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Five Years in the Making: Consumer Advocates’ Role in Passing Comprehensive Surprise Billing Legislation

Quote from consumer about surprise billing and summary of blog

Today, Governor Kemp signed the Surprise Billing Consumer Protection Act into law! Georgians for a Healthy Future and our partners at Georgia Watch strongly supported this bipartisan bill to protect consumers from surprise out-of-network medical bills.

These exorbitant bills often burden patients with high amounts of medical debt. In fact, over half of debt collection actions contain medical debts, leading to bankruptcy for many consumers. Take George C. of Lilburn, for instance, who had his right foot amputated at an in-network hospital. Even after obtaining assurances from his insurer that the provider was in network, he still found himself stuck with costly medical bills. “I found out they used out-of-network providers when they assured me they would [not]. They would not dismiss the bills and I had no alternative but to file for bankruptcy,” said George, after receiving surprise medical bills totaling $60,000.

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Legislative Update: Steep budget cuts and significant health bills close 2020 session

Sine Die

Georgia’s 2020 legislative session comes to a close

Friday, June 26, marked the final day of the 2020 Georgia legislative session. This year’s Sine Die (the last day of the legislative session) came after a months-long suspension due to safety concerns over COVID-19. The final two-week legislative sprint brought the approval of a number of bills that will benefit consumers if approved by the Governor. Unfortunately, this progress comes against a backdrop of steep budget cuts that will put many Georgians at risk, especially those who are most marginalized.

Below you will find an overview of the approved state budget, summaries of notable health-related legislation, and short status reports on other health bills. GHF’s legislative tracker is updated so you can check on the health bills you were watching this session.


General Assembly passes FY2021 state budget

Legislators’ primary responsibility upon returning to the state capitol this month was to finish and pass the FY 2021 state budget, which goes into effect this Wednesday, July 1. On Thursday, the Georgia House and Senate passed a state budget that includes $2.2 billion in budget cuts for the FY 2021 budget. Although cuts were reduced from 14% to 10%, the approved budget curtails funds to many critical health care programs and social services. Notable changes to this year’s budget include:

  • Department of Behavioral Health and Developmental Disabilities: $91 million cut
    • One-third of the cuts ($29 million) comes from adult developmental disability services 
    • Another third ($29.9 million) comes from child and adult mental health services
  • Department of Community Health: Increase of $178 million
    • Increase in funds due to a higher projected growth for Medicaid
    • $19.7 million added to provide six-months of Medicaid coverage for new mothers (see below for more info.)
  • Department of Public Health: $8.2 million cut
    • Funding restored for grants to local health departments
    • No reduction in funding for maternal mortality review board

The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. Voice’s for Georgia’s Children also has a relatively easy-to-read version of the budget changes here.


Our priorities

General Assembly passes four bills to reform PBM practices in Georgia 

This year’s Georgia General Assembly took a keen interest in pharmacy benefit managers (commonly called PBMs). PBMs are companies that manage prescription drug benefits for health insurance companies. In order to secure lower prices on medications, PBMs have adopted practices that are seen as burdensome by pharmacies, restrictive and hard-to-navigate by consumers, and opaque by elected officials. The following four PBM bills were passed last week in an effort to increase patient access to and decrease costs of medications:

  • HB 918, sponsored by Rep. Sharon Cooper, limits the practices of PBMs as they audit pharmacies so that pharmacies can more easily meet audit requests. The bill gives the benefit of the doubt to pharmacies when small or innocuous mistakes are discovered.
  • HB 946, sponsored by Rep. Matt Knight, and SB 313 by Senator Dean Burke are companion bills with the same legislative language. Both bills would require that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. The bills also increase fines on PBMs when they “steer” consumers to specific pharmacies and disallows PBMs from building drug formularies (lists of covered medicines) in a way that discriminates against people with prescription drug needs.
  • HB 991, sponsored by Rep. Matt Hatchet, establishes an oversight committee which will oversee the contracts and subcontracts under the State Health Benefit Plan (covers state employees and their families), Medicaid, and PeachCare for Kids. This legislation aims to increase transparency around the pharmacy benefit managers contracted by these plans. The oversight committee is made of nine members, one of whom must be a consumer covered by one of the state health plans.

