Senate passes three important health care bills  
The Senate passed a bill (S.B. 118) by Sen. Renee Unterman (R-Buford) that would raise the age for mandatory insurance coverage for treatment for children who are autistic from six to 12.
The Senate also passed S.B. 357 – a bill by Sen. Dean Burke, M.D. (R-Bainbridge) that would create a health coordination and innovation council, action that was recommended by Lt. Gov. Cagle’s Health Reform Task Force. 
Finally, the Senate passed S.B. 352 by Sen. Unterman, a bill that would…
– Make it illegal for the “solicitation, acceptance of payment, or offer to pay a commission, benefit, bonus, rebate, kickback or bribe – directly or indirectly and on a cash or in kind basis – or to engage in any split-fee arrangement to induce the referral of a patient or for the acceptance or acknowledgment of treatment of a patient to another provider or health care facility for the purposes of obtaining mental health or substance abuse treatment. It would also be illegal to aid, abet, advise, or otherwise participate in the conduct prohibited by this law.  
–  Create a director of Substance Abuse, Addiction, and Related Disorders who would report to the governor and lead a new Commission on Substance Abuse and Recovery.   
– Prohibit physicians from billing a patient or insurer for excessive, high-tech (i.e., “where billing for drug tests is not limited and tests are ordered for a number of different substances whereby the health benefit plan is billed separately for each substance tested”) or fraudulent drug testing in the treatment of the elderly, the disabled, or any individual affected by pain, substance abuse, addiction, or any related disorder. This would include, but not be limited to, upcoding that results in billing for more expensive services or procedures than were actually provided or performed, unbundling of such billing whereby drug tests from a single blood sample that detect a variety of narcotics is separated into multiple tests and billed separately, or billing an individual for multiple co-pay amounts or for services that are covered by such individual's health benefit plan.
All three bills will now move into the House.  
Week’s highlights include introduction of network, formulary transparency bills 
Rep. David Knight (R-Griffin) introduced two bills that are aligned with the Medical Association of Georgia’s (MAG) priorities for the 2018 legislative session. This includes H.B. 872, which would establish 1) standards for health insurers to select, deselect, and tier physicians and 2) an appeals process for physicians who are deselected or tiered by a health insurer. If this measure becomes law, patients would also be able see a physician at an in-network rate for the entire plan year if the insurer deselects that physician during the plan year. Meanwhile, Rep. Knight’s H.B. 873 would 1) establish transparency standards for formularies and 2) streamline the prior authorization process by requiring the use of a standard form, setting timelines for insurers to respond to the form, and ensuring the continuity of care when a patient switches health insurance plans. Both bills have been assigned to the House Insurance Committee. 
Rep. Sharon Cooper (R-Marietta) introduced H.B. 799, which would require hospitals to contact a patient’s health insurer to get its authority before administering any post-stabilization care. And if the insurer determines that it wants the patient to be transferred to another facility for post-stabilization care, the insurer would be responsible for making arrangements for transferring the patient and bearing the costs. MAG is watching this legislation, which has been assigned to the House Insurance Committee.
Joyce Chandler (R-Grayson) introduced H.B. 847, a bill to have Georgia join the Psychology Interjurisdictional Compact – which “facilitates telehealth and temporary in-person, face-to-face [care] across jurisdictional boundaries.” MAG is monitoring this measure, which is in the House Regulated Industries Committee. 
P.K. Martin (R-Lawrenceville) introduced S.B. 382, which would require the Georgia Department of Public Health to oversee any Georgia Board of Optometry-approved training programs that would allow optometrists to inject pharmaceutical agents. MAG is tracking this bill, which has been assigned to the House Health and Human Services (HHS) Committee.
Sen. Michael Williams (R-Cumming) introduced two health care bills this week. H.B. 399 would allow APRNs to practice on an independent basis. MAG is opposing this this measure. Meanwhile, H.B. 400 would repeal the state’s certificate of need (CON) laws. MAG is keeping a close eye on this legislation. The bills are in the Senate HHS Committee. 
