FY 2018 budget approved

Last week, the General Assembly’s conference committee approved final changes to the FY 2018 budget, the final step before the budget is sent to the Governor for his signature. The final budget includes several important items that facilitate access to health care in Georgia:

• $1 million for four new federally qualified health centers (FQHCs) in Cook, Lincoln, Lowndes, and Seminole counties
• Increased Medicaid reimbursement rates for certain primary care codes
• Increased Medicaid and PeachCare for Kids reimbursement rates for certain dental codes
• $500 add-on payments for newborn delivery in rural areas
• $2.5 million for Medicaid behavioral health services for children ages 0-5
• $7.7 million for supportive housing for adults with behavioral health needs

Surprise billing legislation stalled 

SB 8 was scheduled to receive a House vote on Friday, but instead was recommitted to the House Rules committee for possible changes or amendments. Advocates are urging legislators to utilize this last week of the legislative session to maintain meaningful protections for consumers rather than watering down the legislation to simply require a disclosure that consumers may be billed by out-of-network providers. Health should be an important topic in your life, if you suffer of any health issues such as stress or depression buy kratomand get the results you desire.

Opioid antagonist bill approved by House 

SB 121 was approved by the House on Friday and now only needs the Senate to formally agree to their changes before it is sent to the Governor for his signature. This legislation codifies Governor Deal’s executive order to allow consumers to access opioid antagonist drugs (e.g. Naloxone) over-the-counter without a prescription.

Bill establishing “Georgia Mental Health Treatment Task Force” approved  

SB 4 passed the House of Representatives on Friday with some minor changes. The approved version of the bill provides for a committee of 21 members, rather than the previously proposed 17. The bill was changed at the last minute to include a person with diagnosed mental illness, a family member of a person with a diagnosed mental illness, a licensed professional counselor, and a licensed emergency medical technician or paramedic as members of the committee. The task force is charged with examining the current mental health landscape in Georgia, how Medicaid and other health care services provide the appropriate care for people with mental illness or substance use disorders, and determine what changes may need to be made in and outside of Medicaid to better address the mental health needs of Georgians. The task force may propose an 1115 waiver that addresses these changes for consideration by the General Assembly during a future session.

Prescription Drug Monitoring Program bill approved 

Last week also brought the approval of HB 249 a bill that mirrored SB 81 which we previously covered. This bill moves the Prescription Drug Monitoring Program (PDMP to the Department of Public Health from the Georgia Drugs and Narcotics Agency. HB 249 requires that all physicians register and consult the PDMP under certain prescribing conditions and that providers report certain benzodiazepine  and opioid-based prescriptions to the database. 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.

Thank you!   

Today the American Health Care Act was pulled from the floor of the House of Representatives rather than receiving a vote. Today’s outcome is a victory for health care consumers in every corner of this state. The American Health Care Act would have caused more than half a million Georgians to lose their coverage entirely while doing nothing to improve affordability or quality of care. In fact, it would have led to higher deductibles while stripping consumers of critical protections. It would have forced unconscionable cuts in health care services for vulnerable children, people with disabilities, and seniors who rely on Medicaid for their most basic health needs. Instead, the Affordable Care Act remains the law of the land.

Your voice mattered today. We know how hard you all have worked over the last several weeks to achieve this victory. Your calls, emails, social media activity, and rallies made this possible, and Georgians are better off for it today. Thank you for your dedication and your advocacy!

Our work is not over

While we celebrate today, we know our work is not over. Now it’s time to build on the framework of the Affordable Care Act at the state level to make sure all Georgians can get the coverage and care they need. This means taking a fresh look at expanding Medicaid as well as using every tool in the toolbox to improve our state’s health insurance market so it works as well as it possibly can for all consumers. We look forward to working towards these goals with you to create a healthier future for all Georgians.

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 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. SkinPractice, 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. Taking care of your health is extremely important, this is why I recommend using a waist training for when you workout or simple just do your daily routine. 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!

