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| MAG encouraging lawmakers to pass tort reform bill
The Medical Association of Georgia (MAG) is encouraging state lawmakers to pass S.B. 415, a bill by Sen. Steve Gooch (R-Dahlonega) that would improve the state’s failing tort environment.
This legislation would 1) eliminate “phantom damages” (the difference between what a patient is billed and what they pay for their care, which can translate into much higher medical malpractice awards) and 2) change the state’s ‘Civil Practice Act’ to improve and streamline the process for physicians and small businesses that are involved in lawsuits and 3) establish guidelines for what a judge needs to consider when they decide whether to bifurcate a trial. The measure also includes other legal reforms (e.g., premises liability reform and seat belt admissibility).
Sen. Gooch addressed the bill’s key provisions during a press conference that took take place at the State Capitol on Thursday.
Having passed a Senate Insurance subcommittee, S.B. 415 will now be considered by the full Senate Insurance Committee.
“A lot of the progress we made when tort reform passed in Georgia in 2005 has been stripped away as a result of unfavorable court decisions,” says MAG President Andrew Reisman, M.D., who spoke at yesterday’s press conference. “At the top of the list is a state Supreme Court ruling that struck down the cap on non-economic damages.”
Dr. Reisman credits Sen. Gooch for his vision and leadership, stating that, “He understands that it’s crucial to change the way we litigate lawsuits in this state or face a future that could see physicians cut back on high-risk services, relocate, or retire because they can’t get or afford medical malpractice insurance.”
Georgia ranks sixth on the ‘Judicial Hellholes’ Top 10 list for 2019-2020, and it is near the bottom (41st) of the U.S. Chamber of Commerce’s ‘Lawsuit Climate Survey’ for 2019 – and keeping in mind that the most recent ‘County Health Rankings and Roadmaps’ program report found that Georgia already has the ninth fewest doctors per capita.
In a related development, MAG is encouraging MAG members to share a “Meet Mary” video that highlights the hidden costs that are associated with frivolous lawsuits with their legislators.
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| Senate passes network payment, insurer transparency bills
The Georgia Senate passed some key health care bills this week, including…
– S.B. 352 by Sen. Dean Burke, M.D. (R-Bainbridge), which would require insurers to cover physician/other health care provider charges at in-network rates for the duration of the patient’s contract year if a physician/provider departs the network during the contract year and were advertised as in-network in the insurer’s provider directory when the patient selected their plan. MAG supports this legislation, which has gone to the House Insurance Committee.
– S.B. 303 by Sen. Ben Watson, M.D. (R-Savannah), which would require health insurers to make certain patient cost comparison information available on an interactive and publicly accessible website. This legislation would allow patients to 1) see how much in-network physicians are paid by insurers and 2) see the average amount that in-network physicians actually agree to be paid by insurers and 3) get an estimate for how much out-of-pocket money they will owe their physicians/providers and 4) compare quality metrics for the physicians/providers that are in their network in major diagnostic categories, adjusted for risk and severity. MAG is watching S.B. 303, which has been assigned to the House Special Committee on Access to Quality Health Care.
– S.B. 359 by Sen. Chuck Hufstetler, which would 1) set the price that should be paid for out-of-network emergency care and unanticipated out-of-network non-emergency care at 1) the previously contracted rate between the provider and the insurer or 2) the 2017 median contracted rate, adjusted annually according to the Consumer Price Index (CPI) – whichever is greater – and paid without the need for prior authorization and without any retrospective payment denials and 2) allow a patient to choose out-of-network elective care by consenting in writing and orally at least 48 hours in advance with an estimate of the charges and 3) require an insurer to use the most recent in-network contract rates as the initial payment for a physician/provider when a contract is terminated without cause by the insurer or with cause by a physician/provider within one year of the effective date of the legislation and 4) establish a “baseball-style” arbitration system (i.e., the insurer and physician/provider would each submit a payment amount and an arbitrator would choose one of the numbers and the “loser” would pay the arbitration costs and the bundling or batching of claims would be allowed, with no thresholds). This bill is one of MAG’s priorities for the year, and it has been sent to the House Special Committee on Access to Quality Health Care.
