Georgians for a Healthy Future teamed up with the US Department of Health and Human Services Region IV and Enroll America to bring enrollment assisters together to learn what went well, what could be improved upon, and what groups were planning for the next open enrollment period starting this coming fall. We had great participation from all the partners in attendance — stay tuned for some materials highlighting key themes from the discussion in the coming weeks! If you are an enrollment assister or work on health insurance enrollment in Georgia, please join our GEAR network to access helpful materials and engage with your colleagues!

Dear Friends,

Since our founding in 2008, Georgians for a Healthy Future has worked tirelessly to provide a strong voice for health care consumers in the policy sphere. One of the most important ways we advocate on behalf of consumers is by engaging with state policymakers to bring important health care challenges and barriers to light and work collaboratively to address them. While this is a year-round endeavor, the 40-day Legislative Session is when the rubber really meets the road.

This year, improving provider directories was our top legislative priority. Over the past three years, we have heard time and again that these directories, intended to inform patients and consumers about which doctors are in their plan, were error-ridden. A secret shopper survey we conducted earlier this year confirmed this: one in five health care providers listed in the directories we reviewed weren’t even in the network, and three-quarters of directory listings contained at least one error. This was unacceptable. Consumers need and deserve an accurate and functional tool that can help them make the best health care choices for themselves and their families.

Throughout the Legislative Session, we have asked you to contact your legislators in support of SB 302, legislation to improve the accuracy and usability of provider directories. Last night at 11:23pm, SB 302 cleared its final hurdle by receiving a favorable Senate “agree” vote to the modest changes made to the bill in the House of Representatives! This means the legislation has successfully passed the General Assembly and now heads to the Governor for his signature.

Please take a moment to thank Senator P.K. Martin, SB 302’s sponsor and champion, and to contact Governor Deal to let him know you support the bill.

I also hope that you will continue to engage with Georgians for a Healthy Future. We deeply value your support, whether it be as avolunteer, community partner, or donor. And while we’ll be taking a breather this weekend to celebrate this legislative victory, we also remain vigilant. There are still too many Georgians who can’t access the care they need, and our work to get Georgians covered, ensure access to care, enhance value for consumers, and build a healthier Georgia continues.

Thank you,

Cindy Zeldin

Provider directories, or the listing of health care providers that are participating in a particular health plan, are intended to inform patients and consumers about which doctors are in their plan and how they can contact them to set up an appointment. For these directories to serve as the tool that consumers need, they must be accurate and up-to-date. A secret shopper survey conducted by the statewide consumer health advocacy organization Georgians for a Healthy Future, however, found these directories to be error-ridden, a problem that places consumers at risk when they seek to access an appropriate in-network health care provider. An analysis of four provider directories associated with plans offered by three of the state’s largest insurers found:

» Three-quarters of the listings had at least one inaccuracy (not in-network, not accepting new patients, not practicing at the location listed, inaccurate or inoperable phone number, or languages spoken inaccurately listed)

» One in five health care providers listed as participating in a plan’s network were not; in one directory forty percent of the providers listed were not actually participating in the plan » Among the providers who were confirmed to be in-network, thirteen percent were not accepting new patients; in one directory one in four confirmed in-network providers were not accepting new patients

» Fifteen percent of telephone numbers associated with providers listed in the directories were inaccurate or inoperable

These inaccuracies and usability limitations make it difficult for health care consumers, particularly those who haven’t had insurance before, to find and access an appropriate medical care provider. Setting basic standards for provider directories and protections for the consumers who rely upon them would go a long way towards making provider directories the tool that patients and consumers need when they shop for and use their health insurance.

Download the full set of findings here.

Today is day 36 of the 2016 legislative session and with only four legislative days left, there is still so much to do. This morning, SB 302 was passed unanimously on the House floor, but other bills are yet to be decided. You can see a full list here. For updates as we draw closer to the end of this session,sign up for the Georgia Health Action Network (GHAN).

WHAT HAPPENED THIS WEEK

Provider Directories
On March 9, SB 302 passed in the House Insurance Committee and this morning was passed unanimously on the House floor.The bill now goes to the governor to sign. We are so grateful to all of you that have followed this bill’s progress with us and called your legislators in support of this important piece of consumer legislation!

