Lawmakers act on key health care measures in session’s final days

The House passed a bill (S.B. 8) that would 1) require physicians to provide patients with certain information before elective procedures, including the physician’s status with the patient’s health insurer’s network, the names and other information related to other physicians who will provide services during the procedure, and an estimate of the bill that the patient will receive after the procedure and 2) subject hospitals and insurers to greater transparency requirements and 3) require physicians and hospitals to send initial bills to patients within 90 days – while the Georgia Department of Insurance would establish a patient arbitration process to resolve any billing disputes. MAG and other physician and patient advocacy organizations are opposing S.B. 8 because it is not a comprehensive solution for “surprise medical bills” (i.e., it is limited to transparency and elective procedures, physician pay would be based on the median network rate paid by a health plan or the rate of the health plan in its standard formula for out-of-network reimbursement or Medicare fee-for-service reimbursement, and it does not address emergency settings). The Senate will now have to agree to this bill in its current form as the next step in the legislative process.  

The House Health and Human Services (HHS) Committee did not pass a bill (S.B. 31) by Sen. Joshua McKoon (R-Columbus) that would 1) change the definition of a “destination cancer hospital” to a “hospital facility” for the purpose of the state’s CON requirements and 2) require any such hospital to pay $1 million or one percent of its adjusted gross revenue – whichever is lower – to the Indigent Care Trust Fund and 3) create a new collocated children’s beds category for CON purposes.

The House HHS did pass a measure (H.R. 1592) by Rep. Karen Mathiak (R-Griffin) that would urge health insurers to provide coverage for less-addictive opioids, opioid addiction treatments, and opioid alternative treatments. MAG supports this bill, which will now go to the House Rules Committee.

The Senate HHS passed a bill (H.B. 301) by Rep. Jodi Lott (R-Evans) that would 1) create an income tax credit for taxpayers who are licensed physicians, advanced practice registered nurses or physician assistants who provide uncompensated preceptorship training to medical students, advanced practice registered nurse students or physician assistant students and – having been amended to include S.B. 334 by Sen. Renee Unterman – would 2) move the administration of the Georgia Board of Nursing from the Secretary of State’s office to the Georgia Department of Community Health to operate on an independent basis, much like the Georgia Composite Medical Board does. MAG is keeping a close eye on this measure, which will now move into the Senate Rules Committee.

The Senate passed a bill (S.B. 422) by Sen. Renee Unterman (R-Buford) that would allow pharmacists to help patients perform and interpret any over-the-counter tests. Having also passed the House, this measure will now go to Georgia Gov. Nathan Deal. MAG is neutral on this bill.

The Senate also passed a bill (H.B. 782) that would 1) eliminate a requirement for non-licensed user delegates to register with Georgia’s Prescription Drug Monitoring Program (PDMP) on an annual basis and 2) allow the Georgia Department of Public Health to share data from the Georgia PDMP with other states. The House will have to determine if it agrees to the changes that took place in the Senate as a next step in the legislative process.  

Make it illegal for the “solicitation, acceptance of payment, or offer to pay a commission, benefit, bonus, rebate, kickback or bribe – directly or indirectly and on a cash or in kind basis – or to engage in any split-fee arrangement to induce the referral of a patient or for the acceptance or acknowledgment of treatment of a patient to another provider or health care facility for the purposes of obtaining mental health or substance abuse treatment.

Make it illegal to aid, abet, advise or otherwise participate in the conduct prohibited by this law.  

Create a director of Substance Abuse, Addiction, and Related Disorders who would report to the governor and lead a new Commission on Substance Abuse and Recovery.   

Prohibit physicians from billing a patient or insurer for excessive, high-tech (i.e., “where billing for drug tests is not limited and tests are ordered for a number of different substances whereby the health benefit plan is billed separately for each substance tested”) or fraudulent drug testing in the treatment of the elderly, the disabled, or any individual affected by pain, substance abuse, addiction, or any related disorder. This would include – but not be limited to – upcoding that results in billing for more expensive services or procedures than were actually provided or performed, unbundling of such billing whereby drug tests from a single blood sample that detect a variety of narcotics is separated into multiple tests and billed separately, or billing an individual for multiple co-pay amounts or for services that are covered by such individual's health benefit plan.

