect consumers from surprise out-of-network medical billing. Testimony was heard from insurers, health care providers, hospitals, and the consumer advocacy group, Georgia Watch. While all stakeholders seem to be in agreement that consumers should be held harmless when seeking care at an in-network facility and through no fault of their own encounter an out-of-network provider, there are significant differences on the matter of provider reimbursement for services provided in those situations. No vote was taken on the legislation but is expected to be re-considered by the committee this week. HB 71, legislation that address surprise billing in a different way, is expected to receive its first hearing this week in the House Insurance committee.
Resolution introduced to encourage block grants for state Medicaid program
HR 182 was introduced last week with the purpose of providing legislative permission to the Governor and the Department of Community Health to seek per capita block grant funding for Georgia’s Medicaid program. While resolutions are non-binding and do not impact state law, this resolution could begin a risky conversation among lawmakers. Shifting Georgia’s Medicaid program from its current federal-state partnership structure to a block grant program would mean cuts in services and in beneficiaries, putting Georgia’s most vulnerable children, parents, elderly, and people with disabilities at risk if you’re in one of these cases, you could get in touch with a home care agency. Check out GHF’s block grant fact sheet for more information about the dangers of restructuring the Medicaid program. It is unclear if this resolution will get a hearing or a vote.
Mark Your Calendar!
Save My Care Rally: February 20th
With Congress taking steps to repeal and replace the Affordable Care Act and thus blocking the access to care so many Georgians have gained in the past several years, it is more important than ever to stand up and let them know that Georgians want to #ProtectOurCare.
On February 20th, join the Save My Care bus, GHF, and hundreds of Georgians for a rally in Atlanta. Georgia’s members of Congress will be at home for recess and it’s the perfect time to make sure your elected officials hear you loud and clear.
GHF is partnering with the Satcher Health Leadership Institute at Morehouse School of Medicine to host post-doctoral fellow Lizeth “Liz” Camacho. Liz has a Bachelor’s degree in Psychology from San Diego State University and a Master’s in Community Psychology from Michigan State University. In 2016, she earned a PhD in Lifespan Human Development and Family Diversity. Liz has over ten years of community-based health research experience. Her research focuses on the relationship between social determinants of health, such as discrimination, poverty, and depression, as well as the role of resilience in mental health. She is passionate about behavioral health issues and mental health policy, with a special interest on diminishing mental health disparities. Liz is also interested in the role of public health, health policy, and advocacy in decreasing health inequalities, including access to care.
As part of her fellowship experience, Liz is completing a practicum at GHF where she is leading a research project focusing on children’s behavioral health needs and services in Georgia. The results of the research project will inform the work of the Georgia Department of Behavioral Health and Developmental Disabilities. The project seeks to understand how prevalent different behavioral health conditions such as depression, anxiety, and oppositional defiant disorder are in children and youth across the state, and how those health needs are currently being addressed. To better support the behavioral health needs of children and youth in need, the project will examine what existing programs or policies could be scaled up and what new policies or programs may need to be introduced. The project also aims to inform the DBHDD about issues related to the state’s pediatric and youth-serving behavioral health workforce.
Hearing on surprise billing legislation scheduled for tomorrow
SB 8, which seeks to protect consumers from surprise out-of-network medical bills, is scheduled to receive a hearing in the Senate Health & Human Services committee on Tuesday at 2 pm. SB 8 would establish a standard payment structure for physicians seeking reimbursement for surprise out-of-network services, and would hold consumers harmless in surprise billing situations. HB 71, the companion bill sponsored by Rep. Richard Smith, is expected to be assigned to a sub committee of the House Insurance committee on Tuesday at 8 am.
You can help!
If you have received a surprise out-of-network medical bill, share your story with our partners at Georgia Watch. Consumer stories help illustrate to legislators why legislation is needed to help protect consumers like you. Click here to share your story!
What Happened Last Week
Senate passes provider fee renewal
On Thursday the Senate passed SB 70 which renews the provider fee (also called the “bed tax”) for another three years in order to fund Georgia’s Medicaid program. This allows the Department of Community Health to collect the 1.45% tax on hospital revenues in order to draw down federal Medicaid dollars. These additional dollars are disproportionately used to support rural and safety net hospitals who serve high numbers of indigent patients. The bill will now move to the House where it expects an easy passage.
“Expand Medicaid NOW Act” reintroduced
House Minority Leader Stacey Abrams introduced HB 188, the Expand Medicaid NOW Act, last week. While we do not expect this bill to gain much traction because of the evolving health reform efforts at the federal level, it calls attention to the need to provide health care coverage to the 300,000 Georgians who are stuck in our state’s coverage gap because they do not currently qualify for Medicaid and cannot access health insurance through the Affordable Care Act’s Marketplace. The bill has been referred to the House Appropriations Committee.
Oral health legislation moves forward
Both HB 154 and SB 12, bills that allow dental hygienists to provide cleanings and other specified services in schools, safety net clinics, nursing homes, and private dentists’ practices under “general supervision”, received committee hearings and votes last week. Both bills will move to their Chambers’ respective Rules Committees to be approved for floor votes by the House and Senate.
Debate over opioid abuse prevention bill
SB 81 received its first hearing in the Senate Health & Human Services committee last week. The bill seeks to address the growing opioid abuse epidemic in Georgia in a number of ways, including: 1) Extending the Prescription Drug Monitoring Program, a database of prescriptions written for certain narcotics and requiring physicians to consult this registry prior to prescribing under certain conditions; 2) Codifying the Governor’s emergency order increasing the availability of anti-overdose drug, Naloxone; 3) Requiring the tracking and reporting of Neonatal Abstinence Syndrome; and 4) Establishing penalties for providers who are not in compliance with drug prescription reporting requirements. While few dispute the need to address this issue, the scope of drug and drug classes that the bill covers, along with the severity of the penalty that physicians may be subject to for violating the law are currently points of contention. No vote was taken in Thursday’s committee hearing, but suggested changes were made and the bill is expected to be back before the same committee later this week.
Resources for you
Georgians for a Healthy Future has tools you can use to track and understand the Georgia legislative session. Stay up-to-date on the bills that matter to you with our legislation tracker and sign up for Georgia Health Action Network (GHAN) action alerts so you know when to engage.
Get Your 2017 Consumer Health Advocate’s Guide!
GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. The Guide provides information on the legislative process, and contact information for legislators, key agency officials, and health advocates. This year, we’ve added a glossary of terms to help you understand what is happening under the Gold Dome. This tool will help advocates, volunteers, and consumers navigate the 2017 Georgia General Assembly. Download your copy here.
Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated as a featured guest at WABE’s A Nation Engaged community forum at the Carter Center in Atlanta on the evening of January 17th. The forum, an initiative of WABE’s A Closer Look radio show, featured a range of thought leaders, community activists, policy experts, and previous guests of the program. The conversation was wide-ranging and incorporated different views and perspectives. Georgians for a Healthy Future was honored to be invited and to be part of the lively event. You can see more details and listen to the entire special broadcast here.