MAG encouraging physicians to thank lawmakers for tabling H.B. 71  
The Medical Association of Georgia (MAG) is encouraging physicians to contact their state representative to thank them for tabling H.B. 71, a bill that would have required physicians to accept the same insurance plans as any hospital where they provide care as a condition of medical staff participation. This means the bill is no longer viable for this year’s legislative session. 
“My sincere thanks to every physician who supported MAG’s grassroots efforts to oppose this legislation,” says MAG President Steven M. Walsh, M.D. “And I would like to applaud the members of the House of Representatives, especially Representative Richard Smith, who introduced H.B. 71, for being open-minded and for genuinely listening to our perspectives.”  
Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 404.274.4210 with questions.   
Key health care bills pass House  
The Georgia House of Representatives passed key health care legislation, which will now move into the Senate. This includes… 
– H.B. 65 by Rep. Allen Peake (R-Macon), which would add Tourette's syndrome, autism spectrum disorder, intractable pain (defined as “severe, debilitating pain that has not responded to previously prescribed medication or surgical measures for more than three months”), Alzheimer's disease, human immunodeficiency virus HIV, and acquired immune deficiency syndrome (AIDS) to the list of qualifying conditions for the Low THC Oil Patient Registry. MAG is watching this bill, which has been assigned to the Senate Health and Human Services (HHS) Committee. 
– H.B. 149 by Alan Powell (R-Hartwell), which would establish regulations for trauma scene cleanup services. MAG is watching this bill. 
– H.B. 165 by Rep. Betty Price (R-Roswell), which would prevent the state’s Medical Practice Act from being used to require Maintenance of Certification (MOC) as a condition of licensure or to require MOC to be employed by a state medical facility or for the purposes of licensure, insurance panels, or malpractice insurance. The bill – which is one of MAG’s legislative priorities for 2017 – has been assigned to the Senate HHS Committee.
– H.B. 276 by Rep. David Knight (R-Griffin), which would allow the commissioner of the Georgia Department of Community Health to promulgate rules that are related to the oversight of pharmacy benefit managers (PBM) and investigate PBM for any violations. This bill would prevent a PBM/insurer from requiring the use of a mail-order pharmacy or from requiring a covered individual to pay a different copay for using his/her pharmacy of choice, it would prohibit PBM from prohibiting pharmacies from disseminating information about prescription drug alternatives or delivery services, and it would place other limits on PBM that are related to “financial maneuvers.” The bill has been assigned to the Senate Insurance and Labor Committee.
– H.B. 360 by Rep. Sharon Cooper (R-Marietta), which would allow antibiotic drugs to be prescribed or dispensed to the sexual partner(s) of a patient who is diagnosed with chlamydia or gonorrhea without the need for a physical examination. MAG supports this legislation, which will move into the Senate HHS Committee.
– H.B. 486 by Rep. Tommy Benton (R-Jefferson), which would require proxy caregivers who are “employed or contracted to provide home and community based services, community residential alternative services, or community living services” to receive training that is approved by the Georgia Department of Behavioral Health and Developmental Disabilities. This legislation has been assigned to the Senate HHS Committee.  
House passes bill addressing PDMP 
The House of Representatives also passed a bill (H.B. 249) by Rep. Kevin Tanner (R-Dawsonville) that would address the state’s Prescription Drug Monitoring Program (PDMP).
This legislation includes a provision that would require prescription drug dispensers to update the PDMP every 24 hours – as opposed to the current requirement of every seven days. MAG supports this provision. 
MAG also supports a H.B. 249 provision that would enable prescribers to have up to two practice staff access the PDMP on their behalf. These delegates could include 1) licensed physician assistants, advanced practice registered nurses, or registered nurses who complete a one-time registration process or 2) unlicensed practice staff who complete an annual registration process. It is worth noting that the delegating prescriber or dispenser could be held civilly liable and/or criminally responsible for “the misuse of prescription information obtained by his/her delegates.”
And MAG supports an H.B. 249 provision that would codify the executive order that Georgia Gov. Nathan Deal recently issued that made naloxone available on an over-the-counter basis and that would move the PDMP to the Georgia Department of Public Health (DPH). 
Finally, H.B. 249 would require every prescriber who has a U.S. Drug Enforcement Agency prescribing license to register as a PDMP user by January 1, 2018. DPH would then query the database on a random basis. DPH would be required to certify that the state’s PDMP meets industry standards in June, 2018. If that certification requirement went into effect, prescribers would be required to check the PDMP before they prescribe benzodiazepines or opiates or opioids or opioid analgesics or opioid derivatives. 
This legislation includes exemptions for prescriptions that are written for three days or less, prescriptions that are written for 10 days or less following a surgery, inpatient care, and hospice care. The regulatory boards that oversee their respective prescriber groups would be responsible for enforcement. 