A subcommittee of the House Judiciary Non-Civil Committee heard testimony on H.B. 673, a bill that was introduced by Rep. John Carson (R-Marietta) that would make it illegal for drivers to use a cell phone on anything other than a hands-free basis – with a one-touch exemption. The hearing focused mostly on the one-touch exemption. A second hearing has been set for next Monday. MAG members are encouraged to contact the members of the House Judiciary Non-Civil Committee to urge them to SUPPORT this billClick here for a list of the committee members and their phone numbers and e-mail addresses.
The Senate HHS Committee passed a bill (S.B. 364) by Sen. Chuck Hufstetler (R-Rome) that would allow primary supervising physicians to have up to eight anesthesiologist assistants licensed under them – though they would only be allowed to supervise up to four of them at a given time. MAG is watching this legislation, which has moved to the Senate Rules Committee. 
The House HHS Committee passed three bills this week. H.B. 636 by Rep. Deborah Silcox (R-Sandy Springs) would create a licensure requirement for genetic counselorsH.B. 646 by Rep. Katie Dempsey (R-Rome) – a measure MAG supports – would extend a pilot program to offer bariatric surgery through the State Health Benefit Plan. And H.B. 782 by Rep. Trey Rhodes, another measure MAG supports, would make it easier for unlicensed delegates to register with the Georgia Prescription Drug Monitoring Program (PDMP) and for the Georgia PDMP to share data with other states. All three bills are headed to the House Rules Committee. 
The House Insurance Committee passed a bill by Rep. Richard Smith (R-Columbus) that would require physicians to provide patients with certain information before elective procedures, including the physician’s status with the patient’s health insurer’s network, the names and other information related to other physicians who will provide services during the procedure, and an estimate of the bill that the patient will receive after the procedure. In addition, H.B. 678 would subject hospitals and insurers to greater transparency requirements. This legislation would also require physicians and hospitals send initial bills to patients within 90 days – while the Georgia Department of Insurance would establish a patient arbitration process to resolve any billing disputes. MAG is advocating greater transparency, but it is part of a coalition of specialties that would like to see a more comprehensive solution – like S.B. 359 by Sen. Hufstetler. H.B. 678 will now move into the House Rules Committee.
A subcommittee of the House Insurance Committee passed a measure (H.B. 818) by Rep. Lee Hawkins (R-Gainesville) that would allow a provider to choose how they will be reimbursed by an insurer. MAG supports this bill, which is head to the full House Insurance Committee. 
Finally, a Senate HHS Committee meeting to consider a bill (S.B. 351) by Sen. Renee Unterman (R-Buford) that would grant full scope of practice authority to nurses who practice in counties with populations of 50,000 or less was cancelled. 
MAG to effect change in MOC as member of new Vision Commission
The Medical Association of Georgia (MAG) will play a key leadership role in reforming maintenance of certification (MOC) programs for physicians – as the Continuing Board Certification (CBC) has announced that MAG Executive Director Donald J. Palmisano Jr. has been selected to serve on its new ‘Vision Initiative Commission.’
According to CBC, the Commission will be “responsible for assessing the status of continuing board certification and making recommendations to help enable the current process to become a system that demonstrates the profession’s commitment to professional self-regulation, offers a consistent and clear understanding of what continuing certification means, and establishes a meaningful, relevant and valuable program that meets the highest standard of quality patient care.”
“This is a great development for physicians in Georgia,” says MAG President Frank McDonald, M.D., M.B.A. “MAG is going to have a seat at the table, which means that we will be able to take an active role in fixing the broken MOC system.”
Palmisano is one of just 25 Commission members who were selected from 176 nominations from across the U.S. 
CBC explains that, “The Commission will begin [its work] by conducting a comprehensive assessment of the current continuing board certification system. Feedback will be obtained from various stakeholders through multiple methods including a survey that is now open for input. The Commission will hold hearings and seek feedback on concepts and ideas during the process and will periodically release public reports about their findings.”
It also notes that, “The Commission’s final recommendations will be submitted to the American Board of Medical Specialties (ABMS) and its Member Boards on February 1, 2019.”
The Vision Initiative website – – allows physicians to “actively engage in the process through a dedicated section for feedback and input.”
