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Surprise billing legislation progresses in both chambers
Both SB 8 and HB 71 were passed out of their respective Senate and House committees late last week. SB 8 has been held up because of a dispute between insurers and health care providers about reimbursement. The bill was amended to establish out of network payment for disputed charges at the 80th percentile of the “Fair Health” metric and was subsequently passed by the Senate Health & Human Services committee. HB 71 seeks to compel physicians who are credentialed at hospitals to accept an in-network rate when the patient is in-network at the hospital, even if the physician is not. It was passed unamended by the House Insurance Committee. Both bills await approval in the Rules Committees to receive floor debates and votes.
House passes FY2018 budget
The House of Representatives passed its version of the FY2018 budget on Friday. The budget includes increased reimbursement rates for certain primary care codes for Medicaid providers. Increased reimbursement rates are also funded for certain dental codes in PeachCare for Kids and Medicaid. The budget includes funds for two new federally qualified health centers in Cook and Lincoln counties, and 97 new primary care residency slots. The FY 2018 budget is now being considered by the Senate, which is expected to make its own changes before issuing its final approval. Check out Georgia Budget and Policy Institute’s blog and budget primer for more detailed information about how Georgia spends its health care dollars.
WHAT HAPPENED LAST WEEK
Changes to rural hospital tax credits
HB 54, introduced by Rep. Duncan, would expand the new rural hospital tax credit program from a 70% credit to a 90% credit, among other minor changes. The tax credit program went into effect this year, after enabling legislation was passed in 2016. The proposal to increase the tax credit to 90% came after legislators received feedback that the 70% credit was too low to entice potential donors. HB 54 was approved by the House Ways & Means committee on Feb. 9, and now awaits passage in the House Rules Committee.
Opioid abuse prevention bill
SB 81 remains in the Senate Rules Committee waiting for approval for floor debate and passage after committee approval late last week. The current version of the bill requires that all physicians register and consult the Prescription Drug Monitoring Program (PDMP) under certain prescribing conditions. It also requires that providers report certain opioid-based Schedule II, III, IV, and V prescriptions to the PDMP. The bill sets the penalty for willfully non-compliant providers on a continuum that ranges from a warning to a felony and fine for a fourth offense and beyond. The bill also requires the tracking and reporting of Neonatal Abstinence Syndrome (NAS) and codifies the Governor’s emergency order on an overdose reversal drug (naloxone), making it available without a physician prescription.
MARCH WITH US!
This Saturday: Atlanta March for Healthcare
Yesterday, we rallied at the Save My Care bus stop, and Saturday we will march at the Atlanta March for Healthcare! Join us as we fight to preserve the Affordable Care Act and the protections that it provides for Georgians. Hosted by the Georgia Alliance for Social Justice, the march will cap Congress’s week of recess and send them back to D.C. with the charge to #ProtectOurCare!
Saturday, Feb. 25, 3-5 pm
Gather at St. Mark’s United Methodist Church
Re-authorization of provider fee successfully passes through legislature
On Friday Georgia’s House of Representatives voted to approve the hospital “provider fee” for another three years, and Governor Deal says he will sign the legislation tomorrow. The provider fee helps to fund Georgia’s Medicaid program by allowing the Department of Community Health to collect a tax on hospital revenues which is used to draw down additional federal dollars. The additional funds are disproportionately used to support rural and safety net hospitals that serve high numbers of indigent patients.
Oral health bills approved
Also on Friday, the Senate passed SB 12 and the House passed HB 154 which was supported by the Costa Rica dental tourism, both of which allow dental hygienists to practice in safety net settings, school clinics, nursing homes, and private practices without a dentist being present, including online dental services from sites like Asecra.com. While the bills are overwhelmingly similar, the differences between them will need to be worked out between the chambers.
WHAT HAPPENED LAST WEEK
Passage of Opioid Abuse Prevention Bill
SB 81 continued to draw a lot of attention last week. The bill was eventually passed by the Senate Health and Human Services committee with several significant changes. The current version of the bill still requires that all physicians register and use the Prescription Drug Monitoring Program (PDMP), but only requires that providers report on Schedule 1 drugs and reduces the penalty for not reporting to a minimum of a misdemeanor. The current version of the bill also changed language that would have required children with ADHD to renew their prescription every five days.