The Senate also passed a bill (S.B 316) by Sen. Bruce Thompson (R-White) that would allow military spouses to get a license (e.g., a medical license) “by endorsement” as long as the “potential licensee holds a current license to practice such occupation or profession issued by another state for which the training, experience, and testing are substantially similar in qualifications and scope to the requirements under this state to obtain a license, and that he or she is in good standing in such other state and he or she passes any examination that may only be required to demonstrate knowledge of the laws and rules and regulations of this state specific to the practice of the profession, business, or trade for which such expedited license by endorsement is being sought.” MAG is tracking this bill, which will now go to the House Governmental Affairs Committee.
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| Senate HHS passes MediSpa, licensure compact bills
The Senate Health and Human Services Committee (HHS) passed two key bills this week, including…
– S.B. 323 by Sen. Kay Kirkpatrick, M.D. (R-Marietta), which would 1) require the Georgia Composite Medical Board to establish rules and regulations for the in-office use of sedation in “MediSpas” and 2) prohibit anyone who doesn’t have a license to practice dentistry to administer conscious sedation in a dental facility or during the practice of dentistry in a MediSpa. MAG supports this legislation.
– S.B. 306 by Sen. Valencia Seay (D-Riverdale), which would create a licensure and telemedicine compact for audiologists and speech language pathologists. It is worth noting that there is a comparable bill on the House side (H.B. 956) by Rep. Dave Belton (R-Buckhead). MAG has taken an active role in improving both bills, but it will continue to call for the addition of a physician on the compact’s board.
S.B. 323 and S.B. 306 have moved into the Senate Rules Committee, while H.B. 956 is going to the full House Regulated Industries Committee.
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| House HHS passes Newborn Screening/Genetics & prescribing bills
The House Health and Human Services (HHS) Committee passed two key bills this week. The first was H.B. 1054 by Rep. Sharon Cooper (R-Marietta), a measure that would create the ‘Newborn Screening and Genetics Advisory Committee’ to review and make recommendations to the Georgia Department of Public Health (DPH) when a new disorder is added to the federal ‘Recommended Uniform Screening Panel’ about whether DPH should add the new disorder to the state’s newborn screening panel. MAG is tracking this legislation, which will now go to the House Rules Committee
The second was H.B. 791 by Rep. Ron Stephens (R-Savannah), which would allow pharmacists to convert a maintenance medication prescription from a 30-day supply to a 90-day supply up to the quantities that have been authorized through refills by the physician – although this would not be permitted on the initial fill of the prescription or whenever the physician specifies that the refills should not be combined. MAG is also watching this legislation, which is headed to the House Rules Committee.
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| House committees pass hands-free bill
The House Public Safety Committee passed a bill (H.B. 113) by Rep. John Carson (R-Marietta) that, having been amended a number of times, would prohibit the use of cell phones by drivers who are under 18. Fines would range from $25 to $100 per infraction – regardless of the number of times a person breaks this law, and keeping in mind that the state’s existing law includes fines of $50 for the first occurrence, $100 for the second occurrence, and $150 for the third occurrence. MAG is concerned that the lower fines wouldn’t serve as enough of a deterrent and would undermine the state’s existing “hands-free” law. H.B. 113 is now in the House Rules Committee.
Meanwhile, the House Special Committee on Access to Quality Health Care passed a bill (H.B. 888) by Rep. Lee Hawkins (R-Gainesville) that would…
– Set the price that should be paid for out-of-network emergency care and unanticipated out-of-network non-emergency care at 1) the previously contracted rate between the provider and the insurer or 2) the 2017 median contracted rate, adjusted annually according to the Consumer Price Index (CPI) – whichever is greater – and paid without the need for prior authorization and without any retrospective payment denials.
– Allow a patient to choose out-of-network elective care by consenting in writing and orally at least 48 hours in advance with an estimate of the charges.
