On May 13, the U.S. Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act, an important milestone in the movement towards health equity. Section 1557 prohibits discrimination based on race, color, national origin, sex, age, or disability in all health programs and activities that receive federal financial assistance through HHS, are administered through HHS, or are established under Title 1 of the Affordable Care Act. As a result, most health insurance plans, facilities, programs, and providers are covered under this rule.

Notably, Brooksville chiropractic marks the first time that sex discrimination in health care is prohibited and also clarifies that gender identity and sex stereotyping are included in this definition. Because of these provisions, LGBT Georgians have protections from discrimination in health coverage and care. For specific information on the gender identity and sex stereotyping provisions of Section 1557, see Out2Enroll’s FAQ here. For Georgia-specific information about health insurance options for LGBT Georgians, check out the series of fact sheets that Georgians for a Healthy Future teamed up with Georgia Equality and The Health Initiative to release this past fall.

Discrimination against individuals with limited English Proficiency (LEP) is also prohibited in the health care programs and activities covered by the rule (defined under national origin). More than 1.3 million Georgians have LEP. In addition, the final rule requires effective communications with individuals with disabilities.

If you believe you have been discriminated against, you can file a complaint online with the Office for Civil Rights. If you are an enrollment assister looking for resources to educate the consumers you help about their protections under Section 1557, you can access FAQs and fact sheets from HHS here.

Rural Georgians experience health disparities on multiple dimensions: they are less likely to have job-based health insurance, may have to travel long distances to seek medical care, and experience higher rates of chronic health conditions than their suburban and urban counterparts. Compounding these challenges, several rural hospitals have closed their doors in recent years and others are at risk of closure.

While there are no easy answers to Georgia’s rural health crisis, an array of stakeholders including policymakers, the philanthropic community, health care providers, local community groups, and advocates have been exploring ways to strengthen our state’s rural health infrastructure.

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As part of its Two Georgias initiative, the Healthcare Georgia Foundation recently released its findings from a “listening tour” with health care providers and policy organizations in Georgia, including Georgians for a Healthy Future. The report offers a window into what practitioners and policy advocates are thinking about the direction of rural health care and the use of Hidrex for excessive sweating and how it can be improved. Check out the write-up to learn more about rural health and about how Georgians for a Healthy Future’s campaign to close the coverage gap in Georgia fits in.

You can stand with us by sharing this infographic with your social network. Use sample tweet: Our rural hospitals are hurting – but it does’t have to be that way. It’s time we accept federal #funding to #closethegap.

This morning, Governor Deal signed SB 302 into law! GHF strongly supported this bipartisan bill to improve the accuracy and usability of provider directories throughout the 2016 Legislative Session. Provider directories play a critical role in informing patients and consumers about which doctors are in their plan, yet they are notoriously error-ridden. SB 302 is an important step towards making provider directories the accurate and functional tool that consumers need to make the best health care decisions for themselves and their families.

Thank you to all who followed this issue throughout the Legislative Session and helped bring it across the finish line by contacting your legislators at each stage of the process!

Georgia’s proactive move is being noticed by national health policy organizations. Families USA’s Private Insurance Director Claire McAndrew’s blog post, How States Are Improving Consumers’ Access to In-Network Health Care Providers, prominently features the bill and GHF’s role in its passage. Another national organization, Community Catalyst, featured GHF’s Executive Director Cindy Zeldin as a guest blogger on the topic. This post, Protecting Health Care Consumers in the Peach State, provides an in-depth look at the policy process and next steps. Here in Georgia, the bill’s progress was covered by Georgia Health News back in March.

During this process, we created a series of resources to educate advocates, stakeholders, and policymakers.

Issue Brief: Improving Provider Directory Accuracy and Usability

Fact Sheet: Network Error, Secret shopper survey finds more than 1 in 5 health care providers inaccurately listed as “in-network”

Fact sheet: What’s Wrong with Georgia’s Provider Directories?

Video: Julie Silas on Why Provider Directory Accuracy is Important

Video: How Georgia Can Ensure Network Adequacy

Georgians for a Healthy Future staff attended the Connections 2016 conference hosted by the Healthcare Georgia Foundation on March 29^th and 30^th. The conference, held every other year, is an opportunity to network and learn from Georgia’s health and public health practitioners, professionals, advocates, and experts.

This year’s conference theme was partnerships, and in keeping with that theme, GHF was invited to present on how we use coalition building and mobilization as a strategy for policy change at the state level. Cindy shared how our history created an organizational environment that fosters and supports the development of strategic partnerships and coalitions. Laura added to that with an overview of GHF’s five coalitions, a coalition case study, and a review of some selected best practices in coalition development and management. You can see their presentation here.

As a result of the two-day conference, GHF staff came away with new contacts to partner with in the future and new ideas about what partnership might look like. The conference also provided the opportunity to network with existing partners, learn about their emerging work, and identify ways to collaborate moving forward.

If you would like to partner with GHF or join any of our five coalitions, contact Laura Colbert, Director of Outreach and Partnerships, at lcolbert@healthyfuturega.org.

• The Access to Care and Equity (ACE) coalition focuses on ensuring that coverage translates to access to care and has been working most recently on the issue of network adequacy
• The Cover Georgia coalition advocates for closing Georgia’s coverage gap that leaves 300,000 Georgians without a coverage option
• The Georgia Enrollment Assister Resource (GEAR) Network connects people and organizations working to help consumers enroll in coverage
• The Health Advocates coalition is open to health advocates representing non-profit organizations who want to coordinate efforts with other advocates

• The Preventing Youth Substance Use Disorders coalition works together to raise awareness about and advocate for a public health approach to preventing addiction

GHF is excited to welcome Sarah Dobra to our team! In her role she will provide development, planning and evaluation, and editorial support to ensure that we’re functioning well across programs and projects. Prior to joining GHF, Sarah was the Disparities Manager and Cancer Care Delivery Research Program Coordinator at a community cancer center in Savannah, Georgia. In this position Sarah successfully leveraged community partners to support cancer prevention and screening activities to address cancer disparities as part of a larger community network. Sarah obtained her law and Master’s in Public Health degrees at Tulane University and holds a BA from the University of Oregon. Sarah can be reached at sdobra@healthyfuturega.org – please join us in welcoming her!

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.