MAG Government Relations Director Derek Norton explains that, “MAG took an active role in developing this compromise with Representative Tanner because the initial legislation included a mandate for physicians to check the PDMP every time they wrote prescriptions for every schedule.” 
Senate passes S.B. 81 – minus criminal penalties  
The Georgia Senate passed a measure (S.B. 81) by Sen. Renee Unterman (R-Buford) that is designed to reduce prescription drug abuse. 
MAG supports parts of this “omnibus bill,” including Section 1 – the ‘Jeffrey Dallas Gay Jr. Act’ – which codifies the emergency order that Georgia Gov. Nathan Deal recently issued to allow a standing order so naloxone is available on an over-the-counter basis in the state.
S.B. 81 also includes a provision that would require physicians to register with the PDMP and to check it every time they write a prescription for benzodiazepines, opiates, opioids, opioid derivatives, and opioid analgesics – and every 90 days thereafter – beginning on July 1, 2018. Exemptions would include prescriptions for three days or less, prescriptions for terminally ill patients, and any time the PDMP isn’t operational. First-time prescriptions for benzodiazepines, opiates, opioids, opioid derivatives, and opioid analgesics would be capped at five days unless the prescription is for an acute condition, chronic pain, or pain associated with a cancer diagnosis. The criminal penalties that were originally included in this legislation have been removed.  
Finally, S.B. 81 would 1) create reporting requirements for cases of neonatal abstinence syndrome and 2) require an annual onsite inspection of every narcotic treatment program that is licensed in the state and 3) require the Georgia Department of Community Health (DCH) and the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) to publish an annual report that is based on the DCH/DBHDD’s central registry data base on the number of patients who enroll for treatment, the number of patients who are discharged from treatment, patients’ states of residence, and other information as determined by the two departments.
MAG will continue to work with legislators to improve this legislation, which has been assigned to the House Judiciary Non-Civil Committee.
Senate passes bills array of health care bills
The Georgia Senate passed key health care legislation, which will now move into the House. This includes… 
– S.B. 103 by Sen. Jeff Mullis (R-Chickamauga), which would give the Georgia Department of Community Health (DCH) the authority to 1) investigate pharmacy benefit managers (PBM) and 2) prevent PBM/insurers from requiring the use of a mail-order pharmacy or from requiring an insured patient to pay a different copay for using his/her pharmacy of choice and 3) prohibit PBM from prohibiting pharmacies from providing information about prescription drugs, offering delivery services, or advocating on behalf of an insured to the PBM. This legislation has been assigned to the House Insurance Committee. 
– S.B. 121 by Sen. Butch Miller (R-Gainesville), which would codify Gov. Nathan Deal’s executive order to make naloxone  available in the state on an over-the-counter basis. MAG supports this legislation, which will go to the House Judiciary Non-Civil Committee.
– S.B. 153 by Sen. Matt Brass (R-Newnan), which would allow the sale of certain over-the-counter hearing aids to people who are 18 or older who have had an audiogram within six months. MAG opposes this legislation, which has not yet been assigned to a committee in the House.
– S.B. 164 by Sen. Fran Millar (R-Atlanta), which would limit copay, coinsurance, and deductibles for physical therapy, occupational therapy, and chiropractic visits to what patients pay for primary care visits. MAG opposes this legislation, which has a House committee assignment pending.
– S.B. 166 by Sen. Renee Unterman (R-Buford), which would establish a multi-state licensure compact for nurses. MAG is watching this legislation, which has been assigned to the House Health and Human Services (HHS) Committee.
– S.B. 180 Sen. Dean Burke, M.D. (R-Bainbridge), which would 1) require rural hospitals to report payments to consultants to qualify for the state’s tax credit for rural hospitals and 2) increase the amount of tax-deductible donations individuals and married couples can make to rural hospitals and 3) allow IRS “S” corporation-eligible members to make tax-deductible donations to rural hospitals. MAG is watching this legislation, which has not yet received a committee assignment in the House.
– S.B. 193 by Sen. Unterman, which would eliminate a requirement for women to be medically indigent to receive services from the state’s ‘Positive Alternatives for Pregnancy and Parenting Grant Program.’ The measure would also prohibit the program’s contract management agencies from “referring, encouraging or affirmatively counseling” a person to have an abortion unless their physician diagnoses them with a condition that makes the procedure necessary to prevent the person’s death. MAG is watching this legislation, which has a committee assignment pending in the House.
– S.B. 200 by Chuck Hufstetler (R-Rome), which would require insurers to cover prescriptions that are for less than 30 days at a “prorated daily cost-sharing rate” when it is in the best interest of the patient or when it is for the purpose of synchronizing the insured patient's medications for chronic conditions. MAG has not taken a position on this legislation, which is waiting on committee assignment in the House.
– S.B. 201 by Sen. Unterman, which would require employers to allow employees to use sick leave to care for immediate family members. MAG is watching this legislation, which has been assigned to the House Industry and Labor Committee.