– Require an insurer to use the most recent in-network contract rates as the initial payment for a physician/provider when a contract is terminated without cause by the insurer or with cause by a physician/provider within one year of the effective date of the legislation.
– Establish a “baseball-style” arbitration system (i.e., the insurer and physician/provider would each submit a payment amount and an arbitrator would choose one of the numbers and the “loser” would pay the arbitration costs and the bundling or batching of claims would be allowed, with no thresholds).
This bill is one of MAG’s priorities for the 2020 legislative session, and it will go to the House Rules Committee as a next step.
And in other House news, a House Occupational Professional Licensing subcommittee held a hearing on a bill (H.B. 910) by Rep. Karen Mathiak (R-Griffin) that would establish a license for certified professional midwives – legislation that MAG is opposing.
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| House Special Committee passes PBM bills
The House Special Committee on Access to Quality Health Care passed a number of bills that deal with pharmacy benefit managers (PBMs) this week, including…
– H.B. 918 by Rep. Sharon Cooper (R-Marietta), which would change PBM licensure requirements, prohibit “steering” (i.e., when PBMs force patients to use the pharmacies they own), and reform the process for auditing pharmacies – which are currently conducted by PBMs, insurers, etc.
– H.B. 946 by Rep. David Knight (R-Griffin), which would require PBMs to become more transparent by making them report deviations in public pricing benchmarks, prohibiting them from using “spread pricing” practices or “retroactive recoupments,” and requiring them to pass any rebates along to payors. This bill would also prohibit PBMs from 1) withholding coverage for lower-cost generic drugs and 2) failing to count co-pay assistance towards deductibles and 3) removing a drug from a formulary for the purpose of “steering” patients to a different plan. Plus, it would require physicians who are employed by a PBM to be licensed in Georgia and be practicing an area of medicine that focuses on the same disease or condition for which they are providing the advice.
– H.B. 947 by Rep. Knight, which calls for the state to conduct a study to determine how much money it could save if it carved the pharmacy benefits out of the state’s care management organizations – action that would kick in if the savings were placed at more than $20 million.
MAG supports all three bills, which will now move into to House Rules Committee.
The committee also passed a bill (H.B. 952) by Rep. Cooper that would prohibit corporations that own and operate multiple pharmacies from implementing policies and procedures that restrict the quantity of controlled substances that are dispensed or places a restriction on filling a prescription for a controlled substance that is issued by a specific prescriber. This legislation would allow a pharmacist to decline to fill a prescription if they “reasonably believe” that it’s not for a legitimate medical purpose or it’s not in the patient's best interest or it was written by a prescriber who has been the subject of an enforcement action resulting from controlled substance prescribing by any state or federal agency or entity. MAG supports this legislation, which is also headed for the House Rules Committee.
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| House subcommittee passes cosmetic laser bills
A House Regulated Industries Committee subcommittee passed a bill (H.B. 996) by Rep. Sharon Cooper (R-Marietta) that would expand the definition of “cosmetic laser services” to include “energy based medical procedures using an ultrasound, cyolipolysis, microwave, or radio frequency device that is not expected or intended to remove, burn, or vaporize the live epidermal surface of the skin, but may damage underlying tissue, if used inappropriately and specifies that these services constitute the practice of medicine.” MAG supports this legislation, which will now be considered by the full House Regulated Industries Committee.
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| Lawmakers introduce array of health care bills
New legislation that was introduced this week includes…
– H.B. 991 by Rep. Matt Hatchett (R-Dublin), which would create a ‘Healthcare Transparency and Accountability Oversight Committee’ that would have the authority to review the performance and conduct of all state health care plan contractors, their affiliate subcontractors, and their subcontractor pharmacy benefits managers. MAG supports this legislation, which was assigned to the House Special Committee on Access to Quality Health Care.
