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GHF legislative update: Wrapping up Georgia’s 2023 legislative session

2023 SESSION SINE DIE

The GHF team loves bringing you these weekly legislative updates, and you have told us that you enjoy reading them! Our team works hard to deliver this service to you in a complete and accurate way every week of Georgia’s legislative session. If you rely on these updates to keep you connected to the health happenings under the Gold Dome, please consider supporting our work with a donation today. Thank you very much!

The 2023 Georgia legislative session is over, but GHF is not finished!

We’ve made it to the end of the legislative session and through Sine Die (the last day of legislative session).

In this week’s update we review which notable health bills passed and which bills didn’t quite make it across the finish line. Among those bills is HB 520, this year’s mental health bill, which we cover below.

You can find a full list of this year’s health care-related legislation at GHF’s legislative tracker.


The GHF team loves bringing you these weekly legislative updates, and you have told us that you enjoy reading them! Our team works hard to deliver this service to you in a complete and accurate way every week of Georgia’s legislative session. If you rely on these updates to keep you connected to the health happenings under the Gold Dome, please consider supporting our work with a donation today. Thank you!  

LEGISLATURE FINALIZES FY24 BUDGET ON SINE DIE 

Final budget includes a few additions

The legislature cut it close this year and passed the conference committee’s version of the FY 24 budget late on Sine Die. As a reminder, the House and Senate appointed a conference committee to hammer out their remaining differences in the budget, as they do many years. Here we’ll highlight some of the conference committee’s changes to the health-related accounts of the budget and other notable budget items.

You can read our previous summaries of the Governor’s and state agencies’ FY 24 budget here, the changes the House made here, and the changes the Senate made here

  • Department of Behavioral Health and Developmental Disabilities
    • Add $200,000 each for additional staff for Certified Addiction Recovery Empowerment Specialist (CARES) Warm Line, additional staff for CARES academies, and funds to expand addiction recovery support centers
      • The conference committee added this funding
      • The CARES Academy helps to create a workforce of peers to provide recovery support services to the communities of Georgia
      • The CARES Academy to create a workforce of peers to provide recovery support services to the communities of Georgia
      • Both the CARES Warm Line and Academy are run by the Georgia Council for Recovery
    • Increase funds for 500 COMP and NOW waiver slots for a total of $9.4 million for the new waivers
      • Conference committee kept in the 500 slots from the Senate’s version of the budget
      • The House budget requested $8.1 million for 375 new waiver slots
      • The Governor’s budget requested $4.2 million for 250 new waiver slots
      • NOW & COMP waivers allow people with IDD to receive community-based services. Even with these new slots, 7,000 Georgians with IDD are still on the waiting list for a waiver
    • Add $1.9 million for increased funding for the Georgia Housing Voucher Program (GHVP)
      • This funding was included in the Governor’s request, the House and Senate budgets, and the final budget
      • The GHVP provides permanent supportive housing to eligible individuals who are experiencing severe and persistent mental illness and meet other criteria, in order to promote recovery, independence, and integration into the community. This increased funding was included to support the requirements of the state’s settlement with the Department of Justice over housing for people with mental illness.
    • Restored $1.4 million for the Georgia Mental Health Consumer Network (GMCN) for peer support services
      • The House added $2.7 million and the Senate cut the funding entirely
      • This funding was not included in the Governor’s budget
    • Remove $300,000 increase in funds to hire staff to support the administration of the federal opioid settlement funds
      • The conference committee maintained this cut made by the Senate
      • The funding was not included in the Governor’s budget. The House added it
      • The federal opioid settlement provides Georgia with hundreds of millions of dollars from companies involved in the distribution and sales of prescription opioids. If leveraged correctly, these funds can help the state prevent opioid overdose deaths and prioritize prevention programs
  • Department of Community Health
    • Add $1 million in funding for a remote maternal/fetal health monitoring program for Medicaid eligible high-risk pregnant persons
      • The conference committee maintained this funding which was added by the Senate
      • These funds were not included in the House or Governor’s budgets
      • This funding is tied to SB 106, which establishes the remote maternal/fetal monitoring program
    • Direct DCH to submit a State Plan Amendment (SPA) to CMS to allow for Medicaid reimbursement for services provided by licensed professional counselors, licensed marriage and family therapists, and certified peer support specialists at federally qualified health centers (FQHCs)
      • This direction was added by the conference committee
      • This agency direction was taken from HB 520, the mental health reform bill
    • Maintain $500,000 in start-up grants for 2 federally run qualified health centers (FQHCs)
      • The Senate reduced the funding down to 2 FQHCs and the conference committee maintained that cut in the final budget
      • The House included $750,000 for 3 FQHCs
      • These funds were not included in the Governor’s budget
      • The funding goes towards establishing a school-based health center in Emanuel country and a behavioral health expansion at Christ Community Health Clinic in Augusta. The House’s budget would have also funded a new primary care clinic in Union City.
    • Maintain $2.7 million to provide dental coverage for adults on Medicaid
      • This funding was not included in the Governor’s budget.  It was added by the House
      • Currently, Medicaid only covers emergency dental services for adults on Medicaid. Allowing Medicaid to reimburse for preventive and routine dental services will allow more low-income Georgians to access much needed oral health care
    • Add funding to remove the 5-year waiting period for pregnant women and children who are lawful permanent residents
      • This funding was not included in the Governor’s budget. It was added by the House
      • Currently, immigrants to Georgia must be lawful permanent residents for 5 years before becoming eligible to apply for Medicaid, even when they meet all of the normal eligibility requirements. Removing this waiting period means that immigrants that are legally in the state will be able to access quality health care through the state’s Medicaid program
    • Add $19 million to bring certain primary care and OBGYN Medicaid reimbursement codes up to 2021 Medicare levels
      • This funding was included in the final budget
      • This funding was not included in the Governor’s budget. It was added by the House
      • Traditionally, Medicaid reimburses at a lower rate than Medicare, which means that providers have less of an incentive to see Medicaid patients. By bringing up reimbursement rates to Medicare levels, providers will receive more money for seeing Medicaid patients. The increased rate incentivizes more providers to take Medicaid and, thus, improve access for Medicaid members
  • Office of the Governor – Office of Health Strategy and Coordination (OHSC)
    • Transfer $800,000 to OHSC from DCH for the All-Payer Claims Database (APCD)
      • This funding was included in all versions of the budget. It simply transfers money given to DCH for the APCD before the Office of Health Strategy and Coordination was up and running
    • Direction to OHSC to coordinate and facilitate inter-agency cooperation to develop a State Plan Amendment (SPA) to support youth behavioral and mental health conditions
      • This direction was added by the conference committee
      • This direction was taken from language in HB 520, the mental health reform bill
  • Department of Human Services
    • Provided $32.7 million to support 450 caseworkers, 75 supervisors, and 1 district manager for Medicaid redeterminations during the Medicaid unwinding and make their positions permanent
      • The House budget included $11 million in the FY23 budget to make 300 eligibility caseworker positions permanent
      • The Governor’s budget requested $3.2 million for an additional 300 caseworkers
      • Starting April 1, DFCS began Medicaid redeterminations for almost all 2.7 million Georgia Medicaid members. These additional caseworkers are critical to this massive undertaking and to reducing the number of Georgians who lose their Medicaid coverage due to administrative errors
  • Department of Insurance
    • Provided $46 million for the health insurance reinsurance program
      • DOI originally asked for $92 million, which was included in the Governor’s budget. The House cut it to $61 million and the Senate increase the funding to $173 million. However, the conference committee cut the funding to half of what was originally requested
      • Georgia’s reinsurance program helps to lower premiums for Georgians who purchase their own coverage and for some small businesses. This funding cut could result in higher premiums for 2024
  • Department of Public Health
    • Add $1.7 million for a pilot home visiting program for at-risk and rural communities during pregnancy and early childhood to improve birth outcomes, reduce pre-term births, and decrease infant and maternal mortality
      • The Governor’s budget did not include this funding, it was added by the House
    • Add $931,111 for the PrEP access program, including an expansion of PrEP services in four public health districts
      • This funding was added by the Governor and maintained in each version of the budget.