For the past several years, GHF, Georgia’s enrollment assisters, and other enrollment stakeholders have spent this season reflecting on our work during the preceding open enrollment period and celebrating the accomplishments in connecting people to coverage all over the state of Georgia. But with all of the news about the very real threats to the Affordable Care Act and Medicaid in the past several weeks, the impressive work of Georgia’s enrollment assistance community has been overlooked this year. This year’s open enrollment period was unique, in that it spanned Presidential administrations and is the first OEP in which assisters did not have the dedicated support of the federal government. Obstacles and roadblocks were constructed towards the end of OE4 that made enrolling consumers in coverage more difficult than usual, and that made the work of enrollment assisters all the more critical.  Despite the hindrances and because of the long hours and dedication of Georgia’s enrollment assisters, 493,880 Georgians selected insurance plans through the Marketplace. While this number may seem disappointing when compared to OE3’s 587,845 plan selections, it is a big victory won in an environment of confusion and opposition by clear-eyed assisters for the Georgians they serve. Thank you to all of the assisters across the state that contributed to the success of OE4!

The work of enrollment assisters will only grow in importance in the coming year. In the short term, the stories of our state’s enrollers and the Georgians that they connect to coverage are the most powerful tool available to fight the repeal of the ACA and cuts to Medicaid. If repeal is held off, the new administration has made it clear that consumers will not be prioritized. The newly proposed rules from CMS will make it harder for consumers to enroll or to afford Marketplace coverage, and Georgians will need help navigating the procedures. Community outreach will be necessary to calm worried or confused consumers who do not know how they are impacted. Partnerships with the media and community groups will be instrumental in informing Georgians about how and when to enroll, and what coverage options they have available to them. All of this, and the administration has not said what financial or technical support it will offer enrollment assister programs or assisters going forward.

In this year’s uncertain and shifting health policy climate, enrollment assisters are a trusted resource valued by Georgians and their communities, and will remain essential to the success and endurance of the ACA. Thank you to all of Georgia’s enrollment assisters! We have enjoyed working with you over the past four open enrollment periods and look forward to many more.

Call your Congressman today!

Last night Congressional leadership introduced their 2017 budget reconciliation bill, the vehicle they plan to use to repeal significant parts of the Affordable Care Act and dismantle Medicaid as we know it. Very soon, we expect the Ways and Means and Energy and Commerce Committees to begin advancing the bills toward a vote.

Two people need to hear from you today: your Congressman and Georgia Representative Buddy Carter (District 1), who sits on the Energy and Commerce Committee. Call them both to urge them to oppose any effort to strip away consumer protections, repeal the Affordable Care Act and gut Medicaid. They need to hear that Georgians (YOU!) oppose any plan that:

• Would strip away health care from an estimated 15-20 million Americans, including 1 million Georgians, and repeal consumer protections for millions more;
• Would undermine care for kids, people with disabilities, and older adults, shift costs onto Georgia’s budget and increase uncompensated care through Medicaid cuts; and
• Would substantially decrease financial assistance for low and middle income families who try to purchase health coverage, making insurance less affordable, for those who have health questions, it is necessarily that they take a look at GynoGuide information.

Step 1: Call your Congressman at 1-866-426-2631 to tell him that you oppose the 2017 budget reconciliation bill because it restructures and cuts Medicaid and repeals important parts of the ACA.

Step 2: Call Congressman Carter at (202) 225-5831 to tell him to vote “No” on the budget reconciliation bill.

Friday was Crossover Day at the Capitol, meaning a bill must cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. This week’s legislative update provides a rundown of consumer health legislation: which bills made it through and which did not. You can see a list of all the bills we’re tracking here, along with more information about the bills included here.

Our Priorities

One of two surprise billing bills moves forward

As previously reported, SB 8 passed the Senate almost two weeks ago, but HB 71 did not receive a vote from the full House before the Crossover Day deadline. While HB 71 will no longer be considered on its own, lawmakers could include some of the bill’s language in SB 8 as it moves through the House Insurance committee. We anticipate that consumer protections and transparency requirements will be maintained as the bill progresses through the House.

State budget includes important health items

The FY 2018 budget passed the House in mid-February and is now being considered by the Senate. As passed by the House, the budget includes increased Medicaid reimbursement rates for certain primary care codes and pediatric dental codes at any dental office, which help to increase access to care for people with Medicaid coverage. The budget also includes funding for two new federally qualified health centers in Cook and Lincoln counties. Additionally, the budget includes enhanced funding for supportive housing, an important determinant of health for people with behavioral health issues.

