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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.
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
Video interviews with Julie Silas on network adequacy and provider directories
Who was there? Check out the photo album.
As consumers navigate the new landscape of increasingly narrow networks and high deductibles, they need the right tools and information to choose a health insurance plan that best fits their medical needs and their household budgets. Provider directories are the primary tool available to consumers to determine whether the plan they are selecting has a narrow or broad network and to identify which providers are in their plan. As such, these directories should be accurate, up-to-date, and should truly function as a tool. Despite the important role directories play, they are notorious for being rife with errors and for lacking the functionality to help consumers make optimal choices in the market. By drawing upon model legislation from the National Association of Insurance Commissioners (NAIC) and best practices from other states, Georgia can take steps to improve directories. This policy brief:
– explains the role provider directories play as a tool for consumer decision-making
– describes current provider directory provision in Georgia
– describes common problems with provider directories
– outlines recent policy activity around provider directories
– highlights other state examples of provider directory improvements
When consumers enroll in a health insurance plan, they gain access to a network of medical providers. This network must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. While network adequacy is not a new concept, it has a new urgency in light of the sheer number of newly insured Georgians enrolled in individual plans; the move on the part of insurance companies toward narrow networks and tiered networks, which limit the number of providers plan enrollees can access; new federal standards; and a new model act from the National Association of Insurance Commissioners (NAIC) that provides updated guidance for states. Georgia health care consumers need and deserve clear standards and protections that ensure their coverage translates to access to care without financial hardship. Georgians for a Healthy Future released today at a public policy form held in Atlanta a new policy brief on network adequacy. This policy brief:
– explains the importance of network adequacy for access to care
– outlines current network adequacy standards in Georgia
– summarizes recent policy activity around network adequacy
– sets forth consumer-oriented principles for network adequacy standards in Georgia
– provides policy recommendations to achieve network adequacy in Georgia.
Week 3
Week three was a very exciting one for Georgia health care consumers! The introduction of SB 302 signaled true movement on consumer priorities, like insurer provider directory transparency. Check below to see what happened and how you can get involved.
If you’re looking for a list of all the bills we’re tracking and their status in the legislature, click here.
What Happened This Week
Improving Provider Directories
We are very excited to share with you that last week Senator P.K. Martin (R-9th) introduced legislation to address provider directory inaccuracies and usability limitations. Senators Burke (R-11th), Watson (R-1st), Parent (D-42nd), and Unterman (R-45th) are also co-sponsors of SB 302. The bill has been assigned to the Senate Insurance Committee and we expect it will receive a hearing within the next week. Read SB 302.
Please join us in thanking Sen. Martin for introducing such an important piece of legislation! You can email him here or call him at 404-656-3933.
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.
GHF helped over 100 people get covered
Open enrollment formally concluded on January 31, 2016 and 587,845 Georgians enrolled in the Marketplace (healthcare.gov).
Throughout open enrollment, GHF worked to get Georgians enrolled through direct service and the creation of GEAR (or the Georgia Enrollment Assister Resource Network). GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners who work with consumers to educate them on their health and health care coverage options. If you are interested in learning more about GEAR or want to sign up for the newsletter, email Whitney. Additionally, during this open enrollment period we have provided enrollment assistance to 78 applicants and their families, totaling 141 Georgians. Of those, 91% received financial assistance.
The second week of the Legislative Session was primarily focused on the budget. Check out the updates below on provider directories, closing the coverage gap, and other issues that are important to Georgia health care consumers.
YOU’RE INVITED!
WHAT HAPPENED THIS WEEK?
- In the FY 2016 budget, the legislature included $23 million for partialMedicaid payment parity, with the understanding that full parity may be achievable over the next several budget years. The Governor’s budget maintains last year’s partial parity, but does not add any more funding. We will encourage the legislature to increase the funding for payment parity as they make their budget changes. Need a refresher on what parity has to do with access to care? Check out this blog post.
- Under the proposed budget, monthly insurance premiums for non-certified public school personnel (like bus drivers, cafeteria workers, etc.) will increase in January 2017. You can read more about these changes here.
LET’S CHAT
Thank you for making Health Care Unscrambled 2016 a success! If you weren’t able to attend last week’s Health Care Unscrambled, don’t worry! We’ve pulled together the highlights.
Whether we are giving a dental care or a full mouth restoration, we use the best technology and tools in the industry. Our partner Martindale dental is committed to providing an exceptional level of customer service. Our dental team provides caring, comprehensive treatment with an emphasis on preventative dental care, and the use of products from sensitivity toothpaste to the teeth whitening kits used by denstists.
Health Care Unscrambled in the news
Pictures, videos, & more
Humidification is pretty standard these days. No, you don’t have to have humidification, but it makes CPAP Machineo much more comfortable to use warm and moist air than cool dry air.
Presentations and event materials
- Health Advocate’s Guide to the 2016 Legislative Session
- Health Care Unscrambled 2016 Program
- Fact Sheet – A Networking & Resource Center for Advocates Working for Better Value in Health Care: Health Care Value Hub
- Fact Sheet – A Framework for Thinking about Health Care Value Strategies
- Presentation – Sue Polis, Trust for America’s Health
- Presentation – Lynn Quincy, Consumers Union
Event Sponsors
Champion
Hemophilia of Georgia
Advocate
Easter Seals Southern Georgia
Harry Heiman & Abby Friedman
Polsinelli, P.C.
Ally
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