FINAL LEGISLATIVE ACTION FOR 2023

HB 85: Insurance coverage for biomarker testing | PASSED

HB 85, introduced by Representative Sharon Cooper, HB 85 would require insurance companies to cover comprehensive biomarker testing. Biomarker testing allows patients to receive treatments for diseases, like cancer, that are tailored to the genetic make-up of the disease. Once the specific biomarkers have been identified, doctors are able to select the right medication without having to try other, less-effective drugs first. This bill passed the House and Senate and is currently waiting to be signed by the Governor.


HB 129: Expanding TANF for families | PASSED

HB 129, introduced by Representative Hong Soo, would expand Temporary Assistance to Needy Families (TANF) to pregnant women who meet TANF eligibility criteria. TANF is a cash assistance program for families with children and with very low incomes. To be eligible for TANF, adults must meet a 30-hour-a-week work requirement on top of other activity and financial obligations. TANF benefits are about $280 per month for a family of 3 (which is about 15% of the federal poverty level). This bill passed the House and Senate and is currently waiting to be signed by the Governor.


HB 295: Updates to Georgia’s surprise billing law | PASSED

HB 295, introduced by Representative Lee Hawkins, would update Georgia’s surprise billing law to address a few implementation issues that have arisen now that the law has been in place for two years. The changes are primarily around the provider-insurer arbitration process and do not impact consumer protections from surprise out-of-network medical bills. This bill passed the House and Senate and is currently waiting to be signed by the Governor.


SB 20: The Consumer Access to Contracted Healthcare (CATCH) Act | PASSED

SB 20 was introduced by Sen. Kay Kirkpatrick and is titled the Consumer Access to Contracted Healthcare (CATCH) Act. The original intent of the CATCH Act was to set network adequacy standards for insurers and provides consumers with protections when they are forced to go out of a health plan’s network of providers to access timely care. The bill was weakened substantially before being approved by the Senate, so consumers may not get the benefits of the original bill. This bill passed the House and Senate and is currently waiting for the Governor’s signature. 


