Key health care bills in final stages of legislative process in Georgia
The Georgia Senate passed a measure (H.B. 909) by Rep. Deborah Silcox (R-Sandy Springs) that calls for the Georgia Department of Public Health to create a state designation system – comparable to ones for strokes, trauma, and cardiac care – for perinatal facilities. MAG is neutral on this bill, which will now go to Gov. Nathan Deal.  
The Senate also passed H.B. 769 by Rep. Rick Jasperse (R-Jasper), which would 1) “relax certain restrictions on remote order entries for hospital pharmacies” and 2) require the Georgia Department of Community Health to streamline the billing and credentialing process for new physicians and 3) establish a rural center for health care innovation and sustainability under the umbrella of the existing Office of Rural Health to provide leadership training and health data analysis for rural hospitals and allow for the easier creation of micro-hospitals (i.e., those with two to seven beds that provide stabilization services 24/7) and 4) create a grant program to provide insurance premium assistance for physicians practicing in medically underserved areas. The House has to agree to the changes that the Senate made before it can go to Gov. Deal. MAG is neutral on this legislation.  
Meanwhile, the House passed S.B. 382 by Sen. P.K. Martin (R-Lawrenceville) – a measure that would require the Georgia Department of Public Health to oversee any Georgia Board of Optometry-approved training programs to allow optometrists to inject pharmaceutical agents. MAG is neutral on this bill, which will go to Gov. Deal as a final step in the legislative process. 
The House also passed a bill (S.B. 357) 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. The House must now sign off on this bill in its current form before it can be sent to Gov. Deal. MAG is neutral on this legislation.  
Finally, the House also passed an amended version of S.B. 118 by Sen. Renee Unterman (R-Buford) – legislation that would raise the age for mandatory insurance coverage for applied behavior analysis from six to 20 years. The Senate must agree to this measure in its current form before it can be sent to Gov. Deal. MAG is neutral on this bill.   
MAG continues to call for a better solution for surprise medical bills   
The Georgia House of Representatives Insurance Committee passed a bill (S.B. 8) by Sen. Renee Unterman (R-Buford) that is designed to address surprise medical bills – but not before its chair, Rep. Richard Smith (R-Columbus), “stripped” the measure and replaced its’ provisions with language from a bill (H.B. 678) that he introduced that would 1) 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 and 2) subject hospitals and insurers to greater transparency requirements and 3) require physicians and hospitals to 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. S.B. 8 included transparency requirements and a payment methodology that MAG did not support. Payment would be based on the median network rate paid by a health plan or the rate of the health plan in its standard formula for out-of-network reimbursement or Medicare fee-for-service reimbursement – whatever was greatest. MAG is calling for greater transparency, but it is part of a coalition of medical societies that would like to see a more comprehensive solution for surprise medical bills – like S.B. 359 by Sen. Chuck Hufstetler (R-Rome), which would 1) result in greater transparency for elective procedures and 2) establish a patient/physician mediation process for bills that arise from “unexpected events” that take place during elective medical procedures and 3) establish a standard physician payment model for out-of-network emergency care – the 80th percentile of the independent/neutral ‘FAIR Health’ database. The amended version of S.B. 8 that passed the House Insurance Committee has moved into the House Rules Committee. 
Senate HHS acts on legislation addressing APRNs & PDMP
The Senate Health and Human Services (HHS) Committee passed a bill that was amended in significant ways – H.B. 927 by Rep. Chad Nimmer (R-Blackshear), which originally dealt with Georgia Department of Family & Children’s Services issues. Sen. Renee Unterman (R-Buford), the Senate HHS chair, replaced that measure’s language with the provisions of a bill (S.B. 351) she introduced that would 1) increase the number of advanced practice registered nurses (APRNs) a physician can oversee with a protocol agreement at one time from four to eight and 2) allow physicians to delegate the ordering of radiographic images to APRNs. MAG opposes H.B. 927 in its current form. The bill will go to the Senate Rules Committee as a next step.
Sen. Unterman added key provisions of another bill she introduced (S.B. 352) to a measure (H.B. 782) by Rep. Trey Rhodes (R-Greensboro) that would 1) eliminate a requirement for non-licensed user delegates to register with Georgia’s Prescription Drug Monitoring Program (PDMP) on an annual basis and 2) allow the Georgia Department of Public Health to share data from the Georgia PDMP with other states. The addition of the S.B. 352 language means that H.B. 782 would also now…
– 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.”
