The report notes that federal rules prohibit discrimination against transgender patients, and it was written as the White House considers changing that rule. The groups that produced the study, Georgians for a Healthy Future,…
Surprise billing legislation passed by committee
SB 8 was heard by the House Insurance committee this morning and passed unanimously. Among other transparency and notification requirements, this version of the surprise billing legislation requires that providers and hospitals must provide consumers with information about the plans in which they participate, and that upon the request of consumers, providers give an estimated cost of non-emergency services before they are provided. Insurers must inform consumers whether a provider scheduled to deliver a service is in-network, and if not, an estimation of how much the insurer will pay for the services, among other notification requirements. SB 8 will now go to the House Rules committee.
WHAT HAPPENED LAST WEEK
Senate passed the FY2018 budget
Last week, the Senate approved the FY 2018 budget. The budgets approved by the Senate and House differ slightly, so a conference committee will be appointed to meet and work out the differences. You can check the Differences Report for specifics on the variance between the House and Senate budgets, and we will provide a brief overview of the final version once the conference committee finishes its work.
Insurance coverage for children’s hearing aids passed
SB 206 was approved by the House of Representatives today, and will require private health insurance plans to cover hearing aids for children under 19 years old. The legislation stipulates that the costs cannot exceed $3000 per hearing aid and that the plans cover replacement hearing aids every four years or when the hearing aid fails before that time. Medicaid already covers hearing aids for children who qualify for coverage.
Pharmacy Patients Fair Practices Act passed by both chambers
Both HB 276 and SB 103 were approved by the Senate and House respectively last week and will get sent to the Governor for his signature. This legislation (which we previously covered here) will regulate practices of pharmacy benefit managers so as to allow consumers access to their pharmacy of choice, provide the opportunity for home delivery of medications, and prevent consumers from over-paying for prescriptions. It is really important to find a pharmacy that you can trust, I suggest to check Canadian pharmacies which have been very reliable for me.
Legislation to synchronize multiple medications passed
SB 200 will make it easier for people to synchronize their prescriptions so that they can pick up multiple prescriptions at the same time. The bill requires that insurance plans pro-rate medication co-pays for partial prescription fills so that the schedules for medications can be synced if requested by a patient. Under current law, a person may have to pay a full co-pay even if a pharmacist is providing only a part of their 30-day medication in order to synchronize multiple prescriptions. SB 200 passed the House Insurance committee last week and was approved unanimously by the House this morning.
Senate Health Reform Task Force held first public meeting
The Senate Health Reform Task Force was established by Lt. Gov. Cagle to study how federal health reform efforts would impact Georgia. The task force held its first public meeting on Friday and heard from two federal health policy professionals, Joseph Antos and Jim Frogue. Together, they provided a brief overview of the proposed American Health Care Act, some analysis of how the bill would impact Georgia, and suggestions for legislators to consider. The message from both presenters is that the AHCA is “not favorable” for Georgia because of the way the proposal cuts and caps Medicaid which would lock in Georgia’s pattern of low per capita Medicaid spending.
We agree that this proposal is “not favorable” for Georgia. Despite the harm it would do to our state, the bill seems headed for a vote in the House of Representatives. Call your Congressman today to tell him that this bill hurts Georgia!
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.
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
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, both of which allow dental hygienists to practice in safety net settings, school clinics, nursing homes, and private practices without a dentist being present. 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.
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.
It is a time of uncertainty for health care. Congressional leaders have already begun the process to repeal the Affordable Care Act, landmark legislation that established a framework for coverage that has resulted in the lowest uninsured rate ever recorded, rights and protections for health care consumers, and provisions to advance health equity. With the 2017 Georgia legislative session underway, state leaders have acknowledged that something must be done about Georgia’s high number of uninsured, the state’s struggling rural health care system, and the impending funding cuts to hospitals. With so much uncertainty and change, it may be hard to keep track of what’s going on in health policy.
Join us for a webinar to learn about and discuss expected and proposed changes at the both the state and national levels. We will provide you with the most recent information about “repeal & replace” efforts and #ProtectOurCare advocacy, and how that will impact Georgia. We will also preview health care in Georgia’s 2017 state legislative session and tell you how you can get involved in the health care issues that you care about through advocacy and public engagement. Join us for a look ahead at health care policy in 2017. Register here to join us!
Some of the most pressing and contentious health and insurance issues facing Georgians will be front and center during anticipated legislative study committee meetings this fall. Study committees meet during the off-session to take a closer look into specific policy issues and develop recommendations for the upcoming legislative session. Check out a full listing of House and Senate study committees. Below is a summary of the committees GHF will be actively engaged on the advocacy and policy fronts:
Senate Study Committee on Surprise Billing Practices (SR 974)
This study committee is charged with assessing laws to protect consumers against surprise billing. Surprise billing can occur when an insured consumer receives care from an out-of-network provider and is charged for the amount the insurance did not pay. In some cases consumers seek care knowing the risk. In other cases consumers end up with bills despite making appropriate efforts to stay in-network or because inadequate provider networks require them to go out-of-network to receive care they need. Surprise billing was a hot button issue during the 2016 legislative session as more consumers reported receiving a surprise bill and experiencing financial repercussions. This led to the introduction of legislation (SB 382). This legislation included a wide range of provisions for consumer notifications, network adequacy standards, independent dispute resolutions and regulatory oversight. Although SB 382 did not pass it served as a starting point for discussion and preparation for this study committee. GHF has identified surprise billing and the need for legislation that holds consumers harmless in surprise billing scenarios as a policy priority. GHF, in partnership with Georgia Watch, has been actively engaged on this issue and will present recommendation to the committee. If you are interested in providing testimony or input to this committee, please contact Senator Renee Unterman, the study committee chair. The meeting schedule has not been announced but stay tuned for updates.