– H.B. 1007 (‘Coach Safely Act’) by Rep. Demetrius Douglas (D-Stockbridge), which would require any association that sponsors or conducts sports training or high risk youth athletic activities for children age 14 and under shall require all unpaid or volunteer coaches and athletics personnel to complete an online or residence course approved by the department which provides such coaches and personnel with information and awareness of actions and measures that may be used to decrease the likelihood that youth athletes will sustain serious injuries while engaged or participating in high risk youth athletic activities. MAG supports this legislation, which has been assigned to the House Health and Human Services Committee.
– H.B. 1024 by Rep. Mark Newton, M.D. (R-Augusta), which would provide for an exception to the certificate of need (CON) process for freestanding emergency departments and increases in bed capacity or use of unused beds of a private or public hospital, located in a rural county, provided that any such beds are used exclusively for the treatment of patients in need of behavioral health or developmental disabilities services and provided any such beds may also be leased to a behavioral health provider for treatment of such patients. MAG is evaluating this legislation, which went to the House Special Committee on Access to Quality Health Care.
– H.B. 1027 by Rep. Lee Hawkins (R-Gainesville), which would require pharmacy benefits managers (PBMs) to calculate an enrollee’s defined cost sharing for each prescription drug at the point of sale based on a price that is reduced by an amount equal to at least 80 percent of all rebates received or that will be received in connection with the dispensing or administration of the prescription drug. MAG supports this legislation, which was assigned to the House Special Committee on Access to Quality Health Care.
– H.B. 1032 by Rep. Hatchett (R-Dublin), which would exempt certain facilities that perform medical procedures only in non-sterile procedure rooms from certificate of need (CON) requirements and would exempt those facilities from having to have an operating room or an operating room environment or from having to have any minimum physical plant and operational standards, as specified in the rules of the Georgia Department of Community Health for the purposes of CON. MAG is evaluating this legislation, which was assigned to the House Special Committee on Access to Quality Health Care.
– H.R. 1282 by Rep. Shelly Hutchinson (D-Snellville), which would create the ‘House Study Committee on Evaluating, Simplifying, and Eliminating Duplication of Regulatory Requirements for Mental Health and Social Services Providers’. MAG is following this legislation, which was assigned to the House Special Rules Committee.
– S.B. 417 by Sen. Kay Kirkpatrick, M.D. (R-Marietta), which would address problematic language that is related to background checks in the Medical Licensure Compact bill that passed last year. MAG supports this legislation, which is in the Senate Health and Human Services Committee.
– S.B. 427 by Sen. Jeff Mullis (R-Chickamauga), which would call for the state to conduct a study to determine how much money the state could save if it carved the pharmacy benefits out of the state’s care management organizations – action that would kick in if the savings were placed at more than $20 million. MAG supports this legislation, which has been assigned to the Senate Health and Human Services Committee.
– S.B. 433 by Sen. Burt Jones (R-Jackson), which would require the Georgia Department of Community Health (DCH), pharmaceutical manufacturers, pharmacy benefit managers, insurers, and pharmacists to report information about the price of insulin products. DCH would then be responsible for compiling this information and posting it on its website. Under this bill, non-profit organizations that advocate for patients who have diabetes would be required to report any payments, donations, or subsidies that they receive from pharmaceutical manufacturers. Finally, S.B. 433 would limit the cost-sharing amount that a covered person is required to pay for a covered prescription insulin drug to $150.00 per 30-day supply, regardless of the amount or type needed to fill the covered person's prescription. MAG supports this legislation, which was assigned to the Senate Insurance and Labor Committee.
– H.B. 1060 by Rep. Ginny Ehrhart (R-Marietta), which would make it a felony for any licensed medical professional to provide a minor with treatments including use of puberty suppressants, hormone therapy, and enumerated surgical procedures (e.g., mastectomy, vasectomy, hysterectomy). Violating this law would subject the licensed physician or other treating provider to a prison term of one to 10 years and the revocation of their license. MAG opposes this legislation, which has been assigned to the House Health and Human Services Committee.
– H.R. 1302 by Rep. Katie Dempsey (R-Rome), which would create the ‘Joint Study Committee on Chronic Weight Management and Type 2 Diabetes.’ MAG is evaluating this legislation, which has been assigned to the House Health and Human Services Committee.
