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: sine die
Legislative update: Week 11
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:
- Changes to prior authorization bill
- Bills that still need final action
- Updates to Georgia’s FY22 budget
- Vaccine eligibility opens to all Georgians, ages 16+
- GHF’s got you covered this session!
2021 legislative session ends this week
Georgia’s 2021 legislative session is set to wrap up this week. The final two days of the session take place on today, March 29th and Wednesday, March 31st, also called “Sine Die”. Sine Die marks the 40th and final legislative day for the year and means “no future date set”.
Our next legislative update will include a summary of the more notable bills taken up this session. You can find a full list of health care related legislation at GHF’s legislative tracker.(more…)
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
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.
- 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