Crossover Day Recap

HB 54: Changes to rural hospital tax credit  |  DID NOT CROSSOVER

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 188: Expand Medicaid NOW Act  |  DID NOT CROSSOVER

Sponsored by House Minority Leader Stacey Abrams, this bill was not expected to gain much traction because of the evolving health reform efforts at the federal level. However, 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.

HB 276 & SB 103:  The Pharmacy Patient Fair Practices Act  |  CROSSED OVER

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 certain practices that limit consumer access and choice to preferred pharmacies and to lower cost drugs. Both bills passed their respective chambers.

HB 300: Planning for new FQHCs in Georgia  |  DID NOT CROSSOVER

This bill moves the State Health Benefit Plan (SHBP) from the Department of Community Health (DCH) 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 also establishes a task force that is charged with identifying 100 potential sites for new FQHCs across the state, and advising the DCH 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.

SB 12 &  HB 154: Oral health legislation  | CROSSED OVER

Both bills allow for the “general supervision” of dental hygienists, which means hygienists can practice in safety net settings, school clinics, nursing homes, and private practices without a dentist being present.

SB 70: Renewal of the provider fee  |  SIGNED INTO LAW

This legislation reauthorized the provider fee (aka “bed tax”) for an additional three years. 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. The bill has already passed both chambers and been signed by Governor Deal.

SB 81: Opioid abuse prevention legislation  | CROSSED OVER

SB 81 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 allows the Composite Medical Board to set the penalty for willfully non-compliant providers. 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.

SB 121: Opioid abuse antagonist bill  | CROSSED OVER

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.

Other updates from the Capitol

Senate “Repeal and Replace” Task Force

Early in the legislative session, the Senate established a task force to address impacts to Georgia from any federal changes to the Affordable Care Act. This committee has convened twice, but has not yet scheduled a public meeting. It is unlikely to be a very active committee until there is clarity at the federal level about the direction of health care policy changes, and which provisions or concepts of the ACA will be kept or repealed.

HR 182: Resolution to restructure Georgia’s Medicaid program

HR 182 was introduced 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. It remains unclear if this resolution will get a hearing or a vote.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. Check out GHF’s block grant fact sheet for more information about the dangers of restructuring the Medicaid program. Resolutions do not need to pass one chamber by Crossover Day because they can be adopted by a single chamber. As a result, this resolution remains viable in the House.

As the health care debate ramped up in Washington, February’s Congressional recess presented opportunities for Georgia’s health care advocates to voice their concerns about plans to repeal and replace the Affordable Care Act. GHF participated in two events that highlighted the progress that has been made in Georgia under the ACA and the need to build on its successes rather than repeal it. 

The week began with a rally as the Save My Care bus tour stopped at Liberty Plaza across from the Georgia Capitol.  House Minority Leader Stacy Abrams energized the crowed and spoke of the importance of health care for every Georgian. GHF’s Executive Director Cindy Zeldin reminded the audience that because of the ACA the uninsured rate in the US is lower than it has ever been before and that new consumer protections provided to Georgians with pre-existing conditions, LGBT Georgians, and low-income families helped to narrow disparities in health care access. Georgia consumers Jan and Vicki shared their stories of how the ACA has helped them access the health care they needed when they needed it. You can watch the full rally here.

On Saturday, GHF marched at the Atlanta March for Healthcare organized by the Georgia Alliance for Social Justice. Marchers traveled down Peachtree Street from Midtown to downtown’s Woodruff Park where a rally was held. Along with partner organizations active on health care issues, Cindy reminded those at the rally of how much progress had resulted from the ACA and how interconnected health care is to other social justice issues like racial, gender, and economic equality.

GHF will continue to work to #ProtectOurCare as Congress attempts to pass the American Health Care Act, a proposal that attempts to cut and cap Medicaid and increase costs for low-income families and older Georgians. We hope you’ll join us to rally, march, call, and organize for affordable, accessible, high quality health care for all Georgians.

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.

(Don’t know who your legislators are? Look them up here and find their contact information here.)

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.