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| 100-plus physicians/medical students attend ‘Day at the Capitol’
More than 100 physicians and medical students and nearly 20 state legislators participated in this year’s ‘Physicians’ Day at the Capitol’ event, which took place at the State Capitol in Atlanta on February 19.
The dignitaries included Georgia Gov. Brian Kemp, Georgia Insurance Commissioner John King, Georgia Department of Public Health Commissioner Kathleen Toomey, M.D., Georgia Department of Community Health Commissioner Frank Berry, and Georgia Department of Behavioral Health and Developmental Disabilities Commissioner Judy Fitzgerald.
The breakfast program featured talks by Reps. Mark Newton, M.D. (R-Augusta), Brian Prince (D-Augusta), Kim Schofield (D-Atlanta), Rick Jasperse (R-Jasper), John Carson (R-Marietta), and Sen. Ben Watson, M.D. (R-Savannah).
Meanwhile, the luncheon speakers included Gov. Kemp, Reps. Sharon Cooper (R-Marietta) and Rep. Deborah Silcox (R-Sandy Springs), and Sens. Bill Cowsert (R-Athens), John Kennedy (R-Macon), Chuck Hufstetler (R-Rome), and Kay Kirkpatrick, M.D. (R-Marietta).
“In addition to MAG’s allied sponsors, I would like to express my sincere thanks to the physicians and state leaders who participated in the 2020 Physicians’ Day at the Capitol,” says Medical Association of Georgia (MAG) President Andrew Reisman, M.D. “Physicians from a wide range of specialties and practice settings got a chance to discuss their views on some important health care issues, including the need for tort reform, surprise bills, health insurance, Medicaid, and scope of practice.”
MAG Government Relations Director Derek Norton adds that, “This was a fun and interesting and worthwhile event – and this kind of face-to-face interaction is a proven and effective way for physicians to build relationships with state lawmakers and weigh in on key legislation that will affect them and their patients.”
Along with MAG, the event was sponsored by the Georgia Psychiatric Physicians Association, the Georgia Society of Ophthalmology, the Georgia Society of Anesthesiologists, the Georgia Society of Interventional Pain Physicians, the Georgia College of Emergency Physicians, the Georgia Radiological Society, the Medical Association of Atlanta, the Hall County Medical Society, the Georgia Orthopaedic Society, the Georgia Society of Dermatology and Dermatological Surgery, the Georgia Chapter of the American College of Cardiology, Resurgens Orthopaedics, the Georgia Society of Ambulatory Surgery Centers, and PhRMA.
It is also worth noting that a group of residents from Gwinnett Medical Center attended the event – as well as a group of students from the Mercer University School of Medicine.
MAG members can contact Norton at dnorton@mag.org or 678.303.9280 with any questions that are related to MAG’s advocacy efforts.
Click for ‘Physicians’ Day at Capitol’ photos
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| MAG encouraging lawmakers to pass tort reform bill
MAG is encouraging state lawmakers to pass a bill (S.B. 415) that has been introduced by Sen. Steve Gooch (R-Dahlonega) that would reform the state’s rapidly declining tort environment by eliminating “phantom damages,” which is the difference between what a patient is billed and pays for the care they receive and something that can translate into much higher medical malpractice awards. The bill – which is a pared-down version of a bill (S.B. 390) that Sen. Gooch had introduced earlier in the week – also includes other legal reforms.
MAG President Andrew Reisman, M.D., stresses that, “Much of the significant progress we made when tort reform (S.B. 3) passed in the state in 2005 has been lost as a result of unfavorable court decisions, including a Georgia Supreme Court ruling that struck down the cap on non-economic damages, and trial attorneys who have used legal loopholes to expand liability to the detriment of Georgia’s health care community.”
He is applauding Sen. Gooch for his vision and leadership, as he believes that, “It is essential to reform the state’s tort system to avoid a crisis that could see physicians cut back on high-risk services, relocate, or simply retire because they can’t afford or obtain 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.
S.B. 415 has been assigned to the Senate Insurance Committee.
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| Surprise billing legislation alive in both chambers
The House Special Committee on Access to Quality Health Care and the Senate Health and Human Services Committee passed the House and Senate versions of surprise billing legislation this week, including H.B. 888 and S.B. 359.
These nearly identical bills 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).
Under S.B. 359, hospitals and other applicable facilities would be subject to the same payment methodology and requirements as physicians when it comes to the portions of bills that are related to emergency care.
MAG supports this legislation in general terms, but it is encouraging lawmakers to enhance these bills with language provides greater clarity. The full Senate is expected to vote on S.B. 359 on Monday, while H.B. 888 has been sent back to the House Special Committee on Access to Quality Health Care.