In other news, a bill (H.B. 715) that was introduced by Rep. Shaw Blackmon (R-Bonaire) was recommitted to the House Ways and Means Committee. This legislation would remove the cap on the occupation tax fee that a local government can levy on a physician or other practitioner. MAG is opposing this legislation.
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| AMA offers ‘strong’ support for Georgia bill addressing corporate pharmacies
American Medical Association (AMA) Executive Vice President and CEO James Madara, M.D., has sent a letter to Georgia Rep. Sharon Cooper (R-Marietta) to express AMA’s “strong” support for a bill (H.B. 952) that she introduced to “help prevent corporate pharmacy chains from interfering in the patient-physician relationship.”
Dr. Madara’s letter states that, “AMA supports this bill because in Georgia – and in states throughout the nation – corporate interference in the practice of medicine has harmed patients with acute and chronic pain, those with cancer or palliative care needs as well as patients needing treatment for a substance use disorder.”
It also notes that “AMA [also] supports H.B. 952 because it helps restore the patient-physician-pharmacist therapeutic triad whereby pharmacists can feel free to confer with their physician colleagues rather than follow a corporate policy that strips the pharmacist’s authority under state and federal law.”
Medical Association of Georgia Director of Government Relations Derek Norton says that, “MAG has been a leading advocate for this bill, so we sincerely appreciate AMA’s support and efforts to recognize Representative Cooper for her vision and leadership.”
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CMS responds to physicians’ concerns over plans to address prior authorization
The Centers for Medicare & Medicaid Services (CMS) has responded to a letter that the Medical Association of Georgia and the American Medical Association and a number of other physicians’ advocacy organizations sent to CMS in 2019 to urge it to address the administrative burden associated with the prior authorization process in a comprehensive way (i.e., as opposed to relying on automation as the only solution).
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| MAG thanks & applauds this week's ‘Doctor of the Day’ volunteers
MAG is thanking and applauding its ‘Doctor of the Day’ volunteers for the week of February 24, which include…
Daniel Lopez, M.D.
Ammar Divan, M.D.
Delphanie Head, M.D.
Brad Bushnell, M.D.
Negah Rassouli, 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.
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| MAG reminding members to register/reserve room for legislative seminar
The Medical Association of Georgia (MAG) is reminding its members to register and reserve a room for MAG's 2020 ‘Legislative Education Seminar’ meeting, which will take place at the Brasstown Valley Resort & Spa in Young Harris on May 15-17.
Call 800.201.3205 and mention the “MAG Legislative Education Seminar” to receive a discounted room rate of $199 per night plus taxes and fees. The discount will be available until May 10 or until MAG’s block of rooms sells out.
Contact Christiana Craddock at ccraddock@mag.org with questions related to lodging or registration.
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 questions related to the seminar.
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MAG’s 2020 state legislative priorities
The Medical Association of Georgia’s (MAG) priorities for the 2020 state legislative session include…
Tort Reform
– Addressing the state’s declining tort environment
Tax Credits for Uncompensated Care
– Creating tax credits for physicians who provide uncompensated care
Medicaid
– Continuing to support the waiver process to ensure Georgians have access to health insurance
Scope of Practice
– Addressing issues that undermine patient safety
Health Insurance
– Developing a solution for “surprise medical bills”
– Streamlining and improving the prior authorization process
– Promoting insurance coverage for non-narcotic alternative therapies
– Ensuring patients have access to every physician who is advertised as “in-network” for the duration of a contract year to ensure the continuity of care and requiring insurers to be transparent about how they develop their networks, their standards of participation, and the process they employ to select/de-select physicians for their networks
Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 678.303.9280 with questions related to MAG’s legislative priorities for 2020.
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Follow MAG at the Capitol 24/7
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| MAG’s Government Relations Team
Bethany Sherrer – Legal Counsel & GAMPAC Manager
bsherrer@mag.org or 404.354.1863
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