The House must now determine if it supports H.B. 782 in its amended form as a next step in the legislative process.

The Senate passed a bill (H.B. 314) that would 1) result in greater transparency for elective procedures and 2) establish a patient/physician mediation process for bills that arise from “unexpected events” that take place during elective medical procedures and 3) establish a standard physician payment model for out-of-network emergency care – the 80th percentile of the independent/neutral ‘FAIR Health’ database. MAG supports this legislation, which would put an end to surprise medical bills. The House will have to decide if it agrees to the changes that took place in the Senate as a next step.  

The Senate passed a bill (H.B. 927) that was amended to include the provisions of a measure by Sen. Renee Unterman (R-Buford) – S.B. 351 – that would 1) increase the number of advanced practice registered nurses (APRNs) a physician can oversee with a protocol agreement at one time from four to eight and 2) allow physicians to delegate the ordering of radiographic images to APRNs. MAG opposes H.B. 927 in its current form. The House must now agree to this measure in its amended form.   

The Senate passed a bill (H.B. 65) by Rep. Allen Peake (R-Macon) that would create a ‘Joint Study Committee on THC Medical Oil Access’. The House must now agree to this measure in its amended form as a next step in the legislative process. MAG has not assumed a position on this bill.

The Senate HHS Committee passed a bill (H.B. 647) by Rep. Katie Dempsey (R-Rome) that would create a pilot program for State Health Benefit Plan beneficiaries for the treatment and management of obesity, including medication and counseling. MAG is tracking this legislation, which is headed to the Senate Rules Committee.

The Senate HHS Committee also passed a measure (S.R. 1063) by Sen. Ben Watson, M.D. (R-Savannah) that would create a Senate Study Committee on CON reform. It is worth noting that MAG’s Board of Directors will be studying a number of CON issues, something MAG’s House of Delegates called for when it met in 2017. S.R. 1063 will now go to the Senate Rules Committee.

Finally, the Senate Judiciary Committee passed a bill (H.B. 673) by Rep. John Carson (R-Marietta) that would make it illegal for drivers to use a cell phone on anything other than a hands-free basis. The Senate amended this measure by adding escalating fines and “points” for multiple violations. MAG supports this bill, which will now make its way to the Senate Rules Committee.  