– S.B. 206 by Sen. P. K. Martin (R-Lawrenceville), which would require health insurers to cover billed charges of up to one hearing aid per impaired ear not to exceed $3,000 per hearing aid every 48 months for covered patients who are 18 or younger. MAG is watching this legislation, which has not yet received a committee assignment in the House.  
– S.B. 221 by Sen. Unterman, which would expand 1) the number of medications that optometrists are allowed to prescribe and 2) the pharmaceutical agents optometrists are allowed to administer around the eye – excluding sub-tenon, retrobulbar, peribulbar, intraorbital nerve block, intraocular, or botulinum toxin injections. The bill was amended to require that 1) 30 hours of required training be performed by a board-certified ophthalmologist and approved by the Georgia Composite Medical Board before an optometrist could administer injections and 2) to add facial nerve block, subconjunctival anesthetic, dermal filler, intravenous injections, and intramuscular injections to the list of pharmaceutical agents that an optometrist is not allowed to administer. MAG opposes this legislation, which has a House committee assignment pending. 
– S.B. 241 by Sen. Unterman, which would move the administration of the Georgia Prescription Drug Monitoring Program (PDMP) from the Georgia Drugs and Narcotics Agency to the Georgia Department of Public Health. The bill was also amended to create a disposal program for controlled substances in hospice programs. MAG supports this bill, which has not yet received a committee assignment. MAG remains focused on improving the PDMP’s use, reliability, and accessibility. 
– S.B. 242 by Sen. Unterman, which would increase the number of advanced practice registered nurses (APRN) that a physician can delegate their authority to from four to 10 – including no more than four at any single point in time. This measure would also add county and municipal emergency medical services that have a full-time medical director to the list of organizations that are exempt from limiting the number of APRN their physicians can supervise. MAG opposes this legislation, though it does support a new provision that would require the patient and the patient’s primary care physician to be provided with the name of the APRN’s supervising physician. The bill has not yet been assigned to a committee in the House.  
Key House bills that failed to pass by the end of Crossover Day
A number of health care bills failed to pass the House by the end of last Friday, which was “Crossover Day” – which means the measures cannot be reconsidered until the 2018 legislative session. This includes…
A bill (H.B. 517) by Rep. Tom Taylor (R-Dunwoody) that would have required diagnostic imaging equipment to be registered with the Georgia Department of Community Health (DCH). MAG opposed this legislation, which was in the House Health and Human Services (HHS) Committee.    
A bill (H.B. 519) by Rep. Sharon Cooper that would have required health benefits plans to use certain clinical review criteria to establish step therapy protocols – as well as establishing a step therapy override process. MAG supported this legislation, which was in the House Insurance Committee.
A bill (H.B. 527) by Rep. Mark Newton, M.D. (R-Augusta) that would have allowed podiatrists to jointly own a professional corporation with physicians. MAG did not have a position on the bill, which was in the House HHS.  
A measure (H.R. 431) by Rep. Scot Turner (R-Holly Springs) that would have created a House committee to study the effects of any new federal (i.e., the Trump administration’s) health care policies on Georgia. The measure was in the House HHS Committee. 
Thanking this week’s ‘Doctor of the Day’ volunteers
MAG is thanking and applauding its ‘Doctor of the Day’ volunteers for the week of February 13, which include…
J. Wendell Duncan, M.D.
Kelly C. Homlar, M.D.
Steven M. Kane, M.D.
Bryan J. Whitfield, 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/advocacy/take-action/dod for additional information on the MAG ‘Doctor of the Day’ program, including logistical details and FAQ.
Save June 23-25 for MAG’s ‘Legislative Education Seminar’
MAG is encouraging member physicians to save June 23-25 for its 2017 ‘Legislative Education Seminar’ meeting, which will take place at Brasstown Valley Resort in Young Harris. 
More than 50 physicians and 25 state leaders attended the event in 2016. 
Monitor www.mag.org for details, and contact Derek Norton at dnorton@mag.org or 678.303.9280 with any questions related to MAG’s 2017 ‘Legislative Education Seminar.’
MAG’s 2017 state legislative priorities 
The Medical Association of Georgia’s priorities for the 2017 state legislative session include…
Out-of-Network Billing & Network Adequacy
MAG will 1) support reforms that will require appropriate network adequacy standards for health insurers and 2) call for health insurers to be more transparent in their contracts with physicians’ practices and 3) support legislation that will result in physician payment methodologies that are adequate and sustainable for out-of-network emergency care.  
Medicaid Payment Parity
MAG will be an advocate for the General Assembly to continue to fund the Medicaid parity payment program for all areas of primary care.
Maintenance of Certification (MOC)
MAG will 1) work to ensure that Maintenance of Certification is not a condition of licensure or a condition of hospital credentialing and 2) support efforts that will alleviate the costly and burdensome aspects of MOC for physicians.
Patient Safety
MAG will be an advocate for legislation that improves 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 2017.
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