Bill to increase taxes and raise the age of purchase for vaping products passes

Multiple pieces of legislation were introduced this year that would change the way Georgia regulates tobacco, vaping devices and other nicotine products. Ultimately, only SB 375, sponsored by Senator Jeff Mullins, saw final passage. The bill will establish a 7% tax on vaping products and would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age. This increase in the so-called “age of purchase” brings state law in line with federal law.


Legislation to establish an All Payer Claims Database passed

SB 482, sponsored by Senator Dean Burke, builds on Georgia’s new surprise billing legislation (HB 888). HB 888 authorizes Georgia’s Department of Insurance to establish an all payer claims database (APCD) that will inform the surprise billing payment resolution process. APCDs can be a powerful tool that can also help policymakers, stakeholders, and advocates develop better understandings of health care costs, use of services, population trends, and disparities.

SB 482 goes farther than HB 888 by setting up an advisory body to assist in the creation of the APCD and establishing the purposes of the APCD, among other provisions. The advisory body does not currently include consumer representation. 

The creation of Georgia’s APCD is subject to appropriations. It was not funded in the FY2021 budget but state leaders have expressed optimism about funding it in future state budgets and attracting private funds to help support its development.


Surprise billing legislation awaits Governor’s signature

The Surprise Billing Consumer Protection Act (House Bill 888), was recently passed by the General Assembly and now heads to Governor Kemp’s desk for his signature.

This bill will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers. After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how legislation will work and what consumers may expect.

After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how the legislation will work and what consumers may expect.


Postpartum Medicaid coverage bill passed and funded

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth, up from the current 60-day limit. The General Assembly approved the legislation and funding ($19.7 million) last week. HB 1114 now heads to Governor Kemp’s desk for his signature.

In order for this change to take effect, the Georgia Department of Community Health will need approval from federal health officials.


Sine Die recap

HB 792: Amended FY 2020 Budget | SIGNED BY GOVERNOR HB 792 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2020. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on March 17th.


HB 793: FY 2020 Budget | SIGNED BY GOVERNOR HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. The budget includes several steep cuts to behavioral health and other health care programs. 


HB 719:  Effort to modernize HIV laws | DID NOT PASS HB 719, sponsored by Rep. Deborah Silcox, would modernize Georgia’s HIV-related laws and make progress towards decriminalizing HIV. Current Georgia law deems it a felony for people living with HIV to have sex or donate blood without disclosing their status, or for spitting at or using bodily fluids on a law enforcement officer. Under HB 719 only the act of having sex without disclosing a person’s HIV status would remain illegal.


HB 789: Creation of a surprise bill rating system | PASSED HB 789, sponsored by Rep. Mark Newton, would create a surprise bill rating system based upon the number of certain physician specialty groups contracted with a hospital within a health insurer’s network. 


HB 842: Gracie’s Law – organ transplant discrimination | DID NOT PASS HB 842, sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities.


HB 987: Protection of elderly persons | PASSED HB 987, sponsored by Rep. Sharon Cooper, would increase training requirements for staff members in elderly care facilities and raises the number of staff who would have to be on site at any given time to watch over residents. It would also increase fines for violations or if a facility causes a resident’s death.


SB 303: Georgia Right to Shop Act | PASSED SB 303, sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee, would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information. 


SB 352: Online provider directories | DID NOT PASS SB 352, sponsored by Senator Burke, would allow consumers to see providers at in-network rates for their entire plan year, if the provider is listed as in-network at the time a person enrolls in their health plan. The providers included in a consumer’s insurance plan network changes regularly throughout the year and this bill would assure that the provider network advertised at the time of enrollment is the provider network they are able to access all year long.


