MAG continues work on flawed PDMP bill
The Georgia Senate Health and Human Services (HHS) Committee is considering a bill (S.B. 81) by Sen. Renee Unterman (R-Buford) that is designed to address prescription drug abuse. The Medical Association of Georgia (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. However, MAG is opposed to…
– Section 2-5, which requires physicians to review the PDMP when they prescribe a Schedule II, III, IV or V controlled substance for the first time and every 90 days thereafter – initial, three-day prescriptions notwithstanding. Under this section, prescribers would not be able to prescribe more than a five-day supply of a Schedule II, III, IV or V controlled substance to an adult they are seeing for the first time. Under this section, prescribers would also not be able to prescribe these drugs to a minor for more than a five-day period, and they would be required to discuss the risks associated with the drug with the minor and their parent(s) or guardian. The five-day restrictions would not apply when the prescriber determines that a longer prescription is necessary – and the prescriber would have to note the factors that warranted the longer prescription in the patient’s medical record, along with a statement that the prescriber determined that alternative treatments would not be appropriate. It is also worth noting that a physician would be able to write a prescription for more than five days if they believe it is medically necessary for palliative care or to treat a patient's acute medical condition, chronic pain, or pain associated with a cancer diagnosis. This section does not apply to controlled substances that are used specifically for the treatment of abuse or dependence of a Schedule II, III, IV or V controlled substance.
– Section 2-6. Any prescriber who knowingly or intentionally fails to review the PDMP or knowingly and intentionally disregards the prescription information in the PDMP shall be guilty of a felony. The possible penalties are a fine of up to $50,000 and/or up to one to five years in prison.
MAG Government Relations Director Derek Norton explains that, “The committee heard testimony from several stakeholder groups, including three MAG members – Dr. Vin Puppala, Dr. Kay Kirkpatrick, and Dr. Michelle Zeanah.”
Norton says MAG is working with legislators to address physician concerns. He expects the committee to vote on the bill next Thursday, February 9.
Contact Norton at dnorton@mag.org or 404.274.4210 with questions.
MAG calling for grassroots support to oppose optometrist scope bill
The House Health & Human Services (HHS) Committee is expected to hear a bill (H.B. 36) by Rep. Earl Earhardt (R-Powder Springs) that would allow optometrists to make injections and perform other delicate procedures in and around a patient’s eye or eyelid. The Medical Association of Georgia (MAG) is opposing this measure because it would inappropriately expand optometrists’ scope of practice and it would undermine patient care. 
MAG Government Relations Director Derek Norton explains that, “This bill, while perhaps well-intended, could place thousands of Georgians at risk of blindness and other serious eye health complications.” 
Norton says this committee will vote on H.B. 36 next Tuesday, February 7. MAG members are being encouraged to contact the members of the House HHS by the end of the day on Monday to encourage them to oppose the bill. 
The week’s other key legislative developments
Tuesday, February 7, the Senate Health & Human Services Committee is expected to consider a bill by Sen. Renee Unterman (R-Buford) – the ‘Surprise Billing and Consumer Protection Act’ (S.B. 8) – that would create a payment system for out-of-network care and prohibit balance billing. The Medical Association of Georgia (MAG) is opposing this measure in its current form because it limits what a physician can charge for out-of-network care, and it places new administrative burdens on physicians/practices. MAG has offered some language to address these concerns. 
The Senate passed a measure (S.B. 70) by Butch Miller (R-Gainesville) that would extend Georgia’s Medicaid Provider Fee – also known as the ‘bed tax’ – until June 30, 2020. MAG has not assumed a position on this bill, which will now move into the House. 
Rep. Trey Kelley (R-Cedartown) introduced H.B. 157, which would amend a bill (H.B. 1043) that passed in 2016 to allow physicians who are in a specialty or subspecialty to advertise a board certification that is similar in scope and complexity (i.e., training, documentation, and clinical requirements) to the certifications that are offered by the Accreditation Council for Graduate Medical Education (ACGME) and the Bureau of Osteopathic Specialists of the American Osteopathic Association (AOA). This legislation would also require physicians to show evidence of their board certification upon the request of the Georgia Composite Medical Board. 