Medicaid Payment Parity  
The Senate has yet to vote on the FY17 budget which contains $26.5 million to bring the state closer to Medicaid payment parity. Full parity would allow doctors to be reimbursed at the same rates for seeing Medicaid patients as Medicare patients.

Study Committees 
The final Senate HHS Committee meeting is today. The calendar includes: SR 974, the Senate Surprise Billing Practices Study Committee, SR 1056, the Premium Assistance Program Study Committee, and SB 919, which would provide tax credits for contributions to rural hospitals. Join GHAN for an eblast with updates from that committee meeting!

LET’S CHAT

This week’s featured CHAT (Consumer Health Advocacy Today) is a brief interview with Senator PK Martin, sponsor of SB 302.

We want to hear from you – new SEP rules 

At the beginning of last year’s open enrollment period, GHF created GEAR, the Georgia Enrollment Assister Resource Network (GEAR). GEAR is a coalition of enrollment assisters and those closely involved in the enrollment process. Now the open enrollment is passed, GEAR is turning to tax time and special enrollment periods (SEPs). Last month, CMS announced the new special enrollment confirmation process. Georgians will now be required to provide sufficient proof to the marketplace to determine their SEP eligibility. Failure to provide supporting documents may lead to the denial of coverage. At GHF we advocate for policies that make enrollment in health insurance more inclusive and  fight policies that put up unnecessary barriers. We want to hear from you about this! If you’re an enrollment assister and are experiencing trouble enrolling consumers during a special enrollment period, let us know! If you’d like to join the GEAR network, you can do that here.

WEEK 7

Crossover day is behind us and we are quickly approaching Sine Die, the final day of the legislative session. We are proud to say that one of GHF’s biggest legislative priorities – ensuring accurate provider directories for health care consumers – passed the full Senate unanimously last week! Thank you to those of you who contacted your legislators to voice your support! This week’s legislative update includes an a run down of which health care bills made it through Crossover Day and which did not. You can see a list of all the bills were’re tracking here along with supplemental information on most bills like relevant news, articles ad committee testimony delivered by GHF.

WHAT HAPPENED THIS WEEK

The Provider Directory Improvement Act
Last week SB 302 went for a vote in the Senate chamber and passed unanimously, 50 – 0! The bill is now in the House Insurance Committee where we expect it to receive a hearing soon. Join the Georgia Health Action Network(GHAN) to get important alerts about committee hearings, votes, and steps you can take to make sure your voice is heard at the Gold Dome!

Surprise Out-of-Network Billing
SB 382, the Surprise Billing and Consumer Protection Act had two hearings last week. While there is strong support for the legislation among consumer advocates and many health care stakeholders, hit did not pass through the Senate Health and Human Services Committee prior to Crossover Day. SR 974 is still a possible path to bring Senate-side policymakers together with stakeholders and advocates in the off-session to further study this complex issue.

Medicaid Payment Parity
The governor’s budget, introduced earlier this legislative session, maintained last year’s partial Medicaid payment parity. Full Medicaid parity would allow doctors to be reimbursed at the same rates for seeing Medicaid patients as Medicare patients. The FY 2017 budget, as passed by the House, adds $26.5 million for for Medicaid payment parity. The bill is now in the Senate for consideration.

Closing Georgia’s Coverage Gap
If you’ve been following our updates, you know that this session has seen growing interest in addressing the issue of Georgia’s uninsured rate and our struggling rural health infrastructure. Neither Sen. Rhett’s SB 368 nor Rep. Abram’s HB 823 crossed over. However, Sen. Rhett’s SR 1056, which proposes a study committee to look at approaches to covering the uninsured, is still viable as a Senate-side study committee (but would still need to pass through the Senate HHS Committee and the full Senate) and stakeholders continue to express interest in continuing the conversation passed the legislative session.