SB 408: Family Care Act Sunset Removal | PASSED SB 408, sponsored by Senator Brian Strickland, would extend the sunset on the Family Care Act to July 1, 2023. The Family Care Act allows employees to use sick time to care for ill family members. 


GHF has you covered

Stay up-to-date with the legislative session and COVID-19
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.


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Legislative Update: Medicaid coverage for new moms, tobacco tax increase, & action on state budget

Legislative Update: Week 11

Final days of 2020 legislative session set as General Assembly debates budget cuts

Last week legislators returned to the Capitol to complete their work on the FY 2021 state budget and address key legislative priorities. On Friday, the Georgia Senate passed a state budget that cuts $2.6 billion in spending during the upcoming year. This budget includes deep cuts to K-12 education and to critical health care programs, which we have detailed below along with next steps in the budget process.

On Saturday, the General Assembly set the calendar for the remainder of the legislative session. Both chambers will convene every day this week and plan to conclude their 2020 business this Friday, June 26th, likely late in the evening.

Don’t miss the bevy of action alerts in this week’s email. Scroll down for actions you can take to make improve Medicaid coverage for new mothers, increase Georgia’s tobacco tax, and protect Georgia’s budget from drastic cuts.


Surprise Billing Legislation Unanimously Approved By Senate

Surprise billing legislation heads to Governor’s desk

Last week, the Georgia Senate unanimously approved the Surprise Billing Consumer Protection Act (House Bill 888), bringing Georgia one step away from ending onerous surprise medical bills. HB 888 now heads to Governor Kemp’s desk for his signature. The Governor is expected to sign the bill as he pointed to this issue as a high priority during his January State of the State address.

This bill will mark a huge win for Georgians as it will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers.  Please call these leaders and thank them for their support and dedication to this issue:

  • Gov. Brian Kemp: 404-656-1776
  • Lt. Gov. Geoff Duncan: 404-656-5030
  • Senator Chuck Hufstetler: 404-656-0034
  • Chairman Richard Smith: 404-656-5141
  • Representative Lee Hawkins: 404-656-7855

Legislation to Extend Postpartum Medicaid Coverage Moves Ahead

Postpartum Medicaid coverage bill heads to Senate floor today

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. After unanimous approval in the Senate Health and Human Services committee last week, this legislation heads to the Senate floor for a vote today. 

Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured.

Action alert: Contact your state senator now and encourage their support for the passage and funding of this important piece of legislation! The Senate will convene at noon and a vote on HB 1114 is expected soon after.


 Progress on Tobacco Tax Increase

Resolution to increase tobacco tax moves ahead in Senate

On Friday, the Senate Finance Committee approved SR 435, sponsored by Senator Randy Robertson, aimed at increasing the tobacco tax rate from 37 cents to $1.35 per pack. We thank the members of the Senate Finance Committee for their quick action to find and approve new revenue to improve health in Georgia. Raising Georgia’s tobacco tax could bring in as much as $600 million annually and help to lower smoking rates among youth and adults.

Action alert

  1. Please contact members of the Senate Rules Committee and ask them to approve the bill for a vote on the Senate floor.
  2. Call or email your state senator today and encourage their support for this important piece of legislation!


Georgia Senate Passes State Budger that Includes Deep Cuts

Key health programs see cuts of $250 million

Last Thursday, the Senate passed its version of the FY2021 budget, which will begin July 1, 2020. The budget includes deep cuts to many state agencies, including 12 furlough days for staff and hiring freezes. The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. State agencies and programs that directly impact the health of Georgians were not spared in the budget cuts:  

