As Georgians prepare to cast their votes in this year’s elections, the importance of health care policy has never been clearer. From the future of affordable coverage to the persistent gaps in access for communities around our state, the stakes are high. Georgia’s on-going health challenges highlight the need for candidates who prioritize health and wellness. Georgians need elected leaders who will make decisions that ensure access to affordable, high-quality health care, especially for communities who have historically had more difficult barriers to accessing and affording care.

With this in mind, we’ve developed a set of questions for voters to ask state and local candidates on key health care issues affecting communities around our state. These questions can help guide your conversations with candidates at town halls, forums, or on social media.

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This year, no Georgian has been left untouched by the health or economic impacts of COVID-19. The global pandemic has spotlighted the importance of public policy decisions that prioritize the health and wellness of populations, the consequences of underfunding government agencies (like departments of public health) and other essential public infrastructure, and the disparate impact that public policies have had on Black Americans and other people of color.  National, state, and local leaders, many elected by the public, are responsible for the policy decisions made ahead of and in response to COVID-19, its economic fallout, and the movement for racial justice .

Ahead of election season (October to November 3, 2020), Georgians have the opportunity to learn more about these elected positions, the decision-making power each has, and how their impact on the health and the well-being of Georgians. This year, Georgians will cast their votes for the U.S. President, members of Congress,  state legislators, state supreme court judges, and other positions.  Voters’ decisions about the candidates in each race will have an unprecedented impact on consumers health issues in Georgia as we continue to battle through the current health crisis.

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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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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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. 

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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.

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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. 

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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.

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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.

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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. 

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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.

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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. 

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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.

• Sign up for the Georgia Health ActionNetwork (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• GHF’s 2019-2020 legislative priorities

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.

• COVID-19 Policy priorities for a healthy Georgia — updated weekly
• Your health coverage, care, and well-being — updated weekly
• Mental health & addiction recovery in the time of COVID-19 — updated as new information becomes available
• NEW! Health insurance options for Georgians during COVID-19

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.

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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

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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.

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 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!

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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 assessment, among 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

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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.)

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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.

• Sign up for the Georgia Health ActionNetwork (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• GHF’s 2019-2020 legislative priorities

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.

• COVID-19 Policy priorities for a healthy Georgia — updated weekly
• Your health coverage, care, and well-being — updated weekly
• Mental health & addiction recovery in the time of COVID-19 — updated as new information becomes available
• NEW! Health insurance options for Georgians during COVID-19

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.

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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!

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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!  

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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!

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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.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• GHF’s 2019-2020 legislative priorities

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.

• COVID-19 Policy priorities for a healthy Georgia — updated weekly
• Your health coverage, care, and well-being — updated weekl
• Mental health & addiction recovery in the time of COVID-19 — updated as new information becomes available
• NEW! Health insurance options for Georgians during COVID-19

Surprise medical billing emerges as prominent issue at the Capitol 

Surprise out-of-network medical billing is emerging as a prominent issue within the Georgia General Assembly. A surprise medical bill can occur when a consumer encounters an out-of-network (OON) provider at an in-network facility or in other circumstances. Three pieces of legislation have been introduced to address surprise billing and each attempts to resolve the issue in its own way. In this week’s legislative update, we will provide a broad look at each bill and its provisions. (If you would like more information about any of the bills, click on the provided links to read the full legislation.) All three bills seek to protect patients, and we will monitor and weigh in on the bills as they undergo the inevitable amendment process in committee. We appreciate all of the bill sponsors for remaining vigilant towards protecting patients from unexpected medical bills.

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HB 678: Increased network and billing transparency by health care providers and insurers 

HB 678 is sponsored by Rep. Richard Smith, chairman of the House Insurance Committee, and has the backing of several powerful House lawmakers. The bill improves transparency for consumers by outlining the information that must be provided to consumers by health care providers and practices and by insurers. Providers must inform consumers about their participation in the patient’s insurance network and about how to check the network status of other providers with which the primary provider has coordinated services (e.g. laboratory or radiology services). It also requires insurers to provide consumers with information about when and how to receive approval for services from an out of network provider. Insurers must also communicate to a consumer ahead of a planned procedure if the provider is out of network (OON), and if so, the estimated amount the insurer will cover for the OON services. Lastly, HB 678 provides consumers with 90 days from the time of receiving a medical bill to pay the bill, negotiate payment or initiate arbitration through the Georgia Department of Insurance. After that time period, providers would be allowed to initiate collection proceedings to secure their payment.

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HB 799: Out of network care in emergency situations

While HB 678 applies only to non-emergency situations, HB 799 applies solely to emergency care and medically necessary follow-up care. The legislation, sponsored by Rep. Sharon Cooper, Chairperson of the House Health & Human Services Committee, disallows managed care plans from denying payment for emergency services and disallows hospitals from billing patients for medically necessary care following an emergency situation except for their standard co-pays, co-insurance, and deductibles. For a patient receiving emergency care at an OON hospital and who is covered by a plan that requires prior authorization for post-stabilization care, the legislation outlines how the OON hospital and insurer must coordinate the patient’s transfer to an in-network facility and defines which entities are responsible for specific costs. Under this bill, if a patient (or their representative) does not consent to be transferred to an in-network hospital, the OON hospital must provide verbal notice to the patient that they may be financially responsible for any further post-stabilization care provided.