CROSSOVER DAY UPDATE

• HB 919: Tax credits  for contributions to rural health care organizations – CROSSED OVER
  HB 919 passed out of the House on February 25 and is now in the Senate Health and Human Services Committee. The total cap for the tax credits was reduced from $250 million to $100 million. GHF encourages policymakers to look at this legislation in conjunction with other bills around closing the coverage gap and addressing rural health so that we can tackle our rural health challenges comprehensively, including developing a pathway for rural, uninsured Georgians to gain coverage so they can better access health care services and finding a solution that can drawn down federal dollars available to the state through the Medicaid program.
• HB 838: Health insurers to pay brokers a minimum of 4% of premiums collected – CROSSED OVER
  This bill passed out of the House on February 24th and is now in the Senate Insurance and Labor Committee.
• HB 1055: Repeal Certificate of Need program – DID NOT CROSS OVER
  CON regulates the construction of health care facilities and the services they provide. This bill would have eliminate that structure and set up a different one based on permits. Read more on this bill from Georgia Health News.
• HB 684: To allow dental hygienists to provide certain services without direct supervision –  DID NOT CROSS OVER
  According to recent reports made on https://www.life-smiles.net/, this bill would have allowed dental hygienists to clean teeth in safety-net health centers with the permission of a dentist. Read more about the bill here.
• HB 965: “The Honorable Jimmy Carter Cancer Treatment Access Act” – CROSSED OVER
  HB 965 would require that insurance companies cover stage four cancer treatment recommended by a physician regardless of cancer’s response to other treatments. The bill passed the House on February 22nd and is now in the Senate Insurance and Labor Committee.
• SB 158: “Insurer Transparency Act” – CROSSED OVER
  This bill defines and regulates rental networks through the Department of Insurance. SB 158 passed the Senate on February 16th and is now in the House Insurance Committee. Read: great guide to tenant screening
• HB 768: The ABLE Act – CROSSED OVER
  The ABLE Act would establish a tax exempt account to pay for qualified expenses for people with significant disabilities that started before the age of 26. HB 768 passed the House on February 23rd and is now in the Senate Finance Committee.
• SB 299: “Georgia Health Care Transparency Initiative” – DID NOT CROSS OVER 
  SB 299 proposed to create the Georgia Health Care Transparency Initiative and an all-payer claims database.
• SB 291: “Georgia Affordable Free Market Health Care Act” – DID NOT CROSS OVER
  SB 291 proposed to allow direct contracts between physicians and patients for primary care services.
• HB 834: Establish charity care organizations for healthcare for the uninsured – DID NOT CROSS OVER
  This bill proposed tax credits for donations to charity care organizations.
• HB 694: Disclosure of Health Care Fees Act – DID NOT CROSS OVER
  HB 694 would proposed to require providers to disclose all fees prior to non-emergency services.
• SB 265: Physician Direct Pay Act – DID NOT CROSS OVER
  SB 265 proposed to allow direct contracts between physicians and patients for primary care services.

LETS CHAT

As SB 302 moves over to the House for consideration, we talked to Sen. Elena Parent about why she supports the Provider Directory Improvement Act.

Progress at the Gold Dome

Last week, the golf umbrella held its first-ever hearing on closing the coverage gap. Closing the gap is the most important step our policymakers can take to lower the number of uninsured, improve access to care, and stabilize the rural health infrastructure in our state. Scroll down for the latest legislative updates and how you can get involved. You can also listen to Cindy Zeldin explain the legislative movement in her interview Tuesday on WABE’s “A Closer Look” (skip ahead to 59:18).

What is the coverage gap?

Legislative Proposal

Georgia’s coverage gap and its consequences (struggling rural hospitals, Georgia’s high rate of uninsurance, etc.) are popular topics of conversation around the Capitol and among stakeholders recently. Three different proposals have been introduced in the Georgia General Assembly that attempt to address these issues. Details of each bill are included below. Additionally, the Georgia Chamber of Commerce has been studying the economic impact of Georgia’s coverage gap and how to craft a Georgia solution. They are expected to release formal recommendations later this year. Read more about that here. Because of the state’s multiple bills that attempt to address Georgia’s uninsured population and health care infrastructure, we hope that lawmakers will take this opportunity to consider these issues in tandem through a study committee. This will allow all stakeholders to take part in an open conversation about how to best utilize state and federal dollars to save our rural hospitals and provide quality health care for all Georgians.