  • Department of Behavioral Health & Developmental Disabilities would see a cut of $122 million total, with the biggest cuts focused on services for adults with developmental disabilities, child and adolescent mental health services, (including prevention programs and supported education services), housing vouchers for people with mental illnesses and other adult mental health services, and adult substance use recovery services.
  • Department of Public Health would see a cut of $27.4 million total. More than half of that cut ($13.9 million) would come from a reduction in grants to local health departments and another $4.9 million would be cut from health promotion funds.
  • Department of Human Services (which includes the Dept. of Family & Children Services, Division of Aging Services, and other agencies serving vulnerable populations) would see a cut of $100 million. The funding cut would require 50 Dept. of Family & Children Services office to close and consolidate, exacerbating the limited access of families to food assistance, cash assistance for families with children, and other social services. 
  • Georgia’s Medicaid agency, the Department of Community Health, was able to offset $205 million in cuts because the federal government has increased its support of the Medicaid and PeachCare programs as part of the federal coronavirus relief packages, although some cuts were still made in the DCH budget.

 The budget is now being considered by a conference committee made up of members from both the House and Senate. Please contact these conference committee members to let them know that they can avert these steep budget cuts by considering new revenue options. Several common sense proposals (Increasing Georgia’s tobacco tax, expanding Medicaid, reclaiming the health insurance assessmentamong other options) could increase revenue without impacting the amount of taxes paid by the vast majority of Georgia families. Contact the budget conference committee members today!

  • Senator Mike Dugan: 404-656-7872
  • Senator Blake Tillery: 404-656-0089
  • Senate Butch Miller: 404-656-6578
  • Representative Terry England: 404-463-2247
  • Representative Jon Burns: 404-656-5052
  • Representative Jan Jones: 404-656-5072

Pharmacy Benefit Manager Legislation Keeps Moving

Two bills to reform PBM practices in Georgia move forward 

Georgia’s House and Senate continued their efforts last week to better regulate how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. After presenting a revised version of SB 313, Senator Dean Burke’s bill was approved by the House Special Committee on Access to Quality Health Care. The revised version requires that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. GHF will detail the other revisions included in SB 313 in future email updates.

Additionally, Rep. Knight’s HB 946 was approved by the Senate Insurance & Labor Committee on Friday and was passed by the full Senate today. The bill will return to the House for an “agree” to the bill’s amendments before it heads to the Governor’s desk.
 

(For an overview of both bills in their original forms, please read our March 2nd legislative update.)


GHF has you covered

Stay up-to-date with the legislative session and COVID-19
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.





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Legislative Update: Surprise billing moves ahead, budget cuts, & Georgia Can’t Wait!

Legislative Update: Week 10

The 2020 legislative session has resumed

Yesterday Georgia’s General Assembly resumed the 2020 legislative session after being suspended in March due to safety concerns over COVID-19. Legislators returned to the Capitol on Monday to pick up their work on the state budget and key pieces of legislation. The last ten days of legislative session will be dedicated primarily to the FY 2021 state budget to which Governor Kemp has proposed 11% cuts. Read the State Budget Cuts Are Not Inevitable section below to find out how you can take action for a state budget that supports the health and wellness of Georgians.


Senate committee approves surprise billing legislation

Critical surprise billing legislation heads toward finish line

Earlier this year, companion bills (SB 359 and HB 888) were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. In a rare Sunday meeting, HB 888 was approved by the Senate Health & Human Services Committee. The Senate Rules Committee acted quickly today and approved the bill for a vote on the Senate floor tomorrow, Wednesday, June 17th. Please call your state senator today and encourage their support for this important piece of legislation!


New revenue can improve health in Georgia

State budget cuts are not inevitable

Because of the economic slow-down caused by COVID-19, Georgia’s revenues from sales taxes and other sources have dropped substantially. This has prompted the Governor to call for an 11% cut in state spending. Deep cuts to already-skeletal services and programs will disproportionately harm communities of color and rural communities, weaken Georgia’s health care system as it continues to respond to the pandemic, and curb the state’s ability to recover economically. GHF was one of 37 groups to send a letter to Governor Kemp and state lawmakers last week calling on them to raise new revenues rather than slash spending. New sources of revenue that can also improve health for Georgians include: 

  • Raising Georgia’s tobacco tax — an increase of $1 per pack would bring in $400 million each year and reduce smoking rates in Georgia
  • Expanding Medicaid— in addition to providing health coverage to 500,000 Georgians, Georgia would draw down $3 billion in federal funds each year
  • Re-claiming the health insurance assessment—by collecting the revenue from this existing tax, Georgia could bring in $360 million each year to make health insurance more affordable for consumers and small businesses

Ask Governor Kemp and your state lawmakers today to avert budget cuts and improve health in Georgia by raising state revenue!  


