Tag: NEMT

Legislative Update: Transportation and movement on surprise billing

Legislative Update: Week 5

Legislative session resumes this week

After a brief pause last week due to budget disagreements the Georgia legislature will resume its normal schedule today, February 18th. Today is day 13 (out of 40) 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.


Surprise billing legislation set for committee vote

Senate and House action expected on surprise billing legislation this week

Last month, companion pieces of 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 resolution process that allows insurers and health care providers to settle payment disputes while keeping consumers out of the middle.
 

The Senate Health and Human Services committee heard testimony from insurers, advocates, and medical providers at a hearing on SB 359 last Tuesday. GHF’s Executive Director testified on the bill saying, “the consumer protections in this bill are fair and reasonable. For these reasons, we support (SB 359) and hope to see its successful passage by both chambers during this session.”

HB 888 is scheduled to be heard in the House Special Committee on Access to Quality Health Care today at 2pm.

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!


Prescription drug legislation heard by senate committee

SB 313: Pharmacy benefit managers, the middlemen for prescription drugs

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. Pharmacy benefit managers (PBMs) are companies that manage prescription drug benefits for health insurance companies and in that role are charged with negotiating lower costs for the company and consumers.

At Wednesday’s hearing, patients, doctors, pharmacists and representatives of pharmacy benefit managers offered detailed testimony on the bill. No further action was taken on the bill last week and it is unclear if the Senate Insurance committee will consider it again this week. GHF will continue to report on the bill through the legislative session. (We provided an overview of the bill in an earlier legislative update.)


Rural transit bill could bring changes to Medicaid transportation

Revisions to transit bill attract support from more stakeholders

Adequate transportation is important to the health of Georgians because in most cases people need to go to a location outside of their homes to receive health care. Without access to reliable, safe transportation, Georgians may be forced to skip health appointments and go without medication, or they may not be able to access other things (like healthy foods or good schools and jobs) that would help them stay healthy.

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. The purpose of the proposed “mobility zones” is to eliminate restrictions on crossing county lines for health appointments and other services for seniors, low-income families, and other needy Georgians, and extend transportation services to those who do not have access to local transportation options.

Advocates for Georgia seniors supported earlier versions of the bill and recent revisions to the bill have earned the support of GDOT and Uber. HB 511 has not been scheduled for a hearing but GHF will report on the legislation as the session progresses.


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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Georgians in the Driver’s Seat wants to hear from you

Since launching our Georgians in the Driver’s Seat initiative with The Arc Georgia, GHF staff have spoken with consumers around the state about their transportation needs as they relate to health. During one of those opportunities, GHF met Tannyetta and her four-month-old daughter Ayla at Atlanta’s CAPN Clinic.

Tanyetta enrolled in Medicaid while she was pregnant and both she and Ayla have Medicaid coverage now. In order to get back and forth from health appointments Tanyetta uses a free transportation service through Medicaid. This benefit, available to Medicaid-covered Georgians who do not have their own transportation, is called non-emergency medical transportation (NEMT). Transportation is provided in the form of pre-loaded public transit cards, van transport, rides with ride-share companies, and in other ways depending on the needs of the individual. Tanyetta does not have her own transportation but is able to get to medical appointments safely because of NEMT.

Much like Tanyetta, Georgians around the state are able to see health providers because they can use NEMT if they do not have another way to travel. For almost 400,000 Georgians each year, the service works well. However, there are times when it falls short of its promise. Patients and families are picked up late going to or from an appointment. In the worst cases, they are never picked up at all. People who use wheelchairs are picked up by vans that cannot accommodate their chairs. Parents who need to take one child to see the doctor are blocked from bringing their sibling, forcing them to find alternative and expensive childcare.

The people for whom NEMT is breaking down are often those who need it the most: patients with complex care needs. These riders are children and adults with physical and intellectual disabilities, seniors who would otherwise have to live in nursing homes, and people with multiple chronic conditions. Almost four million NEMT rides are provided to Medicaid-covered Georgians each year. Riders use an average of nine trips per year, demonstrating that those who use the service visit the doctor frequently and rely heavily on NEMT to get them there. When NEMT falls short for these riders, the consequences can be serious, so it is imperative the system works well all of the time.  

In order to improve Georgia’s NEMT services (so that they work all of the time, every time!), we need to hear from the people who use it. You can help! Fill out this rider survey, if you use transportation services to get to health appointments. If you are a caregiver or otherwise help people arrange for NEMT rides, we want to hear from you too.

If you do not fit into one of those categories, share the survey with someone who does! Ask your patients, your social media network, and others to fill out the survey if they have used Medicaid’s transportation services. The survey is available at this link and is open through December 09, 2019: https://www.surveymonkey.com/r/MedicaidTransport.

Have a story about transportation and health that you want to share? Tell us about it! We’ll get in touch with you soon to learn more.


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