MAG is opposing this bill because it has policy (Resolution 313C.15) that reads…
“MAG supports legislation that: 1) requires all health care professionals – physicians and non-physicians – to accurately and clearly disclose their training and qualifications to patients and 2) states that a medical doctor or doctor of osteopathic medicine may not hold oneself out to the public in any manner as being certified by a public or private board including, but not limited to, a multidisciplinary board or “board certified” unless all of the following criteria are satisfied: a) the advertisement states the full name of the certifying board and b) the board is either: 1) a member of the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) or 2) requires successful completion of a postgraduate training program approved by the Accreditation Commission for Graduate Medical Education (ACGME) or the AOA that provides complete training in the specialty or subspecialty certified, followed by prerequisite certification by the ABMS or AOA board for the training field and further successful completion of examination in the specialty or subspecialty certified and 2) MAG opposes any efforts to use or require the Federation of State Medical Board Maintenance of Licensure (MOL) program as a condition of licensure.
H.B. 157 is in the House HHS Committee.  
Rep. Betty Price, M.D. (R-Roswell) introduced H.B 161, legislation that would allow harm reduction organizations – which are focused on “reducing the harm associated with the use of psychoactive drugs in people unable or unwilling to stop” – to sell, lend, rent, lease, give, exchange or otherwise distribute a syringe or needle. In 2016, MAG’s HOD passed a resolution to support this legislation – which is in the House HHS Committee. 
Rep. Price also introduced a bill (H.B 163) that would require drivers who make phone calls while operating a motor vehicle to do so on a hands-free basis, certain exceptions (e.g., 911 calls) notwithstanding. MAG supports this legislation, which is one of its patient safety priorities for the year. The bill is in the House Public Safety and Homeland Security Committee. 
And Rep. Price introduced H.B. 165, which would eliminate the state’s maintenance of certification requirement for the purposes of licensure, insurance panels, or malpractice insurance. This legislation is one of MAG’s priorities for 2017. It has been assigned to the House HHS Committee. 
Sen. Butch Miller (R-Gainesville) introduced S.B. 102, a bill that would create a three-tier cardiac care center designation framework – similar to the state’s stroke and trauma designation system for hospitals. MAG supports this bill, which is in the Senate HHS Committee.
Sen. Jeff Mullis (R-Chickamauga) introduced S.B. 88, a comprehensive regulatory and licensing framework for narcotic treatment programs. MAG is analyzing this legislation, which has been assigned to the Senate Regulated Industries and Utilities Committee. 
Sen. Mullis also introduced ‘The Pharmacy Patient Fair Practices Act’ (S.B. 103), which would authorize the Commissioner of the Georgia Department of Community Health (DCH) to investigate pharmacy benefits managers (PBM). This bill would also place certain restrictions on PBM, including prohibiting them from requiring patients to use mail order pharmacies. And it would allow pharmacists and pharmacies to have more freedom in their interactions with patients (e.g., the ability to deliver prescriptions). MAG is watching this bill, which is in the Senate Insurance and Labor Committee. 
Sen. Greg Kirk (R-Americus) introduced S.B. 106, legislation that would allow certified registered nurse anesthetists to practice independently in pain management clinics. MAG opposes this bill because it undermines patient safety. The bill has been assigned to the Senate HHS Committee. 
The Senate HHS Pharmacology Subcommittee heard S.B. 16, which was introduced by Sen. Ben Watson, M.D. This bill would lower the amount of THC that is allowed in medical cannabidiol, and it would add autism to the list of qualifying conditions. The subcommittee voted to send this measure to the full committee, though it amended the autism exception to be limited to patients who are 18 years or older. 
The House Medical Cannabis Working Group met to discuss Rep. Allen Peake’s (R-Macon) H.B. 65, a bill that would add six conditions to the state’s ‘Low THC Oil Patient Registry’ – including Tourette’s syndrome, autism spectrum disorder, intractable pain (i.e., severe, debilitating pain that has not responded to previously prescribed medication or surgical measures for more than three months, post-traumatic stress disorder), Alzheimer’s disease, human immunodeficiency virus, and acquired immune deficiency syndrome. The committee is expected to modify the bill, which MAG is assessing.  