Georgia Can’t Wait!

Thank you for a successful Virtual Day of Action!

GHF and Cover Georgia welcomed legislators back on to work yesterday by urging them to take action to expand Medicaid. During yesterday’s virtual Day of Action, participants like you sent 500 messages to Governor Kemp and your legislators encouraging them to act immediately to protect the health and financial well-being of 560,000 Georgians by closing Georgia’s coverage gap! Thank you for your advocacy!

If you didn’t get a chance to contact your lawmakers yesterday, call or email today and ask them to act now to close Georgia’s coverage gap!


GHF has you covered

Stay up-to-date with the legislative session and COVID-19

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.


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Legislative Update: More Medicaid for new moms, big & little budgets, and Crossover Day deadlines

Legislative Update: Week 8

General Assembly continues work on budgets ahead of Crossover Day

Last week the Senate passed their version of the FY2020 state budget (the “little budget”). This week the House and Senate will appoint a conference committee to work out the remaining differences in their versions of the little budget before it gets a final approval by both chambers. This morning the House Appropriations committee has passed its version of the FY2021 budget, which will begin July 1st of this year and run through June 30, 2021. The big budget will be considered by the full House chamber later this week.

Committee hearings will continue in earnest as legislators try to move their priority bills ahead of this week’s Crossover Day deadline. (Crossover Day is the 28th day of session and the deadline by which bills must pass the House or the Senate in order to remain viable to become law.) In next week’s legislative update, we will run down which health bills were left on the cutting room floor and which ones remain viable for this year.


Bill introduced to extend postpartum Medicaid coverage

Legislation would allow moms to keep Medicaid coverage up to six months after giving birth

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured. The bill has been referred to the House Health & Human Services committee and has the support of Healthy Mothers Healthy Babies Coalition of Georgia, GHF, and other consumer health advocacy groups.

Learn more about this legislation and maternal health in Georgia in a new blog from the Georgia Budget & Policy Institute.


Surprise billing and Gracie’s Law approved

Surprise billing protections are another step closer to passage

Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. Last week the House passed its version of this important consumer-focused legislation, HB 888. The Senate has already approved SB 359, which closely mirrors the House bill. The Senate bill is expected to be amended in the House Special Committee on Access to Quality Health Care so that it exactly matches the House version and better protects against surprise bills in emergency situations. Both bills are expected to be considered up by their respective committees after Crossover Day.


Gracie’s Law moves on to Senate

Gracie’s Law (HB 842), sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities. Gracie’s Law was approved by the House on February 28th and is now in the Senate Health and Human Services Committee. The bill is supported by The Arc of Georgia, the Georgia Council on Developmental Disabilities, and other disability advocacy organizations.

(For more on this bill, please read our earlier legislative update.)


Pharmacy benefit manager legislation keeps moving

Four bills to reform PBM practices in Georgia move forward ahead of Crossover Day

Georgia’s House and Senate continued their efforts last week to change how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. 

HB 946 and HB 947, both sponsored by Rep. Matt Knight and HB 918, sponsored by Rep. Sharon Cooper, were passed by the House on Wednesday. HB 946 was referred to the Senate Insurance and Labor committee, and HB 918 and HB 947 were referred to the Senate Health and Human Services committee. Similarly, SB 313sponsored by Senator Dean Burke, was approved by the Senate on Thursday.