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SB 359: Consumer Coverage & Out of Network Medical Care Act

SB 359 is the only Senate-side legislation introduced thus far to address surprise out-of-network billing and is sponsored by Senator Chuck Hufstetler, Chairman of the Senate Finance and member of HHS committees. The legislation contains many of the same transparency provisions for non-emergency care as HB 678 with regard to information that health care providers and hospitals must supply to consumers, but provides for more robust disclosure by insurers to consumers about possible OON costs. It also contains provisions similar to that of HB 799 with respect to emergency situations, but goes farther to stipulate that insurers must treat OON emergency care as if it were in-network by applying a consumer’s cost-sharing towards their in-network deductible and out-of-pocket maximum. The legislation also makes mediation available to consumers who receive elective medical care during which an unexpected event arises resulting in surprise bill greater than $1000. SB 359 is expected to be more controversial than the other two bills because it sets a payment resolution process that sank previous legislative attempts.

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RSVP today for Cover Georgia Day at the Capitol!

Join us next Thursday, February 15th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of low-income Georgians. This is the most important step that our elected officials can take to slow the growing opioid crisis, strengthen our state’s struggling rural health care system, and improve the health & finances of hard-working, low-income Georgia families. Take advantage of this opportunity to talk with your elected officials about closing Georgia’s coverage gap! RSVP today!

Can’t make it? Send an email to your state legislators asking them to put an insurance card in the pockets of all low-income Georgians.

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Legislation prioritized by Senate leaders approved by HHS Committee

At Thursday’s Senate Health & Human Services Committee, the two pieces of legislation resulting from the Health Care Reform Task Force were considered. Both SB 357 and SB 352 received strong support from legislators and stakeholders. GHF’s partners at the Georgia Council on Substance Abuse and Mental Health America of Georgia rose in support of SB 352, which would create a 15-member Commission on Substance Abuse & Recovery supported by a director. Both bills were passed by unanimous voice votes. You can find a description of both bills in last week’s legislative update blog.

New legislation would establish proposed Health Coordination and Innovation Council

Last week, the first legislation to result from the Lieutenant Governor’s Health Care Reform Task Force was introduced. SB 357, sponsored by Senator Dean Burke, would establish the Health Coordination and Innovation Council, the Health System Innovation Center, and an advisory board to the Council.

Health Coordination & Innovation Council

According to the Task Force’s final report, the Health Coordination and Innovation Council (aka “the Council”) will act as a permanent statewide coordinating platform, bringing together all of health care’s major stakeholders. As the legislation is currently written the Council will be made up of 13 members including the director of health policy & strategic planning, the Commissioners of the Departments of Community Health, Public Health, Human Services, and Behavioral Health and Developmental Disabilities, and eight members to be appointed by the Governor representing Georgia’s medical schools and academia and private health care sector. A consumer representative is not explicitly written into the bill text at this time.

Health System Innovation Center

The Health System Innovation Center is proposed as a research organization that utilizes academic, public health policy, data, and workforce resources to develop new approaches for financing and delivering health care in Georgia. The structure of the Center is not outlined in the legislation, but it is clear that its initial charge will be to synthesize existing studies and data to inform a strategic plan to improve access to health care in rural Georgia. The Center’s work will inform the Council.

We expect more legislation and proposals may emerge from the Health Care Reform Task Force in the coming days. As these proposals emerge, we will continue to keep you updated.

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Legislation establishes Commission on Substance Abuse & Recovery

Senator Renee Unterman continues to spearhead efforts to address the opioid and substance use crisis in Georgia and last week, she introduced SB 352 which, among other things, establishes a Commission on Substance Abuse & Recovery. The Commission is to be headed by the director of Substance Abuse & Recovery and will serve as chair of the 15-member commission, including two representatives from the advocacy community. The Commission is charged with coordinating data among relevant government entities; informing strategies to combat the opioid crisis within the Departments of Public Health and Education, the Attorney General’s Office, and other state entities; consulting with the Governor’s office on a potential Medicaid waiver related to opioid abuse; and developing and informing other efforts to expand access to prevention, treatment, and recovery support services across the state.

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Come to the state Capitol on February 15th!

Join us on Thursday, February 15th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of low-income Georgians. This is the most important step that our elected officials can take to slow the growing opioid crisis, strengthen our state’s struggling rural health care system, and improve the health & finances of hard-working, low-income Georgia families. Take advantage of this opportunity to talk with your elected officials about closing Georgia’s coverage gap! RSVP today!

Can’t make it? Send an email to your state legislators asking them to put an insurance card in the pockets of all low-income Georgians.

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House continues to consider state budget bills

The Georgia House of Representatives continues its consideration of both the “little” and “big” budgets this week. HB 683, the FY2018 supplementary budget (also called the “little budget”), makes necessary, mid-year adjustments to the current state budget. The Governor’s proposed amended FY2018 budget provides an extra $5 million to the Georgia Trauma Care Network Commission from increased Super Speeder collections, but includes few other health care-related changes. The House Appropriations Committee and its subcommittees spent much of last week in budget hearings regarding the FY 2019 budget. The House’s consideration of the “big budget” will accelerate when they pass the FY2018 supplementary budget to the Senate for its consideration

 

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The Legislature plans to finish work by March 29th

The schedule for the remainder of the legislative session has been set. Crossover Day, the day that legislation must move from one chamber to the other in order to be considered in 2018, will fall on February 28. The legislature will be in session Monday through Thursday each week until Crossover Day. The remaining 12 legislative days will be broken up throughout March, culminating on Sine Die, the last day of the session, on March 29th. The full calendar can be accessed here.