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| Senate Insurance passes tort reform bill
The Senate Insurance Committee passed tort reform legislation by Sen. Steve Gooch (R-Dahlonega). S.B. 415 is a MAG priority bill that and 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. It also includes other legal reforms (e.g., premises liability reform and seat belt admissibility). S.B. 415 will now move into the Senate Rules Committee.
It is worth noting that Rep. Tom McCall (R-Elberton) has introduced a comparable bill (H.B. 1089) that addresses phantom damages and mandatory trial bifurcation for cases where the plaintiff seeks damages of more than $150,000 – legislation that has been assigned to the new House Special Committee on Access to the Civil Justice System.
And in a related development, MAG is opposing a bill (S.B. 390) by Sen. Gooch that passed the Senate Judiciary Committee that would reform Georgia’s ‘Civil Practice Act’ by changing how much a physician can charge for producing medical records and that includes civil penalties for not producing the records within 30 days. MAG supported this measure in its original form, but it has been amended in ways that would give trial attorneys an unfair advantage. This bill has moved into the Senate Rules Committee.
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| House passes six key health care bills
Georgia’s House of Representatives passed six key health care bills this week, including…
– H.B. 888, a bill 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 and 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 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 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). One of MAG’s priorities for 2020, this bill will now move into the Senate Health and Human Services (HHS) Committee.
– H.B. 918, a bill by Rep. Sharon Cooper (R-Marietta) that would change pharmacy benefit managers (PBMs) licensure requirements and 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. MAG supports this legislation, which is going to the Senate Insurance Committee.
– H.B. 946, a bill by Rep. David Knight (R-Griffin) that would require PBMs to become more transparent by making them report deviations in public pricing benchmarks and prohibiting them from using “spread pricing” practices or “retroactive recoupments” and requiring them to pass any rebates along to payors. This measure 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, be seeing or having seen patients in the last five years, and be practicing or having practiced in the last five years in the same specialty for which they’re providing advice. MAG supports this legislation, which was assigned to the Senate Insurance Committee.
– H.B. 947, another bill by Rep. Knight that 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 this legislation, which is headed to the Senate Insurance Committee.
– H.B. 816, a bill by Rep. Karen Mathiak (R-Griffin) that would allow physicians and chiropractors to jointly own a professional corporation. MAG is monitoring this legislation, which is now going to the Senate HHS Committee.
– H.B. 932, a bill by Rep. Houston Gaines (R-Athens) that would allow physicians and podiatrists to form professional corporations together. MAG is evaluating this measure, which has been sent to the House HHS Committee.
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| Senate passes bills addressing MediSpas, PBMs & licensure
The Georgia Senate passed three important bills this week, including…
– S.B. 323, a bill by Sen. Kay Kirkpatrick, M.D. (R-Marietta) that 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, which will now go to the House HHS Committee.
– S.B. 313, a bill by Sen. Dean Burke, M.D. (R-Bainbridge) that would address pharmacy benefit managers (PBMs) practices – such as “steering” (i.e., forcing patients to use PBM-owned pharmacies) and pharmaceutical manufacturers’ rebates. This measure includes language from a MAG 2019 House of Delegates resolution that calls for physicians to be involved with prior authorization and step therapy determinations, formulary development, and formulary management. These physicians would have to be licensed in Georgia, be seeing or having seen patients in the last five years, and be practicing or having practiced in the last five years in the same specialty for which they’re providing advice. MAG supports this legislation, which will now move into the House Special Committee on Access to Quality Health Care.
– S.B. 306, a bill by Sen. Valencia Seay (D-Riverdale) that would create a licensure and telemedicine compact for audiologists and speech language pathologists. It’s worth noting that there is a comparable bill in the House Rules Committee (H.B. 956) that was introduced by Rep. Dave Belton (R-Buckhead). MAG has taken an active role in improving both bills, and it will continue to call for the addition of a physician on the compact’s board. S.B. 306 is now headed to the House Regulated Industries Committee.
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| House committee passes cosmetic laser services, APRN legislation
The House Regulated Industries Committee 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 is headed to the House Rules Committee.
The House Regulated Industries Committee also passed a measure (H.B. 1092) by Rep. Alan Powell (R-Hartwell) that would 1) allow APRNs who are working under a protocol agreement with a physician to order radiographic imaging in non-life-threatening situations and 2) increase the APRN-to-physician ratio from 4:1 to 6:1. MAG opposes this legislation, which is going to the House Rules Committee.
And the House Regulated Industries’ House Occupational Professional Licensing subcommittee held a second hearing on a bill (H.B. 910) by Rep. Karen Mathiak (R-Griffin) that would establish a license for certified professional midwives – something MAG is opposing.
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| ‘Transparency & Accountability Oversight’ bill clears hurdle
The House Special Committee on Access to Quality Health Care passed a bill (H.B. 991) by Rep. Matt Hatchett (R-Dublin) that would create a ‘Healthcare Transparency and Accountability Oversight Committee,’ which 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 is slated to move to the House Rules Committee.
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| Senate HHS has busy week – passes six bills
The Senate Health and Human Services (HHS) Committee passed six noteworthy health care bills this week, including…
– S.B. 391, a bill by Sen. Kay Kirkpatrick, M.D. (R-Marietta) that would allow pharmacists to fill a 30-day supply of a prescription medication early when a state of emergency has been declared or when a hurricane warning has been issued – Schedule II medications notwithstanding. This would only apply when a pharmacist determines that the prescription is 1) essential to the maintenance of life or the continuation of therapy for a chronic condition and 2) the interruption of such therapy might reasonably produce undesirable health consequences or cause physical or mental discomfort. Under S.B. 391, the pharmacist would have to let the prescriber know about the early prescription request within 48 hours. And, insurers would be required to cover these early prescriptions. MAG will continue to monitor this bill.