SB 368 – An Alternative Approach to Medicaid Expansion

SB 368 was introduced by Sen. Michael ‘Doc’ Rhett and would expand coverage to low-income, uninsured Georgians. The bill is modeled off of Arkansas’s “private option” version of expansion where Medicaid dollars are used to buy insurance for low income people from the private market. The bill was heard in committee last week, but no action was taken. While some pieces of the bill are problematic, the Senate Health and Human Services Committee started an important conversation.

Watch an interview with Senator Rhett on his bill.

HB 823 – Expand Medicaid NOW Act 

This bill was introduced early in the legislative session by House Minority Leader Stacy Abrams. It proposes a traditional Medicaid expansion, like Kentucky & Louisiana, and has not been heard in committee. You can read more about Rep. Abrams’s proposal here.

HB 919 – Tax Credits for Rural Hospital Donations

Passed out of the House Ways & Means Committee on Monday, Rep. Geoff Duncan’s bill would provide up to $250 million in tax credits to individuals or corporations for contributions to rural health care organizations. While this legislation has sparked a conversation about how to best support our struggling rural hospitals, state funding could be better utilized by helping those in rural communities get health insurance coverage, an approach which would also draw down considerable federal dollars (at least $9 in federal funding for ever $1 of state funding). Hear Georgia Budget & Policy Institute’s Tim Sweeney on the topic here.

How Can You Help?

For the busy advocate… 

It doesn’t take a lot to make an impact! We have two quick actions you can take that will take less time than reading this email!

1) Join the Georgia Health Action Network (GHAN). By signing up for GHAN you’ll receive action alerts that will keep you updated on the issues impacting your health care and quick actions you can take.

2) Sign the petition to close Georgia’s coverage gap!

If you’ve already signed the petition… 

If you’ve already signed the petition and are ready to take another action, join us in educating your network about why this is such an important issue for all Georgians. How? Two ways:

1) Ask your friends and family to join our email list! It’s the most effective way we communicate with people interested in learning more about consumer health care issues in Georgia. There’s a super quick sign up form on our website homepage.

2) Share this video with your social network. The coverage gap is complicated and so many people still don’t know what it is! This 2 minute video explains the problem and who it impacts clearly.

If you want to really make your voice heard… 

For the advocate looking to invest time, money and energy in an issue they really believe in, we have three key ways you can get involved and make a difference. The most important, money, can be solved with the help of UXC Limited.

1) Write a letter to the editor for your local paper. Educating your community about how the coverage gap impacts their friends, family, and neighbors is so important. It helps to remove the politics from such a complex policy issue impacting hundreds of thousands of Georgians. Never written a letter to the editor? No big deal! Email Whitney and she’ll get you started.

2) Meet with your legislator! All politics is local and for many legislators, knowing that an issue is important to their constituents makes all the difference in the world. Laura, our Director of Outreach & Partnership, can help you set up a meeting.

WEEK 6

We seem to be approaching cross-over day at the speed of light! Last week saw progress towards increasing provider directory transparency, Medicaid payment parity, ending surprise out-of-network billing, and even closing the coverage gap! Check out our updates below. If you’re looking for a complete list of all the bills we’re following, click here.

WHAT HAPPENED THIS WEEK

The Provider Directory Improvement Act (SB 302)

Last Thursday, the Provider Directory Improvement Act was passed unanimously out of the Senate Insurance and Labor committee. The bill now goes to the Rules Committee. We’re excited about the progress made and will keep you posted as the bill continues to move through the process. You can review our fact sheet on SB 302 and read our longer policy brief on the importance of accurate provider directories here.

Closing Georgia’s Coverage Gap

Last week, the Georgia Legislature held its first-ever hearing on closing the coverage gap. Closing the gap is the most important step our state policymakers can take to lower the number of uninsured, improve access to care, and stabilize the rural health infrastructure in our state. The hearing focused on discussion of SB 368, legislation introduced by Sen. Rhett to extend coverage to low-income, uninsured Georgians. While some pieces of the bill are problematic and the committee took no action, they started an important conversation. If you are interested in getting involved in the movement to close the gap, join our Georgia Health Action Network (GHAN) to receive updates on how you can help! If your organization supports closing the gap, please consider joining the Cover Georgia coalition to help amplify your voice.