MAG reminding members to complete ‘Vision Commission’ MOC reform survey
The Medical Association of Georgia (MAG) is reminding its members to complete a survey that the new ‘Vision Initiative Commission’ is conducting to solicit physician feedback to reform maintenance of certification (MOC) programs.
The Vision Initiative Commission says that it will “begin its work with a comprehensive assessment of the current continuing board certification system. Feedback will be obtained from various stakeholders through multiple methods beginning with [this survey].”
The survey takes about 10 minutes to complete.   
The Vision Initiative Commission will be “responsible for assessing the status of continuing board certification and making recommendations to help enable the current process to become a system that demonstrates the profession’s commitment to professional self-regulation, offers a consistent and clear understanding of what continuing certification means, and establishes a meaningful, relevant and valuable program that meets the highest standard of quality patient care.”
The Vision Initiative was established by the American Board of Medical Specialties and its 24 member boards.  
MAG Executive Director Donald J. Palmisano Jr. is a member of the Vision Initiative Commission.
Contact Palmisano at dpalmisano@mag.org with questions. Click to complete MOC reform survey
MAG thanks & applauds this week's ‘Doctor of the Day’ volunteers
MAG is thanking and applauding its ‘Doctor of the Day’ volunteers for the weeks of March 12 and 19, which include… 
Michelle Zeanah, M.D.
Stephen Jarrard, M.D.
Clark Hill, M.D.
Steve Tuck, M.D.
Jim Morrow, M.D.
Mboh Elango, M.D.
MAG Doctor of the Day volunteers work in the Medical Aid Station at the state Capitol, where they provide free minor medical care to legislators and their staff members. 
Go to www.mag.org/dod for additional information on the MAG ‘Doctor of the Day’ program, including logistical details and FAQ. 
MAG encouraging members to register for annual legislative seminar
The Medical Association of Georgia (MAG) is encouraging its members to register for MAG's 2018 ‘Legislative Education Seminar’ meeting, which will take place at the Brasstown Valley Resort in Young Harris on June 1-3. 
The Brasstown Valley Resort is sold out for this event. Contact Anita Amin at anita@associationstrategygroup.us for information on other lodging options in the area.  
Monitor MAG’s communications and www.mag.org for additional details, and contact Derek Norton at dnorton@mag.org or 678.303.9280 with any other questions related to the seminar.  
Georgia Physicians Leadership Academy’s 10th class experiences ‘Day at the Capitol’ 
Members of the MAG Foundation’s Georgia Physicians Leadership Academy’s (GPLA) 10th class participated in a ‘GPLA Day at the Capitol’ event at the State Capitol in Atlanta on March 6. In addition to discussing key issues and legislation with state lawmakers, they had their picture taken with Georgia Gov. Nathan Deal.
Pictured from the left are MAG Manager of Programs & Initiatives Lori Cassity Murphy, MAG Manager of Membership Outreach & Meeting Planning Renai Lilly, Zachary Lopater, M.D., Chip Cowart, M.D., MAG student intern Monica Uppal, Eddie Richardson Jr., M.D., Sudha Tata, M.D., Gwinnett Medical Center’s ‘MAG Resident of the Month’ Brian Xavier, M.D., Anna Skold, M.D., Syamala Erramilli, M.D., Bhavin Adhyaru, M.D., Margaret Wong M.D., Gov. Deal, GPLA Advisor William Clark, M.D., GPLA Steering Committee Chair John Sy, D.O., Kelly Homlar, M.D., Sultan Simms, M.D., GPLA Vice Chair Stephen Jarrard, M.D., Nikki Hughes, M.D., John Johnson, M.D., Keisha Callins, M.D., and Masoumeh Ghaffari, M.D. Unless otherwise noted, all are members of GPLA’s 10th class. 
MAG’s 2018 state legislative priorities 
The Medical Association of Georgia’s (MAG) priorities for the 2018 state legislative session include…
Health Insurance
– Developing a solution for the “surprise health insurance coverage gap.”
– Streamlining and improving the prior authorization process.
– Promoting more and better health insurance coverage options for pain therapy.
– Ensuring that patients have access to every physician insurers advertise as “in-network” for the duration of the contract year to ensure the continuity of care.
– Requiring insurers to be transparent about how they develop their networks, their standards of participation, and the process they use to select and de-select physicians for their networks.
– Allowing patients to make their own health care decisions based on the best treatment options, their medical history, and the advice they receive from their physician rather than an insurer’s step therapy protocols.
Patient Safety
– Working with allied stakeholders (e.g., MagMutual) on key patient safety initiatives, including distracted driving.
Medicaid
– Exploring a waiver option to access federal funds to expand the state’s Medicaid program.
Scope of Practice
– Addressing scope of practice issues that undermine patient safety.  
Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 678.303.9280 with questions related to MAG’s legislative priorities for 2018. 
Follow MAG at the Capitol 24/7 
Whether you are using a laptop or a tablet or a handheld device, you can always get the latest state legislative news in Georgia by following MAG on Twitter at www.twitter.com/MAG1849, on Facebook at www.facebook.com/MAG1849, or by visiting www.mag.org/governmentrelations
MAG’s Government Relations team 
Derek Norton – Director
dnorton@mag.org or 404.274.4210  
Bethany Sherrer – Associate, Legal Counsel & GAMPAC Manager
bsherrer@mag.org or 404.354.1863  
Christiana Craddock – Legislative Assistant
ccraddock@mag.org or 678.303.9271
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