– S.B. 311, another bill by Sen. Kirkpatrick that would prohibit kickbacks, commissions, bribes, benefits, rebates, and bonuses by substance abuse providers or solicited by substance abuse providers to induce referral of a patient and outlaws fraudulent marketing techniques designed to deceive individuals into expensive long term recovery facilities. This measure would also prohibit ‘high-tech drug testing’ (i.e., testing an individual’s specimen for a number of different substances and billing and receiving payment separately for each substance that's tested). MAG is watching this legislation, which is scheduled for a full Senate vote on Monday.
– S.B. 28, a bill by Sen. Lester Jackson (D-Savannah) that would require health insurance copays to be “reasonable in relation to covered benefits to which they apply” and would “require that copays be used as an incentive rather than a barrier to accessing appropriate care.” MAG is tracking this legislation.
– S.B. 321, a bill by Sen. Chuck Hufstetler (R-Rome) that would increase the physician oversight ratio from 4:1 for APRNs and 2:1 for PAs (4:1 in certain locations) to 6:1 for all midlevel providers – giving physicians the freedom to choose the mix – although the ratio limit in hospitals, colleges or universities, the Georgia Department of Public Health, county boards of health, community service boards, free health clinics, birthing centers, or federally qualified health centers (FQHCs) would not change. This bill would also eliminate the requirements for PAs be “licensed to” a physician and for a physician to “regularly” see patients where their PA practices. MAG has voiced its concerns over the exceptions to the ratio limits and the need for physicians to “regularly” see patients where their PA practices requirement.
– S.B. 417, a bill by Sen. Kirkpatrick that would address problematic language that is related to background checks in the Interstate Medical Licensure Compact bill that passed last year. MAG supports this legislation.
– S.B. 482, a bill by Sen. Dean Burke, M.D. (R-Bainbridge) would create a ‘Georgia All Payer Claims Database’ (GAPCD) to collect claims data from insurance companies, the Department of Community Health, Medicaid care management organizations, Medicare plans, entities that contract with institutions of the Department of Corrections to provide medical, dental, or pharmaceutical care to inmates, the State Board of Workers' Compensation, and the Georgia Access to Medical Cannabis Commission. The legislation would also establish a GAPCD Advisory Committee to make recommendations about the GAPCD framework and plan to facilitate the “reporting of health care and health quality data resulting in transparent and public reporting of safety, quality, cost, and efficiency information at all levels of health care.” MAG will continue to track S.B. 482.
These bills will now go to the Senate Rules Committee as a next step.
The Senate HHS also held a hearing on S.B. 347, a measure by Sen. Gloria Butler (D-Stone Mountain) that would require surgical smoke evacuation systems in operating rooms in ambulatory surgery centers and hospitals. MAG has advised lawmakers that it would like to see more evidence on the effects of the surgical smoke and the efficacy of the evacuation systems.
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| Lawmakers introduce bills that address sexual assault, tort & more
This week’s new legislation includes…
– H.B. 1076, a bill by Rep. Scott Holcomb (D-Atlanta) that would 1) create a statewide sexual assault kit tracking system and 2) require the Georgia Composite Medical Board (GCMB) to refuse to grant a license to an applicant or to suspend or revoke a physician’s license if it finds (following an investigation) that they have committed a sexual assault on a patient or have pleaded guilty to committing a sexual assault on a patient or have been found guilty by a court of law of committing a sexual assault on a patient. This legislation also calls for health care professionals to report the name of a physician to GCMB if they have reasonable cause to believe that the physician has sexually assaulted a patient. Finally, it would require GCMB to issue an annual report that addresses the number of physicians it has investigated for sexual assault, sexual abuse, sexual misconduct, or the exploitation of a patient and the outcome of any investigations (i.e., whether it refuses, revokes, or suspends a physician's license or issues a private or public disciplinary order). MAG is evaluating this bill, which has been assigned to the House Judiciary Non-Civil Committee.
– H.B. 1101, a bill by Rep. Martin Momtahan (R-Dallas) that would require health insurers to disclose certain information prior to or contemporaneously with a claim settlement offer. This includes the limits of coverage in the policy and information about the case. This legislation would also require insurers to provide the claimant with notice of Georgia law pertaining to the claim and the claimant’s rights. MAG is evaluating this bill, which has been assigned to the House Special Committee on Access to the Civil Justice System.
– H.B. 1105, a bill by Rep. Mark Newton, M.D. (R-Augusta) that would require hospitals to complete a survey to disclose whether they have the technological capability to share certain patient information with other hospitals on an electronic basis. As a condition of getting and maintaining a certificate of need (CON), this legislation would require every hospital be a “meaningful electronic health records user of certified electronic health records technology” by July 1, 2022. MAG is evaluating this legislation, which has been assigned to the House Special Committee on Access to Quality Health Care.
– H.B. 1114, a bill by Rep. Sharon Cooper (R-Marietta) that would extend postpartum Medicaid coverage from two months to six months and to require Medicaid to cover lactation care and services. MAG supports this legislation, which has been assigned to the House HHS Committee.
– S.B. 484, a bill by Sen. Kay Kirkpatrick, M.D. (R-Marietta) that calls for Georgia to join a multistate compact that is will “incentivize the development of cures for diseases through substantial financial awards.” The compact states will “pay a financial award to someone who developed a cure for a disease by utilizing the money the state saves by utilizing the cure.” MAG is monitoring this legislation, which has moved to the Senate Rules Committee.
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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 March 2, which include…
Stephen Holbrook, M.D.
Stuart Segerman, M.D.
Jeff Linzer, M.D.
Kamesha Harbison, 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.
To reserve your room, 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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