In a related development, ABMS recently released a summary of a ‘National Medical Specialty Societies and State Medical Societies Summit on Maintenance of Certification’ that took place in December.
The summary was “drafted, edited and approved by Hal Lawrence, M.D. (representing S2C2, national medical societies), Donald J. Palmisano Jr. (representing AAMSE, state medical associations) and Lois Nora, M.D. (representing ABMS, member boards).”
ABMS says the summary “captures the major themes, concerns and issues discussed at the [group’s] first joint meeting…”
The introduction notes that, “In recent years, physicians have grown increasingly concerned with the costs, variation, and relevance of the [MOC] programs established by [ABMS] and [its] member boards. Physicians have increasingly felt threatened by the high-stakes exam, and [they] feel that MOC has incorrectly become a de facto requirement for licensure, credentialing, and reimbursement.”
MAG has been a leading advocate for MOC reform at the state and national levels. Palmisano served on one of the summit’s panel discussions, while Dr. McDonald took an active role in the meeting.
Contact Palmisano at with questions.
AMA outlines spending package’s key health care provisions    
The American Medical Association (AMA) reports that the “…[U.S.] Senate and House passed a fifth continuing resolution to keep the federal government operational until March 23. The spending package, which passed with bipartisan majorities in both the Senate (71-28) and the House (245-182) included a number of health care issues of interest to medicine.”
AMA sent a letter to Congressional leaders urging them to pass the bill. 
The following is AMA’s summary of the bill’s key health care provisions…
Technical amendments to MACRA
Makes several changes to the Medicare Access and CHIP Reauthorization Act (MACRA) that the AMA has been strongly advocating for, including…  
– Excluding Medicare Part B drug costs from MIPS payment adjustments and from the low-volume threshold determination  
– Eliminating improvement scoring for the cost performance category for the third, fourth and fifth years of MIPS
– Allowing CMS to reweight the cost performance category to not less than 10 percent for the third, fourth, and fifth years of MIPS and requiring CMS to update its website by December 31 of each year [and to provide] information on resource use measures including measures under development, the time-frame for such development, potential future resource use measure topics, a description of stakeholder engagement, and the percent of expenditures under Medicare Part A and B that are covered by resource use measures
– Allowing CMS flexibility in setting the performance threshold for years three through five to ensure a gradual and incremental transition to the performance threshold set at the mean or median for the sixth year 
– Allowing the Physician Focused Payment Model Technical Advisory Committee (PTAC) to provide initial feedback regarding the extent to which models meet criteria and an explanation of the basis for the feedback
Physician fee schedule update (in lieu of mis-valued codes)  
Reduces the Physician Fee Schedule conversion factor for 2019 from 0.5 percent to 0.25 percent. This is more favorable language than, and is in lieu of, the language in the House bill that would extend the “mis-valued codes” provision for one additional year. The AMA estimated, based on the recommendations of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), that the mis-valued code provision in the House bill would have reduced the statutory 0.5 percent payment update in 2019 by 0.45 percent. Rejection of the mis-valued code policy is an important outcome for future budget saving exercises. On a bipartisan basis, policymakers have recognized that the mis-valued code “budget dial” is tapped out and should be shelved. 
Permanently repeals the Independent Payment Advisory Board (IPAB).
Children’s Health Insurance Program (CHIP)  
CHIP is extended for an additional four years beyond the previous Continuing Resolution’s six-year extension, with appropriations made through 2027.
Community Health Centers  
Funding for community health centers is reauthorized for two years at a level of $3.8 billion for FY 2018 and $4 billion for FY 2019.  
Medicare payment cap for therapy services 
Permanently repeals the outpatient therapy caps beginning on January 1, 2018
National Health Service Corps  
Funding for the National Health Service Corps is extended at the FY 2015-2017 annual level of $310 million for two additional years.
Teaching Health Center Graduate Medical Education 
Funding for Teaching Health Center Graduate Medical Education is extended for two years at an annual level of $126.5 million, more than doubling annual funding for this program.
Geographic Practice Cost Indices (GPCI) floor 
Extends the work GPCI floor for two additional years through January 1, 2020.  