Senate Study Committee on Premium Assistance (SR 1056)
This committee will closely examine models and policies for premium assistance programs as an alternative to Medicaid expansion and is anticipated to be a forum for a robust discussion about policy options to close the coverage gap. Because Georgia has not yet accepted federal funds to cover low-income Georgians through Medicaid or a Medicaid waiver, approximately 300,000 Georgians remain stuck in a coverage gap. These Georgians do not qualify for Medicaid under current rules and do not earn enough money to qualify for financial help through the Marketplace. Closing the coverage gap by opening up coverage through Medicaid to all Georgians with incomes up to 138 percent of the federal poverty level is a policy priority GHF champions. During the last legislative session SB 368 was introduced and policymakers took a first step toward conversation on ways to close the coverage gap. Although SB 368 did not pass, it sparked a process that led to the upcoming study committee. GHF will present recommendations to the committee and amplify our campaign to close the coverage through our Cover Georgia Coalition. Cover Georgia is a coalition of more than 70 organizations that have come together to educate the public, engage Georgia’s policymakers, and advocate to close the coverage gap by expanding Medicaid. To learn more about Cover Georgia click here and to join please contact Laura Colbert at email@example.com or 404-567-5016 ext. 2. Study committee appointments and meeting schedule have not been announced. If you are interested in providing testimony or input to this committee stay tuned for updates.
Senate Study Committee on Opioid Abuse (SR 1165)
In light of the rise of opioid addiction and related overdose deaths, this study committee was created to examine legislative approaches Georgia could take to curb the opioid epidemic and save lives. Committee members have been appointed and include the commissioner of public health, Director of Georgia Drugs and Narcotics agency, a pharmacist, medical doctor and citizen with personal experience with opioid overdose claim that the cases of prescription drug abuse amongst teens are rising. The first committee meeting is scheduled for September 30th in Gainesville and the second meeting will be held October 27th at the Capitol. Save the dates and we will provide more information soon. GHF in partnership with the Georgia Council on Substance Abuse will present recommendations on activating Medicaid codes to promote the use of an evidence-based substance use screening and prevention tool known as SBIRT (screening, brief intervention, and referral to treatment) statewide and a fiscal analysis of the costs and benefits of implementing SBIRT through Medicaid to the committee. To find out more about SBIRT and our Preventing Youth Substance Use Disorders coalition visit our website. If you are interested in providing testimony or input to this committee please contact Senator Renee Unterman, the study committee chair.
Other Study Committees to Watch
- Senate Study Committee on Hearing Aids for Children (SR 1091)
- Senate Study Committee on Emergency Cardiac Centers (SR 1154)
- Senate Study Committee on State Sponsored Self-Insured Group Health Insurance Plan (SR 1166)
- House Study Committee on Mental Illness Initiative (HR 1093)
- House Study Committee on Professional Employer Organizations (HR 1341)
The first month of session is behind us and there is still so much to do! We’re excited about the discussion and movement around provider directory transparency. If you’re interesting in receiving action alerts as important legislation moves through the legislative process and small advocacy actions you can take, join the Georgia Health Action Network(GHAN)!
To see a full list of bills we’re following, click here.
WHAT HAPPENED THIS WEEK
Improving Provider Directories
SB 302, the Improving Provider Directories Act, will be heard, and possibly voted on, in the Senate Insurance and Labor Committee this Thursday.
Please call or email the members of the committee to let them know that you support the Improving Provider Directories Act!
Sen. Charlie Bethel (Chairman) 404-651-7738
Sen. David Shafer (Vice Chairman) 404-656-0048
Sen. P.K. Martin (bill sponsor) 404-656-3933
Sen. Gail Davenport 404-463-5260
Sen. Marty Harbin 404-656-0078
Sen. Ed Harbison 404-656-0074
Sen. Burt Jones 404-656-0082
Sen. Joshua McKoon 404-463-3931
Sen. Renee Unterman (bill co-sponsor)
Sen. Larry Walker 404-656-0081
GHF supports updating Georgia’s network adequacy standards. We don’t expect to see legislation this year, but there are conversations happening in both chambers and in both parties. GHF will be advocating for a study committee to meet during 2016 so that the legislature will have enough information during the 2017 legislative session to debate the best standards for Georgia. To read more about network adequacy and why it matters to Georgia, check out our new policy brief.
Surprise Out-Of-Network Billing
In both the House and Senate we are still hearing strong interest in addressing surprise out-of-network billing. It is probable that we will soon see a bill that adresses this issue and we will keep you updated on any such developments.
Closing Georgia’s Coverage Gap
Rep. Stacey Abrams has sponsored HB 823, the Expand Medicaid Now Act. While we don’t expect this legislation to receive a hearing this year, it is sparking important conversations about the coverage gap in Georgia. Read more here.
This week we are highlighting in our Consumer Health Advocacy Today video series a conversation with Representative Debbie Buckner on her health priorities for the 2016 legislative session.
GHF and Georgia Watch host policy forum on network adequacy, surprise out-of-network billing, and provider directory accuracy.
Early in February, GHF and Georgia Watch partnered to host policymakers, stakeholders, and advocates at a policy panel on important health insurance consumer protections. The event opened with remarks from Senator Dean Burke and included presentations from Consumers Union’s Julie Silas, Georgia Watch’s Beth Stephens, and GHF’s Meredith Gonsahn. If you missed the event, you can find presentations and materials below!
Julie Silas’s presentation: Finding Policy Solutions for Provider Directories and Surprise Medical Bills
Meredith Gonsahn’s presentation: Improving Network Adequacy and Provider Directory Standards in Georgia
Who was there? Check out the photo album.