– Make it 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.
MAG is keeping a close eye on H.B. 782, which is in Senate Rules Committee.
And in a related development, Sen. Unterman added S.B. 352’s provisions to a bill (H.B. 161) that was introduced by Rep. Betty Price, M.D. (R-Roswell) that would authorize syringe needle exchange programs in the state – a provision MAG supports. MAG continues to track this bill, which is also in the Senate Rules Committee.
House HHS acts on bills related to anesthesiologist assistants, step therapy & more 
The House Health and Human Services (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 any given time. MAG is watching this legislation, which will now go to the House Rules Committee. 
The House HHS also passed a stripped-down version of a bill (S.B. 325) by Sen. Kay Kirkpatrick, M.D. (R-Marietta), that would have originally allowed Georgia to join the Interstate Medical Licensure Compact – replacing it with the provisions of a bill (H.B. 519) that its chair, Rep. Sharon Cooper (R-Marietta), introduced and a bill (H.B. 646) that Rep. Katie Dempsey (R-Rome) introduced. MAG supports the H.B. 519 language, which would add four exemptions to the state’s step therapy statute. And MAG is neutral on the H.B. 646 language, which would extend a pilot program to offer bariatric surgery through the State Health Benefit Plan. S.B. 325 is now headed to the House Rules Committee. It is also worth noting that there is a good chance lawmakers will revisit the legislation addressing the Interstate Medical Licensure Compact in 2019.  
The House HHS Committee passed a bill (S.B. 422) by Sen. Renee Unterman (R-Buford) that would allow pharmacists to help patients perform and interpret any over-the-counter tests. MAG is watching this bill, which will also now move into the House Rules Committee. 
The House HHS also passed a recently-amended bill (S.B. 81) by Sen. Unterman  that would create a new collocated children’s beds category for certificate of need (CON) purposes – though it would not represent a CON exemption, nor would it create a special process. MAG is tracking this bill, which is also headed to the House Rules Committee.
The House HHS did not pass (S.B. 31), a bill by Sen. Joshua McKoon (R-Columbus) that had been stripped down and replaced with language that would 1) change the definition of a “destination cancer hospital” to a “hospital facility” for the purpose of the state’s CON requirements and 2) require any such hospital to pay $1 million or one percent of adjusted gross revenue – whichever is lower – to the Indigent Care Trust Fund. It is worth noting that there is still a chance that this bill will be considered by lawmakers before the end of this year’s legislative session. 
‘Hands-free’ bill remains in Senate Judiciary   
The Senate Judiciary Committee is considering a bill (H.B. 673) 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. MAG supports this bill, which is expected to be amended before the committee votes on the measure sometime next week. 
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 March 12, which include… 
Steve Tuck, M.D.
Jim Morrow, M.D.
Mboh Elango, 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. 
MAG looking for ‘Doctor of the Day’ volunteer for Sine Die (March 29)  
The Medical Association of Georgia (MAG) is looking for a physician to serve as its ‘Doctor of the Day’ program volunteer from about 3  p.m. until the session ends  on Sine Die – the legislative session’s final day – Thursday, March 29.
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.
MAG's Doctor of the Day…
– Has a reserved parking place
– Is assisted by a nurse
– Is 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 MAG’s Doctor of the Day on March 29, contact Christiana Craddock at ccraddock@mag.org or 678.303.9271 as soon as possible.
Go to www.mag.org/dod 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 $195 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 anita@associationstrategygroup.us with questions related to lodging. 
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 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.
Medicaid
– 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 dnorton@mag.org 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 www.twitter.com/MAG1849, on Facebook at www.facebook.com/MAG1849, or by visiting www.mag.org/governmentrelations. 
MAG’s Government Relations team 
Derek Norton – Director
dnorton@mag.org or 404.274.4210  
Bethany Sherrer – Associate, Legal Counsel & GAMPAC Manager
bsherrer@mag.org or 404.354.1863  
Christiana Craddock – Legislative Assistant
ccraddock@mag.org or 678.303.9271
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Medical Association of Georgia
1849 The Exchange, Suite 200
Atlanta, GA 30339
678.303.9290

Derek Norton, Government Relations Director, 678.303.9280
Bethany Sherrer, Associate, 678.303.9273
Christiana Craddock, Legislative Assistant, 678.303.9271
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