(For an overview of the bills, please read our March 2nd legislative update.)


GHF has you covered

Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.


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Legislative Update: Surprise billing, mental health, & Gracie’s law

Legislative Update: Week 4

Legislative session paused amid budget disagreements

The Georgia legislature voted to pause the official legislative calendar last week due to the difficult and sometimes contentious discussions over the state budget. Governor Kemp’s proposed budget cuts for the current and subsequent state budgets have left the legislature to the difficult tasks of finding savings where possible, making cuts to some services and programs, and debating how to bring in sufficient revenue. Speaker of the House David Ralston has instructed the House to hold only budget-related hearings this week. 

The legislature plans to officially reconvene next Tuesday, February 18th for day 13 of this year’s legislative session. According to the legislature’s new calendar, Crossover Day (the day by which a bill has to be approved by at least one chamber in order to remain “alive” for this year) is scheduled for March 12th.

Strong surprise billing legislation introduced

Surprise billing legislation would protect consumers in emergency & non-emergency situations

Last week companion legislation were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a fair payment resolution process that takes consumers out of fights between insurers and health care providers. If passed, these bills would protect 2.6 million Georgians from surprise medical bills.

SB 359 has been read and reffered to the Senate Health and Human Services committee. HB 888 is in House first readers and in the House Special Committee on Access to Quality Health Care.

Call one or more of these committee leaders to ask for their support of SB 359 and HB 888: 

  • Sen. Ben Watson, Chairman of Senate HHS committee,
    404-656-7880
  • Sen. Dean Burke, Vice Chairman of Senate HHS committee, 404-656-0040
  • Rep. Mark Newton, Chairman of the House Special Committee, 404-656-0254
  • Rep. Sharon Cooper, Vice Chairman of the House Special Committee, 404-656-5069

If your state Senator or Representative is on either committee, please call them as well!

House examines mental health and organ transplant issues

Involuntary commitment emerges as theme in mental health legisation

Two pieces of mental health legislation garnered attention from mental health advocates and legislators last week.

HB 544, sponsored by Rep. Chuck Efstration, would make changes to how people in mental health or SUD crises can be committed to emergency involuntary treatment. This legislation could have negative consequences for people with substance use disorders who could be involuntarily committed to treatment under certain circumstances. This bill sits in the House Judiciary committee but the discussions of this issue may instead be moved to a subcommittee of the Behavioral Health Innovation and Reform Commission.

HB 760, sponsored by Rep. Sharon Cooper, would give peace officers the authority to take a person to a physician or emergency department for emergency examination under certain circumstances. This legislation is not supported by mental health advocacy groups because it could lead to involuntary committal for people with mental health issues. The bill now sits in the House Public Safety and Homeland Security committee.

Gracie’s Law would protect organ transplant discrimination for Georgians with disabilities

Rep. Rick Williams has introduced HB 842, titled “Gracie’s Law.” According to the Georgia Council on Developmental Disabilities (GCDD), Gracie’s Law would protect patients with disabilities from being removed from the organ donor waiting list because of their disability. According to an article in GCDD’s Making a Difference magazine, “While the Americans with Disabilities Act (ADA) denies discrimination based on any disability, there is still a lack of federal enforcement,” prompting the need for state action on this issue. This bill has been referred to the House Insurance committee. You can read more about Gracie’s Law here (pg. 12-13).

Thank you!

Cover Georgia logo

Health care heroes like you submitted 1,710 comments!

Before the legislative session began, Governor Kemp filed paperwork with health officials in the federal government to move forward with plans to change Medicaid and private insurance in Georgia. When health officials needed your input on the Medicaid plan, more than 1700 Georgians like you stepped up! 
 

We are incredibly grateful for your advocacy on behalf of Georgians and communities who would benefit from Medicaid expansion in Georgia. Thank you for speaking up for your friends, neighbors, and all Georgians! Now your comments become part of a powerful legal record that health officials must take into acocunt as they decide whether or not to approve Governor Kemp’s Medicaid plan.