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| Reps. Cooper & Knight introduce bills addressing PBMs
Rep. Sharon Cooper (R-Marietta) introduced a bill (H.B. 918) that would close the loopholes that were created when an “anti-steering” law was enacted in the state in 2019. “Steering” is when a pharmacy benefit manager (PBM) directs a patient to use a pharmacy that it owns, which are often mail-order businesses. MAG supports this legislation, which has moved into to House Special Committee on Access to Quality Health Care.
Meanwhile, Rep. David Knight (R-Griffin) introduced a bill (H.B. 946) that 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. It would also 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.
And, H.B. 946 would empower patients with more choices by strengthening the aforementioned “anti-steering” law. MAG supports this legislation, which is in the House Special Committee on Access to Quality Health Care.
Finally, Rep. Knight introduced H.B. 947 – a bill that calls 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 is in House Special Committee on Access to Quality Health Care.
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| Senate Insurance passes bill on network coverage/pay
The Senate Insurance Committee passed a bill (S.B. 352) by Sen. Dean Burke, M.D. (R-Bainbridge) that 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 advanced to the Senate Rules Committee.
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| Lawmakers introduce other key health care bills
Other key health care bills that were introduced during the week include…
– H.B. 910, a bill by Rep. Karen Mathiak (R-Griffin) that would establish a license for certified professional midwives. MAG opposes this legislation, which has been assigned to the House Regulated Industries 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 Health and Human Services Committee.
– H.B. 952, a bill by Rep. Sharon Cooper (R-Marietta) 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 also 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 has been assigned to the House Special Committee on Access to Quality Health Care.
– H.B. 961, a bill by Rep. Sam Park (D-Lawrenceville) that would require the state to identify high-cost prescription drugs that represent a “significant expenditure” for the state that have increased in price by more than 50 percent or more over the past five years or 15 percent or more over the past 12 months. This measure would also authorize the state Attorney General to require the applicable drug manufacturer to justify the increase in the wholesale acquisition cost of the drug. MAG is evaluating this legislation, which has been assigned to the House Insurance Committee.
– S.B. 375, a bill by Sen. Jeff Mullis (R-Chickamauga) that would restrict the sale of cigarettes, tobacco products, tobacco related objects, alternative nicotine products, or vapor products to those who are 21 years of age and older. MAG supports this legislation, which is in the Senate Regulated Industries and Utilities Committee.
– S.B. 376, a bill by Sen. Jen Jordan (D-Atlanta) that would cap the cost sharing amount that an insured person is required to pay for a covered insulin drug prescription at $100 for a 30-day supply, regardless of the amount or type of insulin that’s needed. MAG supports this legislation, which was assigned to the Senate Insurance and Labor Committee.
– 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 is tracking this legislation, which is in the Senate Health and Human Services 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 February 10, which include…
Michelle Zeanah, M.D.
James Short, M.D.
Rasean Hodge, M.D.
LaJune Oliver, 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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| Georgia House & Senate honor AMA, ACP & AAP leaders
On February 18, the Georgia House and Senate honored three Georgia physicians who lead national physicians’ advocacy organizations with resolutions, including American Medical Association President Patrice Harris, M.D., M.A., American College of Physicians President-elect Jacqueline Winfield Fincher, M.D, MACP, and American Academy of Pediatrics President Sara H. Goza, M.D., FAAP. They are pictured in the center of this photograph – including Dr. Fincher in the red dress, Dr. Harris in the black/gray outfit, and Dr. Goza in the navy-blue outfit – in the Senate chamber with a host of dignitaries.
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| Gov. Kemp welcomes AMA, ACP & AAP leaders
On February 18, the Georgia House and Senate honored three Georgia physicians who lead national physicians’ advocacy organizations with resolutions, including American Medical Association President Patrice Harris, M.D., M.A., American College of Physicians President-elect Jacqueline Winfield Fincher, M.D, MACP, and American Academy of Pediatrics President Sara H. Goza, M.D., FAAP. From the left are Georgia-AAP lobbyist Betsy Bates, MAG General Counsel Bethany Sherrer, MAG Government Relations Director Derek Norton, MAG Executive Director Donald J Palmisano Jr., Dr. Goza, Dr. Harris, Georgia Gov. Brian Kemp, Dr. Fincher, Dr. Fincher’s husband, James L. Lemley, M.D., Georgia ACP Executive Director Mary Daniels, and Georgia AAP Executive Director Rick Ward.
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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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