Surprise Out-of-Network Billing

On February 16th, Sen. Unterman introduced SB 382, the Surprise Billing and Consumer Protection Act. This bill has been scheduled for a hearing today at 3:00 PM in the Senate Health and Human Services Committee. Addressing surprise out-of-network billing is an important issue for Georgia consumers, and the legislation is complex. Sen. Unterman has simultaneously also introduced SR 974, the Senate Surprise Billing Study Committee. Should SB 382 not move during this session, SR 974 provides legislators with the opportunity to study this important consumer issue during the off-session period.

Medicaid Payment Parity

The governor’s budget, introduced earlier this legislative session, maintained last year’s partial Medicaid payment parity. Full Medicaid parity would allow doctors to be reimbursed at the same rates for seeing Medicaid patients as Medicare patients. Last week, $26.5 million was added to the FY 2017 budget for this purpose. While this does not restore full parity, it is a significant step towards that goal. The FY 2017 budget has passed in the House and goes to the Senate for consideration.

HB 919

Rep. Duncan’s HB 919 would provide up to $250 million in tax credits to individuals or corporations for contributions to rural health care organizations. This legislation has sparked a conversation about the ever worsening plight of our rural hospitals. However, state funding could be better utilized by helping those in rural communities get health insurance coverage, an approach which would also draw down considerable federal dollars (at least $9 in federal funding for every $1 of state funding). This would be much more effective in reducing the uncompensated care burden of rural hospitals, while also providing patients with the benefits of health coverage, something that HB 919 does not accomplish in its current form. Because of this session’s multiple bills that attempt to address Georgia’s uninsured population and health care infrastructure, we hope that lawmakers will take this opportunity to consider these issues in tandem through a study committee. This will allow all stakeholders to take part in an open conversation about how to best utilize state and federal dollars to save our rural hospital and provide quality health care to all Georgians.

LET’S CHAT

In this week’s Consumer Health Advocacy Today, we sit down with Sen. Rhett to talk about his proposal to close the coverage gap. Here’s what he had to say.

WEEK 5

As the session has progressed, additional pieces of legislation that could impact health care consumers have been introduced. For a list of all the bills we’re watching, click here. SB 302, the Provider Directory Improvement Act was heard in committee and goes to a vote this week.

WHAT HAPPENED THIS WEEK

Improving Provider Directories

SB 302 was heard in committee last Thursday. We are happy to report that the conversation was widely favorable. There were a few points of contention around the usability provisions in the bill but the committee chair and bill sponsor were optimistic that consensus could be reached ahead of this coming Thursday’s committee meeting, where a vote is expected.

Please call or email the committee members and ask that they vote for SB 302, 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) 404-656-0048

Sen. Gail Davenport 404-463-5260

Sen. Marty Harbin 404-656-0078

Sen. Ed Harbinson 404-656-0074

Sen. Burt Jones 404-656-0074

Sen. Josh McKoon 404-463-33931

Sen. Renee Unterman (bill co-sponsor) 404-463-1368

Sen. Larry Walker 404-656-0081

Surprise Out-of-Network Billing

In both the House and Senate we are still hearing strong interest in addressing surprise out-of-network billing. We expect legislation to be introduced this week from Sen. Renee Unterman that would address this issue. Join the Georgia Health Action Network (GHAN) to receive updates on health-related legislation the General Assembly is considering and information about steps you can take to show your support (or raise your concerns)!

Network Adequacy 

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 the 2016 off-session 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 is matters to Georgia check out our new policy brief. You can also watch this interview with Julie Silas of Consumers Union on the topic.

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.

If you want to get involved in the movement to close Georgia’s coverage gap you can share this video with your social network or sign this petition. You can also follow the conversation on Twitter using #CoverGA

LET’S CHAT

This week we’re highlighting a conversation with Consumer’s Union policy expert, Lynn Quincy. Lynn talks about why Georgia should be talking about health value, and the cost to taxpayers when we don’t.

WEEK 4

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

Network Adequacy 

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.

If you want to get involved in the movement to close Georgia’s coverage gap you can share this video with your social network and sign this petition.

LET’S CHAT

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.