Key health care bills pass – while others fail – before end of ‘Crossover Day’

Yesterday (March 7) was ‘Crossover Day’ – the last day a bill could move from one chamber to the other and still have a clear path of being passed into law in 2019.

One noteworthy measure that passed the Georgia House of Representatives before the crossover deadline was H.B. 233 by Rep. David Knight (R-Griffin). This bill is designed to preserve patient choice by restricting Pharmacy Benefit Managers and insurers from steering patients to the pharmacies they own and from sharing patient information with affiliated entities for commercial purposes. MAG is watching this bill.
After a lengthy debate, the House also passed a bill (H.B. 481) by Rep. Ed Setzler (R-Marietta) that would outlaw abortions after a fetal heartbeat can be detected around six weeks unless the pregnancy is the result of rape (with a police report) or incest, the abortion is necessary to avert death or serious bodily harm to the mother, it is necessary to preserve the life of an unborn child, or the pregnancy is deemed medically futile. This measure would also create a civil cause of action for a woman upon whom an abortion is performed against the physician who performs it.

Meanwhile, some of the important bills that the Georgia Senate passed before the crossover deadline include…

S.B. 56 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 are related to “unexpected events” that take place during elective medical procedures and 3) establish a standard physician payment model for out-of-network emergency care – a blended rate that encompasses the average of the 80th percentile of charges and the 95th percentile of allowed amounts from an independent, non-profit database. MAG supports this legislation, which would put an end to surprise medical bills. This measure has been assigned to the House Insurance Committee.

S.B. 121 by Sen. Larry Walker (R-Perry), which would 1) increase how long prescription information remains in the state’s Prescription Drug Monitoring Program (PDMP) data base from two years to five years and 2) authorize the State Attorney General's Medicaid Fraud Control Unit to access the PDMP data base for enforcement purposes. MAG continues to evaluate this legislation.

S.B. 142 by Sen. Walker, which would require insurers to note that an insured person is fully-insured on their health insurance identification card. MAG supports this bill.

S.B. 184 by Sen. Greg Kirk (R-Americus), which would allow State Health Benefit Plan enrollees to seek primary care at federally-qualified health centers with reimbursement at no less than the Medicare maximum allowable reimbursement rate. MAG is following this measure.

S.B. 195 by Sen. Hufstetler, which 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. MAG supports this bill, which is one of its priorities for this year’s legislative session.

MAG Government Affairs Director Derek Norton emphasizes that, “One of the day’s most significant developments was that H.B. 84 failed to pass the House as a result of a tremendous grassroots effort by the House of Medicine.”

H.B. 84 by Rep. Richard Smith (R-Columbus) would have 1) required 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) subjected hospitals and insurers to greater transparency requirements and 3) required physicians and hospitals to send initial bills to patients within 90 days – while the Georgia Department of Insurance would have had to establish a patient arbitration process to resolve any billing disputes.
Another key bill that failed to pass the House was H.B. 198 by Rep. Matt Hatchett (R-Dublin). This measure would have 1) exempted Cancer Treatment Centers of America and Legacy Sports Institute from some of the state’s certificate of need (CON) requirements and 2) required hospitals and other health care facilities to become more transparent – although it wouldn't have changed the rules for ambulatory surgery centers.

And another measure that did not pass the Senate before the end of the crossover deadline was S.B. 109 by Sen. Walker – a bill that would have allowed advanced practice registered nurses (APRNs) to order radiographic imaging pursuant to a protocol agreement after five years of experience. MAG opposed this legislation.

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 4, which include…
Mark Griffiths, M.D.
Keisha Callins, M.D.
Carmen Sulton, M.D.
Brad Bushnell, M.D. 
Matt Keadey, 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.
Don’t forget to register & get discounted room for MAG’s legislative seminar 
The Medical Association of Georgia (MAG) is reminding members to register and to reserve a room for MAG's 2019 ‘Legislative Education Seminar’ meeting, which will take place at the Brasstown Valley Resort & Spa in Young Harris on May 31-June 2. 
Call 800.201.3205 and mention the “MAG Legislative Education Seminar” or click here 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. 
The seminar costs $100 per person, which includes a breakfast, a lunch, and two dinners.
Click here to register for the seminar and to select your meal choice for the plated dinner that will take place on Friday, May 31 – keeping in mind that the dinner on Saturday, June 1 will be a buffet. 
Monitor MAG’s communications and for additional details, and contact Derek Norton at or 678.303.9280 with any questions related to the seminar.   
MAG’s 2019 state legislative priorities 

Health Insurance

– Developing a solution for the “surprise health insurance coverage gap”

– Streamlining and improving the prior authorization process

– Promoting more and better coverage options for pain therapy

– Ensuring patients have access to every “in-network” physician for the duration of their contract year

– Requiring insurers to be transparent about their networks, standards of participation, and process for selecting/de-selecting physicians

– Allowing patients to make health care decisions based on the best treatment options, their medical history, and the advice they receive from their physicians vs. an insurers' step therapy protocols

– Continuing to oppose insurers' retrospective ER claims review policies

Rural Health Care

– Recruiting and retaining an adequate physician work force

– Improving the accessibility of health care in rural areas

Patient Safety

– Working with allied stakeholders (e.g., MagMutual) on key patient safety initiatives, including cancer screening and treatment for substance abuse (e.g., detoxification units and “Casey’s Law”)

– 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 2019.
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 – Legal Counsel & GAMPAC Manager or 404.354.1863  
Christiana Craddock – Legislative Assistant or 678.303.9271
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