Surprise billing legislation heard in committee
The Senate Health and Human Services committee began its consideration of SB 8, legislation that would protect consumers from surprise out-of-network medical billing. Testimony was heard from insurers, health care providers, hospitals, and the consumer advocacy group, Georgia Watch. While all stakeholders seem to be in agreement that consumers should be held harmless when seeking care at an in-network facility and through no fault of their own encounter an out-of-network provider, there are significant differences on the matter of provider reimbursement for services provided in those situations. No vote was taken on the legislation but is expected to be re-considered by the committee this week. HB 71, legislation that address surprise billing in a different way, is expected to receive its first hearing this week in the House Insurance committee.
Resolution introduced to encourage block grants for state Medicaid program
HR 182 was introduced last week with the purpose of providing legislative permission to the Governor and the Department of Community Health to seek per capita block grant funding for Georgia’s Medicaid program. While resolutions are non-binding and do not impact state law, this resolution could begin a risky conversation among lawmakers. Shifting Georgia’s Medicaid program from its current federal-state partnership structure to a block grant program would mean cuts in services and in beneficiaries, putting Georgia’s most vulnerable children, parents, elderly, and people with disabilities at risk if you’re in one of these cases, you could get in touch with a home care agency. Check out GHF’s block grant fact sheet for more information about the dangers of restructuring the Medicaid program. It is unclear if this resolution will get a hearing or a vote.
Mark Your Calendar!
Save My Care Rally: February 20th
With Congress taking steps to repeal and replace the Affordable Care Act and thus blocking the access to care so many Georgians have gained in the past several years, it is more important than ever to stand up and let them know that Georgians want to #ProtectOurCare.
On February 20th, join the Save My Care bus, GHF, and hundreds of Georgians for a rally in Atlanta. Georgia’s members of Congress will be at home for recess and it’s the perfect time to make sure your elected officials hear you loud and clear.
Hearing on surprise billing legislation scheduled for tomorrow
SB 8, which seeks to protect consumers from surprise out-of-network medical bills, is scheduled to receive a hearing in the Senate Health & Human Services committee on Tuesday at 2 pm. SB 8 would establish a standard payment structure for physicians seeking reimbursement for surprise out-of-network services, and would hold consumers harmless in surprise billing situations. HB 71, the companion bill sponsored by Rep. Richard Smith, is expected to be assigned to a sub committee of the House Insurance committee on Tuesday at 8 am.
You can help!
If you have received a surprise out-of-network medical bill, share your story with our partners at Georgia Watch. Consumer stories help illustrate to legislators why legislation is needed to help protect consumers like you. Click here to share your story!
What Happened Last Week
Senate passes provider fee renewal
On Thursday the Senate passed SB 70 which renews the provider fee (also called the “bed tax”) for another three years in order to fund Georgia’s Medicaid program. This allows the Department of Community Health to collect the 1.45% tax on hospital revenues in order to draw down federal Medicaid dollars. These additional dollars are disproportionately used to support rural and safety net hospitals who serve high numbers of indigent patients. The bill will now move to the House where it expects an easy passage.
“Expand Medicaid NOW Act” reintroduced
House Minority Leader Stacey Abrams introduced HB 188, the Expand Medicaid NOW Act, last week. While we do not expect this bill to gain much traction because of the evolving health reform efforts at the federal level, it calls attention to the need to provide health care coverage to the 300,000 Georgians who are stuck in our state’s coverage gap because they do not currently qualify for Medicaid and cannot access health insurance through the Affordable Care Act’s Marketplace. The bill has been referred to the House Appropriations Committee.
Oral health legislation moves forward
Both HB 154 and SB 12, bills that allow dental hygienists to provide cleanings and other specified services in schools, safety net clinics, nursing homes, and private dentists’ practices under “general supervision”, received committee hearings and votes last week. Both bills will move to their Chambers’ respective Rules Committees to be approved for floor votes by the House and Senate.