Finally, Sen. Butch Miller (R-Gainesville) introduced a measure (S.B. 121) that would 1) make naloxone available on an over-the-counter basis under a standing order by a state health officer and 2) reclassify naloxone as a Schedule V controlled substance. MAG supports the bill, which has not yet been assigned to a committee.  
MAG promoting ‘Trauma Awareness Day at Capitol’
The Medical Association of Georgia and the Georgia Society of American College of Surgeons (GSACS) are encouraging physicians and other applicable health care providers in the state to register for ‘Trauma Awareness Day at the Capitol,’ which will take place from 8:30 a.m. to 2 p.m. next Tuesday, February 7.
The event will begin with a breakfast briefing at the Georgia Railroad Freight Depot – which is across the street from the State Capitol at 65 Martin Luther King Jr. Drive – at 8:30 a.m. 
Physicians and other health care providers will be calling on lawmakers to use $1 million of the “super speeder” fines that are collected in Georgia to install ‘Stop the Bleed’ trauma care kits in schools and public spaces in the state.
Contact GSACS at gasacs@gmail.com with questions.
MAG promoting ‘End the Surprise Insurance Gap’ video
The Medical Association of Georgia (MAG) is encouraging physicians and medical practice staff across the state to promote a new ‘End the Surprise Insurance Gap’ video with their patients thru every available social media channel.   
MAG and the Georgia College of Emergency Physicians and the Epilepsy Foundation of Georgia recently kicked-off the ‘End the Surprise Insurance Gap’ campaign with a rally at the State Capitol.
MAG President Steven M. Walsh, M.D., called for state lawmakers to put an end to balance billing in emergency care settings by passing legislation that will address the “surprise coverage gap” that has been created by health insurers.
Dr. Walsh stressed that, “Physicians have seen their patients’ financial burden increase in dramatic ways as health insurance companies have narrowed their networks.”
He also pointed out that, “A lot of patients do their research and try to do the right thing and go to a hospital that is in their insurance network (during an emergency), but they generally don’t have any way of knowing when a doctor they need to see is in or out of the network.”
And Dr. Walsh emphasized that, “Emergency department physicians want to be included in these networks. The problem is that health insurers often offer physicians inadequate, take-it-or-leave-it deals – forcing them to opt out of the network. The insurers wash their hands of medical bills they should cover. This harms the patient and undermines the doctor-patient relationship.”
Contact MAG Executive Director Donald J. Palmisano Jr. at dpalmisano@mag.org with questions related to the ‘End the Surprise Insurance Gap’ campaign.
Make a difference as MAG's ‘Doctor of the Day’
The Medical Association of Georgia (MAG) is encouraging physicians in the state to serve as a MAG ‘Doctor of the Day’ program volunteer during this year’s legislative session, which is expected to last until the middle of April. 
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. 
As a MAG Doctor of the Day, you will…
– Be introduced in the House and Senate chambers by your state representative and senator
– Have your photo taken with the Gov. Nathan Deal (contingent on his availability)
– Have a reserved parking place
– Be assisted by a nurse
– Be protected by the state’s ‘Good Samaritan Law’
The MAG Doctor of the Day program is a non-political service. Volunteers do not serve as lobbyists when they serve as a MAG Doctor of the Day volunteer.
If you are interested in serving as a MAG Doctor of the Day volunteer, click here for a form that you can print, complete and submit to Liz Bullock at ebullock@mag.org or you can simply can call her at 678.303.9271.
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. 
Thanking this week’s ‘Doctor of the Day’ volunteers
MAG is thanking and applauding its ‘Doctor of the Day’ volunteers for the week of January 30, which includes…
Ronald Brown Sr., M.D.
Delphanie Head, M.D.
James M. Tallman, M.D.
Robert Steven Tuck, M.D

Physicians who are interested in serving as a MAG ‘Doctor of the Day’ volunteer can click here to complete an application or they can contact Liz Bullock at ebullock@mag.org or 678.303.9271.
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.
Follow MAG at the Capitol 24/7
Whether you're 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/resources/GR.
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