Laura Colbert, executive director of Georgians for a Healthy Future, agreed the issues of drug prices and transparency, coupled with the role PBMs play in the equation, will come up…
Tag: crossover day
Legislative update: Week 9
The GHF team prides itself on delivering timely and accurate updates to you on health care happenings at the Capitol. We hope that you enjoy reading our weekly legislative updates and that they help you stay informed and connected. If you enjoy them, please consider supporting our work with a donation today. Thank you for your continued support!
In this week’s update:
- Action alerts: Tell your legislators to support Medicaid expansion & prior authorization!
- Our priorities: Express lane Medicaid & expanding telehealth services
- Crossover day recap
- Advocacy events this week: LGBT advocacy & League of Women Voters virtual legislative day
- President Biden signs COVID-19 relief including extra Medicaid expansion funding for Georgia
- GHF’s got you covered this session!
A statement from Georgians for a Healthy Future regarding COVID-19
Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times.
We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.
We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.
Legislative Update: Week 9
Crossover Day brings action before suspension of legislative session
Last Thursday, March 12th was the 28th day of the Georgia legislative session, which is also referred to as Crossover Day. Crossover Day is the final day for a bill to cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. The General Assembly finalized changes to the current state budget (FY2020) before suspending the legislative session on Friday, March 13th due to safety concerns about COVID-19. Lieutenant Governor Geoff Duncan and House Speaker David Ralston have committed to resuming the 2020 legislative session when public health concerns subside.
In the sections below, you will find a rundown of consumer health legislation and their statuses following Crossover Day. Those that “crossed over” remain viable and those that “did not cross over” are considered dead for this year. You can see a list of all the bills we’re tracking here.
The General Assembly convened this morning for a one-day special session. They are expected to pass a resolution approving Governor Kemp’s declaration of a public health emergency. With this action, Governor Kemp will have additional power and authority to manage the state’s response to COVID-19.
Surprise billing legislation companion bills cross over
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. 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. Both bills have crossed over from their chambers of origin to the opposite chamber.
Legislation to extend postpartum Medicaid coverage crosses over
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. HB 1114 was approved by the House last Tuesday.
Crossover Day recap
HB 792: Amended FY 2020 Budget | SENT TO 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 has been sent to the Governor.
HB 793: FY 2021 Budget | CROSSED OVER
HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. For more information on the health care highlights in the proposed FY 2021 budget, read the Community Health, Behavioral Health, and Public Health budget overviews from the Georgia Budget & Policy Institute.
HB 511: Rural transit bill | CROSSED OVER
HB 511, sponsored by Representative Kevin Tanner, would create a new division within the Georgia Department of Transportation (GDOT) that would, among other things, oversee rural transit programs including Medicaid’s non-emergency medical transportation (NEMT) services. The bill would divide the state (except for 13 metro-Atlanta counties) into eight regions in which counties could collaborate to raise revenue for and coordinate rural transit services.
HB 544: Mental health emergency involuntary treatment | DID NOT CROSS OVER
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.
HB 719: Effort to modernize HIV laws | CROSSED OVER
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 731: | Tobacco tax increase | DID NOT CROSS OVER
HB 731, sponsored by Rep. Ron Stephens, would raise Georgia’s tobacco tax to $1.87 from its current level of $0.37.
HB 760: Mental health; peace officer authorization | DID NOT CROSS OVER
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.
HB 842: Gracie’s Law – organ transplant discrimination| CROSSED OVER
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 864: | Excise tax on vaping products | DID NOT CROSS OVER
HB 864, sponsored by Rep. Bonnie Rich 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.
HB 918: Restricts onerous PBM audits of pharmacies | CROSSED OVER
HB 918, sponsored by Rep. Sharon Cooper, puts in place limits on the practices of PBMs within these audits so that pharmacies can more easily meet audit requests and the benefit of the doubt is given to pharmacies when small or innocuous mistakes are discovered.
HB 946: Increases accountability for PBMs | CROSSED OVER
HB 946, sponsored by Rep. Matt Knight, would increase fines on PBMs when they “steer” consumers to specific pharmacies and would prohibit PBMs from paying affiliated pharmacies more than independent ones. The bill would require PBMs to pass along rebates to insurers (who would presumably pass those savings on to consumers) and would ban programs called “co-pay accumulators.” Co-pay accumulators increase out-of-pocket costs for consumers who need prescription drugs, especially those with expensive medications and those with high deductibles and other cost-sharing.
HB 947: Examining the costs of PBMs in Medicaid | CROSSED OVER
HB 947, sponsored by Rep. Matt Knight, would require Georgia’s Department of Community Health to complete an independent study to find out if Georgia would save money by removing the current PBM structure from its Medicaid plans. If the estimated savings are more than $20 million annually, Georgia would eliminate PBMs from most of the state’s Medicaid plans.
HB 1079: Authorizes full Medicaid expansion through an 1115 waiver | DID NOT CROSS OVER
HB 1079, sponsored by Rep. Kim Schofield, would allow the state to submit a new 1115 waiver that would expand Medicaid to all Georgians making less than 138% of the federal poverty line.
HB 1114: Extending postpartum Medicaid coverage | CROSSED OVER
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.
HB 1151: Network adequacy | DID NOT CROSS OVER
HB 1151, sponsored by Rep. Kim Schofield, would increase consumer access to health care by imposing quantitative standards on insurance companies’ provider networks. Georgia has the narrowest provider networks in the country, forcing people to pay more to find care outside of their insurance plan’s approved providers. Network adequacy standards would ensure that consumers can access a provider in their insurance network for all covered benefits.
HB 1153: Short-term limited duration plans | DID NOT CROSS OVER
HB 1153, sponsored by Rep. Kim Schofield, would limit short-term health plans to 3 months and provide consumer protections like protections for people with pre-existing conditions.
HR 1280: Addressing childhood lead exposure | DID NOT CROSS OVER
HR 1280, introduced by Rep. Katie Dempsey, establishes a Joint Study Committee on Childhood Lead Exposure to address the issue of thousands of Georgia children under six years of age who were found to have lead poisoning, which is irreversible and can cause speech, language, and behavioral problems, lower IQ levels, and nervous system damage.
*Note: Because this is a resolution (rather than a bill), this resolution is still viable for passage and could be used to establish a House study committee.
SB 298: Raising age to purchase tobacco and vaping products| DID NOT CROSS OVER
SB 298, sponsored by Sen. Renee Unterman, would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age, among other things.
SB 303: Georgia Right to Shop Act | CROSSED OVER
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 313: Benchmarking for prescription drug prices | CROSSED OVER
SB 313, sponsored by Senator Dean Burke, had its second hearing in the Senate Insurance and Labor committee last Wednesday. This bill would update Georgia’s oversight of pharmacy benefit managers and add important consumer protections.
SB 348: Consumer Right to Access Act | DID NOT CROSS OVER
SB 348, sponsored by Senator Kirkpatrick, is aimed at addressing network adequacy. The bill includes similar language to SB 352 (below) and also directs Georgia’s Insurance Commissioner to set quantitative network adequacy standards to ensure Georgia consumers have adequate access to care within their insurance plans.
SB 352: Online provider directories | CROSSED OVER
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.
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.