General Assembly passes array of key bills before session’s end
The Georgia General Assembly passed an array of key health care bills during the 2020 session’s final week, including…
S.B. 28 by Sen. Lester Jackson (D-Savannah), which would require 1) health insurance copays to be “reasonable in relation to covered benefits to which they apply” and 2) “copays [to] be used as an incentive rather than a barrier to accessing appropriate care.” MAG supports this legislation.
S.B. 303 by Sen. Ben Watson, M.D. (R-Savannah), which would require health insurers to make certain patient cost comparison information available on an interactive and publicly accessible website. Doing so would allow patients to 1) see how much in-network physicians are paid by insurers and 2) see the average amount that in-network physicians actually agree to be paid by insurers and 3) get an estimate for how much out-of-pocket money they will owe their physicians/providers and 4) compare quality metrics for the physicians/providers that are in their network in major diagnostic categories, adjusted for risk and severity. MAG supports this bill.
S.B. 306 by Sen. Valencia Seay (D-Riverdale), which would create a licensure and telemedicine compact for audiologists and speech language pathologists. MAG is neutral on this legislation.
S.B. 313 by Sen. Dean Burke, M.D. (R-Bainbridge) and H.B. 946 by Rep. David Knight (R-Griffin), which would address pharmacy benefit managers (PBMs) practices – such as “steering” (i.e., forcing patients to use PBM-owned pharmacies) and pharmaceutical manufacturers’ rebates. These measures include language from a MAG 2019 House of Delegates resolution that calls for establishing requirements for physicians who are involved with prior authorization and step therapy determinations, formulary development, and formulary management (i.e., they would have to 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 are providing advice). Under this legislation, the Georgia Department of Community Health would be encouraged to require the use of Georgia-licensed physicians for prior authorization or step therapy appeals or determinations in its future contracts with PBMs. MAG supports these bills, which are identical.
S.B. 321 by Sen. Chuck Hufstetler (R-Rome), which would 1) increase the physician PA supervision ratio from 4-to-1 in a group practice and 2-to-1 in a solo practice to 4-to-1 for all and 2) allow APRNs to order radiographic imaging in non-life-threatening situations if it is included in their protocol agreement. MAG opposes this legislation.
Another bill (S.B. 359) by Sen. Hufstetler (R-Rome) that would create liability protections for physicians, other health care providers, health care entities, businesses, and sports venues for claims related to COVID-19. Physicians, health care providers, and health care entities would be protected from liability for the injury or death of a patient for COVID-19 or where the response to COVID-19 reasonably interfered with the arranging for or the providing of the health care services or medical care at issue and for the transmission, infection, exposure, or potential exposure of COVID-19 to an individual. These protections would not apply in cases of gross negligence, willful and wanton misconduct, reckless infliction of harm, or intentional infliction of harm. MAG supports this bill.
S.B. 375 by Sen. Jeff Mullis (R-Chickamauga), which would 1) make the sale of cigarettes, tobacco products, tobacco related objects, alternative nicotine products, or vapor products to individuals under the age of 21 illegal and 2) create a regulatory structure and licensure fee for businesses that sell alternative nicotine products and consumable vapor products and 3) set a rate for the taxation of consumable vapor products. MAG supports this legislation.
Another bill (S.B. 482) by Sen. Burke that would create a ‘Georgia All Payer Claims Database’ (GAPCD) to collect claims data from insurance companies, the Georgia Department of Community Health, Medicaid care management organizations, Medicare plans, entities that contract with institutions of the Georgia 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. This measure would also establish a GAPCD Advisory Committee to make recommendations about the GAPCD framework and develop a 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 is neutral on this bill.
S.B. 391 by Sen. Kay Kirkpatrick, M.D. (R-Marietta), which 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. 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 neutral on this legislation, which was also added to H.B. 791 (see below).
H.B. 752 by Rep. Dave Belton (R-Buckhead), which addresses inadequate language that is in state law that is related to the background checks that are conducted before Georgia can operate as a “home state” for physicians wishing to gain licensure under the Interstate Medical Licensure Compact and physical therapists can gain licensure under the Physical Therapy Compact. MAG supports this legislation.
H.B. 789 by Rep. Mark Newton, M.D. (R-Augusta), which would 1) address “surprise bills” by creating a “star” rating system to highlight which health insurance plans include both certain medical specialties (i.e., emergency medicine, radiology, anesthesiology, and pathology) and hospitals in the same networks and 2) require health insurers to make this information available on their websites and in their printed directories. MAG is neutral on this bill.
H.B. 791 by Rep. Ron Stephens (R-Savannah), which would allow pharmacists to convert a maintenance medication prescription from a 30-day supply to a 90-day supply up to the quantities that have been authorized through refills by the physician – although this would not be permitted on the initial prescription or whenever the physician specifies that the refills should not be combined. This bill was amended to include S.B. 391’s provisions (see above). MAG is neutral on this legislation.
H.B. 918 by Rep. Sharon Cooper (R-Marietta), which would change 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 bill.
Another bill (H.B. 1114) by Rep. Cooper that would extend postpartum Medicaid coverage from two months to six months and require Medicaid to cover lactation care and services. MAG supports this legislation.
H.B. 932 by Rep. Houston Gaines (R-Athens), which would allow physicians and podiatrists to form professional corporations together. MAG is neutral on this bill.
H.B. 991 by Rep. Matt Hatchett (R-Dublin), which would create a ‘Healthcare Transparency and Accountability Oversight Committee’ that 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 bill.
H.B. 1125 by Rep. Trey Kelley (R-Cedartown) requires the Department of Community Health and Georgia Composite Medical Board (GCMB) to compile information on factors and pertinent history to identify individuals with a high risk for breast cancer. GCMB would be tasked with distributing this information to physicians annually. And the State Health Benefit Plan would be required to cover breast cancer screening for individuals with a high risk for breast cancer who are 30 years of age or older. MAG is neutral on this legislation.
The Senate passed S.R. 981 by Gloria Butler (D-Stone Mountain), which would create a Senate Study Committee on Surgical Smoke Evacuation Systems. This measure did not require House action. MAG is neutral on this bill.
These measures will now be sent to Georgia Gov. Brian Kemp.
Note: The July 1 edition of MAG’s ‘e-News from MAG’ newsletter will include a comprehensive summary of this year’s state legislative session, which ended on Friday, June 26.