Reducing EHR Significant Hardship  
Removes the current mandate that meaningful use standards become more stringent over time. This eases the burden on physicians as they would no longer have to submit and receive a hardship exception from HHS.
Closing the Donut Hole for Seniors  
Closes the Medicare Part D prescription drug “donut hole” sooner than under current law by increasing the discounted price manufacturers provide from 50 percent to 70 percent.
Emergency Medicaid Funds for Puerto Rico and the U.S. Virgin Islands  
Puerto Rico’s Medicaid caps for 2018-2019 are increased by an additional $4.8 billion. The Virgin Islands’ caps are increased over the same time period by $142.5 million. Also, 100 percent federal cost sharing for Medicaid is provided for both territories through September 30, 2019.
Prevention and Public Health Fund (PPHF) 
The Senate bill reduces funding for the PPHF by $1.35 billion between FY 2018-2027. 
Other Select Budget Agreement Provisions
– $6 billion in funding for the opioid crisis and for mental health
– $4 billion to rebuild and improve VA Hospitals and clinics
– $2 billion for NIH research (above CURES Act increases)
AMA Litigation Center releases lists of current cases
The American Medical Association (AMA) Litigation Center is promoting the availability of a list of 25 active cases. It says that, “We hope this will give [physicians] a broader understanding of our presence in courts across the country.” 
The Litigation Center also notes that it is “always looking for new and interesting cases to support.” 
Contact Leonard Nelson at or 312.464.5532 or Erin Sutton at or 312.464-4801 with questions. 
Click here for information on the Litigation Center’s case selection criteria
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 run through the end of March.  
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. 
As MAG's 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. Physicians 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 Christiana Craddock at You can also simply call Craddock at 678.303.9273.
Go to for additional information on the MAG ‘Doctor of the Day’ program, including logistical details and FAQ. 
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 5, which include… 
Thomas Haltom, M.D.
Richisa Hamilton, M.D.
Hugh Smith, M.D.
Scott Pugel, 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 for additional information on the MAG ‘Doctor of the Day’ program, including logistical details and FAQ. 
Early bird discount available for MAG’s annual legislative seminar
The Medical Association of Georgia (MAG) is encouraging member physicians to reserve a room for MAG's 2018 ‘Legislative Education Seminar’ meeting, which will take place at the Brasstown Valley Resort in Young Harris on June 1-3. 
Call 800.201.3205 and mention the “MAG Legislative Education Seminar” or click here to receive a discounted room rate of $189 per night plus taxes and fees. The discount will be available until May 2 or until MAG’s block of rooms sells out. Contact Anita Amin at with questions related to lodging. 
Monitor MAG’s communications and for additional details, and contact Derek Norton at or 678.303.9280 with any other questions related to the seminar.  
MAG’s 2018 state legislative priorities 
The Medical Association of Georgia’s (MAG) priorities for the 2018 state legislative session include…
Health Insurance
– Developing a solution for the “surprise health insurance coverage gap.”
– Streamlining and improving the prior authorization process.
– Promoting more and better health insurance coverage options for pain therapy.
– Ensuring that patients have access to every physician insurers advertise as “in-network” for the duration of the contract year to ensure the continuity of care.
– Requiring insurers to be transparent about how they develop their networks, their standards of participation, and the process they use to select and de-select physicians for their networks.
– Allowing patients to make their own health care decisions based on the best treatment options, their medical history, and the advice they receive from their physician rather than an insurer’s step therapy protocols.
Patient Safety
– Working with allied stakeholders (e.g., MagMutual) on key patient safety initiatives, including distracted driving.
– Exploring a waiver option to access federal funds to expand the state’s Medicaid program.
Scope of Practice
– Addressing scope of practice issues that undermine patient safety.  
Contact MAG Government Relations Director Derek Norton at or 678.303.9280 with questions related to MAG’s legislative priorities for 2018. 
Follow MAG at the Capitol 24/7 
Whether you are 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, on Facebook at, or by visiting
MAG’s Government Relations team 
Derek Norton – Director or 404.274.4210  
Bethany Sherrer – Associate, Legal Counsel & GAMPAC Manager or 404.354.1863  
Christiana Craddock – Legislative Assistant or 678.303.9271

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