Debate over opioid abuse prevention bill
SB 81 received its first hearing in the Senate Health & Human Services committee last week. The bill seeks to address the growing opioid abuse epidemic in Georgia in a number of ways, including: 1) Extending the Prescription Drug Monitoring Program, a database of prescriptions written for certain narcotics and requiring physicians to consult this registry prior to prescribing under certain conditions; 2) Codifying the Governor’s emergency order increasing the availability of anti-overdose drug, Naloxone; 3) Requiring the tracking and reporting of Neonatal Abstinence Syndrome; and 4) Establishing penalties for providers who are not in compliance with drug prescription reporting requirements. While few dispute the need to address this issue, the scope of drug and drug classes that the bill covers, along with the severity of the penalty that physicians may be subject to for violating the law are currently points of contention. No vote was taken in Thursday’s committee hearing, but suggested changes were made and the bill is expected to be back before the same committee later this week.
Resources for you
Georgians for a Healthy Future has tools you can use to track and understand the Georgia legislative session. Stay up-to-date on the bills that matter to you with our legislation tracker and sign up for Georgia Health Action Network (GHAN) action alerts so you know when to engage.
Get Your 2017 Consumer Health Advocate’s Guide!
GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. The Guide provides information on the legislative process, and contact information for legislators, key agency officials, and health advocates. This year, we’ve added a glossary of terms to help you understand what is happening under the Gold Dome. This tool will help advocates, volunteers, and consumers navigate the 2017 Georgia General Assembly. Download your copy here.
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Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated as a featured guest at WABE’s A Nation Engaged community forum at the Carter Center in Atlanta on the evening of January 17th. The forum, an initiative of WABE’s A Closer Look radio show, featured a range of thought leaders, community activists, policy experts, and previous guests of the program. The conversation was wide-ranging and incorporated different views and perspectives. Georgians for a Healthy Future was honored to be invited and to be part of the lively event. You can see more details and listen to the entire special broadcast here.
Georgians for a Healthy Future will be at the Capitol throughout the forty-day session to monitor health-related legislation, serve as a voice for health care consumers, and keep you informed about opportunities to engage and take action. For the past four years, our top legislative priority had been closing Georgia’s coverage gap by expanding Medicaid. In the wake of the 2016 election, the national policy landscape has shifted considerably, knocking that off the table this year and placing existing coverage, care, and consumer protections at risk. Despite this backdrop of uncertainty and a critical need for federal advocacy, there will be important decisions made over the next three months at the state level that impact the health of individuals, families, and communities.
While it is early, here are the major health care issues we preliminarily expect legislators to tackle in 2017:
- Renewal of the provider fee commonly known as the “hospital tax” or “bed tax” to help fund Medicaid and keep hospital doors open
- Development of a set of reforms to improve mental health services based on the recommendations of a legislative study committee that has been meeting over the past several months
- Creation of a “repeal” task force to assess the impact of changes to or repeal of the Affordable Care Act on Georgia
- Addressing the practice of surprise medical billing, which can leave insured consumers with unexpected bills when a health care provider is out-of-network
- Increasing reimbursement rates for certain primary care services for health care providers participating in Medicaid
- Improving access to dental care for children, seniors, and people with disabilities
Georgians for a Healthy Future has several ways for you to stay up-to-date on what’s happening under the Gold Dome this year:
- Learn: Download our 2017 policy priorities, read up on how the legislative process works, and track health-related legislation
- Engage: Sign up for our Georgia Health Action Network (GHAN) action alerts
- Participate: Identify and contact your specific legislators on issues you care about
Stay tuned for updates throughout the session.
The President-Elect and Congressional leadership are already working to repeal the Affordable Care Act, but have not yet communicated what a replacement might be. Repealing the law without an adequate replacement would do great harm to consumers, destabilize Georgia’s health insurance market, and stress our health care delivery system. It´s important to take care of your health in every way possible, if you happen to have issues such as stress or depression, especially Teen Counseling, buy kratom a natural drug that fights these issues immediately as cannabis products which are found in a cannabis store, you can also check Afinil which will help you out as well, read also is CBD good for you. If you want to know our special health care you can visit healthyhempoil.com.