Stay tuned! Health officials are still reviewing Governor Kemp’s planned changes for private insurance. When the time comes, we will ask you to speak up again by submitting a comment again! Here and at coverga.org, we will let you know what those changes mean for you and your loved ones and when you can comment.

GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.


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Legislative Update: Pharmacy benefit managers, health costs, & vaping

Legislative update: Week 3

Georgia House continues budget considerations 

Last week the Georgia House of Representatives resumed its budget hearings in earnest. The House Appropriations subcommittee on Health met on Tuesday to hear more from state agency leaders about their amended FY2020 budget requests. The FY2020 budget runs through June 30, 2020, and is sometimes called the “little budget”. 

It was clear during last week’s hearings that the House may not simply agree to the budget cuts requested by Governor Kemp. Many Appropriations committee members expressed concerns about how the agencies’ proposed cuts would impact access to health care in rural Georgia, the availability of mental health and substance use services, and other critical health services and supports.

Both chambers will reconvene today, February 3rd, for the tenth day of the legislative session. Before scrolling to the latest news on emerging bills and other happenings under the Gold Dome, don’t forget to tell officials what you think of Governor Kemp’s Medicaid plan. The comment deadline is this Friday.


Less than a week to go!

The comment period ends on Friday! Take action now!

Before the legislative session began, Governor Kemp filed paperwork with health officials in the federal government to move forward with their plans to change Medicaid and private insurance in Georgia. Now those health officials need your input, beginning with the Medicaid plan! 

Governor Kemp’s Medicaid plan will leave thousands of low-income Georgians with no meaningful way to get health insurance. Instead of expanding Medicaid to cover 490,000 Georgians, this plan would cover only 50,000 people and cost three times more per person.

We need you to step up AGAIN and become a health care hero by telling national officials what you think of the Medicaid plan! The deadline for comment is Friday, February 7th. Visit coverGA.org to comment today!

Did you submit a comment in November? Please submit a comment again so federal officials can hear directly from you.


Senate starts with prescription drugs & price transparency

SB 313: Updating how Georgia regulates pharmacy benefit managers

Senator Dean Burke has introduced SB 313, a law that would update Georgia’s oversight of pharmacy benefit managers and add important consumer protections. Pharmacy benefit managers (PBMs) are companies that manage prescription drug benefits on behalf of health insurers, and are a new favorite focus of policy makers who want to address rising health care costs. 

SB 313 requires PBMs to charge health insurers the same price for a drug as it receives from the drug manufacturer and that PBMs pass all rebates from the manufacturer to the health plan. (Ideally, these savings are then passed along to consumers.) The bill also disallows PBMS from building drug formularies (lists of covered medicines) in a way that discriminates against people with prescription drug needs. The bill also strengthens the Insurance Commissioner’s ability to hold PBMs accountable to state laws and regulations.

This bill is complex and GHF will continue to report on it through the legislative session. The bill has been referred to the Senate Insurance Committee.


SB 303: Georgia Right to Shop Act

SB 303 would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information. The legislation is sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee. It has been referred to the Senate Insurance Committee and is expected to be heard this week. 


Focus on nicotine & tobacco continues

Legislation would tax vaping products

Representative Bonnie Rich introduced HB 864 last week, which would add a 7% excise tax to vaping products and would require businesses that sell vaping products to register with the state for a $250 fee. This bill is one of at least three pieces of legislation that would change how Georgia taxes and regulates tobacco or other nicotine products. HB 731, sponsored by Rep. Ron Stephens, would raise Georgia’s tobacco tax to $1.87 from its current level of $0.37. SB 298, sponsored by Sen. Renee Unterman, would increase the age that Georgians are allowed to purchase tobacco products to 21 years of age, among other things.

Both House Bills have been referred to the House Ways & Means committee and SB 298 has been referred to the Senate Regulated Industries committee.


GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.


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