SB 47: Update the Indoor Air Quality Act | PASSED

SB 47, sponsored by Sen. Chuck Hufstetler, would update the Indoor Air Quality Act.The changes would prohibit vaping in the same areas that smoking is currently banned in Georgia. Georgia’s smoking ban was put in place in 2005, well before vaping became popular. This bill passed the House and Senate and is currently waiting for the Governor’s signature. 


SB 65: Enable Georgia to establish a state-based marketplace for health insurance | PASSED 

SB 65 will allow Georgia to move its health insurance marketplace from healthcare.gov (which is managed and run by the federal government) to a state-based marketplace (SBM). This bill passed the House and Senate and is currently waiting for the Governor’s signature. 


SB 140: Ban on some gender-affirming care for trans youth | PASSED

SB 140 will ban certain kinds of gender-affirming health care for minors–specifically hormone replacement therapy (HRT) for youth who have not started HRT prior to July 1, 2023 and gender-affirming surgeries. It also criminalizes medical providers for administering gender-affirming care in line with established standards of care. The Governor signed this bill into law.

GHF opposed SB 140 because of the negative impacts it will have the mental health & well-being of transgender children and youth. Research shows that gender-affirming health care greatly improves the mental health and overall well-being of gender-diverse, transgender, and nonbinary children and adolescents.

Click here for a statement from our partners at Georgia Equality following the bill’s signing.If you or someone you know may be impacted by this bill, support and resources are available at PFLAG’s Georgia-specific page and through TransParent


HR 603: House study committee on certificate of need

HR 603 creates a House study committee to examine Georgia’s certificate of need policies. CON is a program run by the Department of Community Health that evaluates the need for new hospitals, facilities, and certain health services. Under current law, hospitals and clinics must receive a CON before they can open new locations, expand their bed capacity, or offer certain major health services (like open heart surgery). 

The committee will be made up of 7 members of the House and 4 non-legislative members which are appointed by the speaker. We expect the committee to meet over the summer and early fall. The committee must issue its report by December 1, 2023.


SR 279: Senate study committee on certificate of need 

SR 279 creates a Senate study committee on certificate of need. Because the House and Senate have created study committees on the same issue, we expect they will coordinate their meetings and activities.

The committee will be made up of 7 members of the Senate, including the HHS and Regulated Industries chairs and five non-legislative members. The five non-legislative members will include executives from a nonprofit hospital, a for-profit hospital, and a rural hospital, a physician, and an expert on health care costs that works in the insurance industry. We expect the Senate and House committees to coordinate their meetings and activities over the summer and fall. The committee must issue its report by December 1, 2023.


HB 343: Change requirements of Pharmacy Benefits Managers (PBMs) | DID NOT PASS 

HB 343, introduced by Representative Mark Newton, aimed to change requirements for pharmacy benefits managers (PBMs). The Lowering Prescription Drug Costs for Patients Act would have required PBMs to pass the discounts receive from drug makers down to consumers, possibly lowering out of pocket prescription prices. This bill passed the House and was tabled in the Senate HHS committee. 


HB 404: The Safe at Home Act | DID NOT PASS 

HB 404, known as The Safe at Home Act, would give enforceable rights and protections to renters in Georgia. HB 404 would require landlords to ensure rental homes are “fit for human habitation.” The bill also increases protections for tenants facing eviction for falling a few days behind on rent. This bill passed the House and passed out of the Senate Judiciary committee. The bill did not receive a floor vote, but is still alive for next year.


HB 520: Updates to mental health reform bill | DID NOT PASS

HB 520 seeked to build on last year’s sweeping Georgia Mental Health Parity Act. HB 520 aims to address the statewide shortage of mental health providers, understand the capacity for in-patient mental health and substance use treatment, streamline the ways that state agencies involved in behavioral health can share data, and address the needs of so-called “familiar faces” (people that cycle between homelessness, jails, and hospitals due to serious mental illness). This bill passed the House and did not receive a vote in Senate HHS. However, the bill is still alive for next year.

We are disappointed that HB 520 didn’t yet receive full approval by the Senate. One section of the billwas amended into SB 23 and passed. Several other items were included in the final budget, as noted above. The remainder of the bill will likely be taken up next year, as 2023 is the first year of a two-year session. GHF looks forward to continuing our work to increase access to mental health services and securing the remaining parts of the bill next year.  


SB 99: Repeal Georgia’s Certificate of Need requirement in rural counties | DID NOT PASS

SB 99, introduced by Senator Greg Dolezal, would repeal Georgia’s Certificate of Need (CON) requirement for new acute care hospitals located in counties with fewer than 50,000 residents. The aim of the bill is to reduce barriers for new hospitals to open in rural parts of the state. In order to be exempt from CON, the new hospital would also need to accept Medicaid and Medicare patients, treat uninsured patients, and demonstrate that at least 10% of their annual revenue goes to indigent care, charity care, or bad debt. (Currently, hospitals are required to devote 3% of their revenue to these costs but most far exceed 3%.) This bill passed the Senate and did not receive a vote in the House Health committee. The bill is still alive for next year.


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