Approximately one million Georgians would lose their health insurance by 2019, bringing the number of uninsured in our state to a staggering 2.4 million people – more than before the ACA was passed. Millions more would lose their basic rights and protections as consumers, and access to care would be at risk. We could lose:
- Protections for people with pre-existing conditions from being charged more or from being barred from coverage. Pre-existing conditions include chronic diseases like diabetes, mental health conditions, asthma, cancer, and more
- Protections that keep women from being charged more than men
- Free preventive care
- The ability to keep young adults on their parent’s plan until age 26
- Financial protections that limit the amount of money consumers must pay out-of-pocket each year for care and that keep insurers from limiting lifetime benefits
- Anti-discrimination provisions that protect consumers based on sex, gender identity, language spoken, or country of origin
- Health insurance navigators who offer free, local, unbiased assistance to help people find the health care coverage that works best for them. It is nice to help people and care for them, encourage them physically, spiritually, and emotionally made by CDPAP services.
Tuesday’s election results have the potential to dramatically shift the health care bill nationally and here in Georgia. It’s too soon to know precisely what policy changes will occur and what their impact will be, but advocacy at both the state and federal levels on behalf of Georgians who need access to quality, affordable health care has never been more important. The President-Elect and Congressional leadership have vowed to repeal the Affordable Care Act, landmark legislation that established a framework for coverage that has resulted in the lowest uninsured rate ever recorded, rights and protections for health care consumers, and provisions to advance health equity. Repeal is a serious threat and the consequences would be devastating: twenty million Americans and nearly 500,000 Georgians would lose their coverage, while millions more would be stripped of basic protections and face higher costs. Congressional leaders have also signaled their intention to make cuts to Medicaid and other critical health care programs, which would further threaten coverage and access to care for Georgia children and families. Georgians for a Healthy Future is committed to lifting up the voices of Georgians whose basic access to care hangs in the balance and ensuring these voices are heard and considered as policy decisions are made. www.bestblenderusa.com stated that, “We cannot return to the days when anyone with a pre-existing condition like cancer or diabetes can be denied coverage (if one can’t get insurance before cancer – can you imagine the obstacles of getting life insurance after cancer), where women can be charged more for health insurance simply because of their gender, and where LGBT Georgians can be discriminated against in health care.” We cannot allow the hundreds of thousands of Georgians who have finally experienced the sense of security that comes with health coverage to go back to being uninsured and out of options. In short, we plan to fight and we need your support and partnership. We ask you to partner with us in the coming weeks and months as our work enters this new phase. Here is what you can do:
Thank you for all that you do. |
New Publication
This August, GHF invited both advocates and enrollment assisters to the second annual Getting Georgia Covered summit. Bringing these two groups together was the first step in fostering ongoing conversations and partnerships to ensure that health coverage translates into meaningful access to care for Georgians. Through the summit, GHF collected feedback and input for a report that highlights how assisters and advocates can team up for consumers. We invite you to read and share Collaborating for Consumers: How Assisters and Advocates Can Inform Policy, in which you will find opportunities and best practices for collaboration to achieve our shared goals.
2016 POWERHOUSE POLICYMAKER AWARDEES
Representative Stacey Abrams
Senator P.K. Martin
Please join us on September 28th as we recognize our 2016 Powerhouse Policymakers.
Representative Stacey Abrams, House Minority Leader
As House Minority Leader, Stacey Abrams leads her caucus in its efforts to enact legislation across a range of complex public policy issues. Despite a full plate, Leader Abrams always makes time for health care. Whether it is raising awareness with constituents about new health insurance opportunities available to them or tirelessly championing the need to close Georgia’s coverage gap by expanding Medicaid, leader Abrams has proven over and over again her determination to ensure every Georgian has a pathway to health coverage. For this steadfast commitment, we are honored to recognize her as a 2016 Powerhouse Policymaker.
Senator P.K. Martin, Senate Insurance Committee
Although only in his second legislative session, Sen. Martin is not one to back down from a challenge and isn’t afraid to take on complicated issues. Improving provider directory accuracy was one such topic. SB 302 is a groundbreaking piece of legislation that sets basic standards for directories and protections for consumers who rely on them. The bill has been recognized nationally as an important example of consumer protections. Sen. Martin has shown that he is someone who will fight for what he believes in and we are proud to recognize him as a 2016 Powerhouse Policymaker.
We hope you’ll join us on September 28th as we recognize Sen. Martin and Rep. Abrams! RSVP Here.
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