MAG has high expectations for 2020 legislative session 
Dear MAG members, 
I am honored and excited to represent you and your patients during Georgia’s 2020 state legislative session – which will get underway this Monday, January 13. This is my fourth year as the Medical Association of Georgia’s (MAG) chief lobbyist, and you should have great peace of mind knowing that MAG has been the leading advocate for physicians in the state since 1849. 
The legislative process is the most important way to improve Georgia’s practice environment and to protect and preserve your autonomy as a physician and maintain your relationships with your patients.
MAG’s Government Relations team has been actively involved in an array of study committees, state agency meetings, and political campaigns since the legislative session ended in 2019.
I truly believe that we are in a position to achieve great success and enhance Georgia’s heath care system in 2020 – keeping in mind that there will be several new faces and committee chairs at the State Capitol this year.
Based on the direction that we received from MAG’s Council on Legislation, MAG’s Board of Directors, and MAG’s House of Delegates, the legislative priorities that will serve as our roadmap for 2020 will include addressing Georgia’s declining tort environment, out-of-network or “surprise” billing, health insurance reform, tax credits for uncompensated care, improving health care in rural areas, and ensuring your patients have access to health insurance. Of course, we will also be ready to address any scope of practice issues that come up. 
MAG has enjoyed great success in the legislative arena in recent years, and 2019 was no different. For example, MAG supported a measure (S.B. 106) that gave the Georgia Department of Community Health the authority to submit a Section 1115 waiver to the Centers for Medicare & Medicaid Services to expand the number of Georgians who are insured by Georgia’s Medicaid program and enable the governor to submit a Section 1332 waiver to the U.S. Secretary of Health and Human Services to get permission to “pursue innovative strategies for providing their residents with access to high quality, affordable health insurance.” MAG will keep you posted as the federal government considers these waiver applications, and I encourage you to read the second article in this newsletter – which addresses the letter that MAG President Andrew Reisman, M.D., submitted to Georgia Gov. Brian Kemp to express MAG’s views on the waiver applications. 
In 2019, MAG also played a key role in passing H.B. 63, which established exceptions to health insurers’ step therapy protocols; H.B. 128, which exempted “low” payments under high-low agreements in med-mal agreements from the requirement to report settlements to the Georgia Composite Medical Board; S.B. 16, which allowed Georgia to join the Interstate Medical Licensure Compact; S.B. 18, which enabled physicians to enter into direct primary care agreements with their patients without being subject to health insurance regulations; S.B. 115, which established a Georgia telemedicine license for physicians in other states, and; S.B. 118, which amended portions of the ‘Georgia Telemedicine Act,’ including prohibiting insurers from requiring their customers to use telemedicine and providing pay equity for health care providers who use telemedicine. 
MAG also supported the formation of two legislative study committees, including a Senate committee that has assessed the state’s tort climate and a joint House/Senate committee that has examined ways to simplify the physician oversight process for mid-level health care providers.
And MAG played a key role in securing additional pay for Medicaid primary care and OB-GYN physicians in Georgia in FY 2016, FY 2017, FY 2018 and FY 2019.
Legislators did not pass legislation addressing “surprise” or balance billing in 2019, but we are cautiously optimistic that compromise legislation to address these important issues will pass in 2020. 
Because it’s an election year, I believe that this is going to be a fast-paced and politically charged session. This means that legislators will be thinking about the short and long-term political implications for the decisions they make. In this political environment, we will see a lot of legislation introduced in 2020 – but I would be surprised if a lot of it passes through both chambers and makes it to the governor’s desk.
I cannot overstate the importance of MAG’s political action committee, so I encourage you to join GAMPAC in 2020. This is an easy and effective way to help ensure that Georgia’s legislative environment is favorable to physicians and patients. I also encourage you to join us at ‘Physicians’ Day at the Capitol’ on Wednesday, February 19 – and I hope that you will attend MAG’s ‘Legislative Education Seminar’ at the Brasstown Valley Resort in Young Harris on May 15-17 (see the articles below for details). 
I would like to express my sincere thanks to the MAG Council on Legislation, including its chair, W. Scott Bohlke, M.D., as well as our legislative allies – including Georgia's county medical societies and state specialty societies – for their ongoing support.
I would also like to thank the individual physicians who support MAG’s advocacy efforts, whether that’s making a phone call, sending an email, attending an event, or meeting with legislators. Our grassroots efforts are always a huge part of our success under the Gold Dome.
I encourage you to read e-News from the Capitol throughout the legislative session, and I encourage you to share it with your colleagues and applicable practice staff.
Finally, I encourage you to reach out to me at dnorton@mag.org or any member of MAG’s Government Relations team if you have any comments or questions during this year’s legislative session.
We sincerely value your perspective – and please remember that we are here to serve you. 
Derek Norton
Director, Government Relations
Medical Association of Georgia 
MAG weighs in on state’s federal health care waivers applications
On December 3, Medical Association of Georgia (MAG) President Andrew Reisman, M.D., submitted a letter to Georgia Gov. Brian Kemp that addressed MAG’s views on the ‘Georgia Pathways’ Section 1115 and ‘Georgia Access’ Section 1332 health insurance waivers applications that Gov. Kemp recently submitted to the federal government.
MAG’s ‘Georgia Pathways’ (Section 1115 Waiver) comments included the following...
– MAG supports the waiver’s overall goal (i.e., health insurance for adults who are under 100 percent of FPL), which is aligned with MAG Policy 290.971: “MAG supports innovations and modifications of the Georgia Medicaid program balancing the needs of Georgia’s uninsured patients with the need to achieve a sustainable solution to the budget shortfalls and expected future financial challenges.”
– MAG supports the $0 copay for primary care visits because it will encourage patients to establish a medical home with a primary care physician, which will reduce the state’s overall health care costs.
– MAG believes that patients who transition from the Georgia Pathways plan to a commercial health insurance plan should still have access to the funds they accumulated in their Georgia Pathways ‘Member Rewards Account.’
– This plan’s employer-sponsored insurance premium assistance feature is important because the administrative burden associated with private insurance is generally lower than the one associated with care management organizations (CMOs) – and private insurers typically offer better reimbursement.
– MAG members want to know if this proposal includes any “hold harmless” provisions (i.e., physicians would not be subjected to additional risk or liability), especially during the early stages of the program’s implementation.
– MAG members are concerned about the work requirement for adults who have chronic conditions and/or who don’t meet Medicaid’s “disabled” standards. MAG would consequently like to work with the state and other applicable stakeholder groups to develop exemptions for specific diagnoses, especially those that are related to mental health conditions.
– The state should look for ways to reduce the administrative burden associated with CMO prior authorization processes, which result in a multitude of patient care and claims problems.
– Reimbursement levels need to be high enough to establish and sustain an adequate network of physicians across all specialties – keeping in mind that a lot of physicians don’t accept Medicaid because they would effectively lose money on every patient they see (i.e., the cost of providing the care is higher than the payment).
– The state needs to work with health insurers to find ways to compensate physicians for “no-shows” and missed appointments, which translate into costs the practice can’t recover. The state should also work with insurers to develop innovative solutions to help patients secure reliable forms of transportation to get to and from appointments.
– The plan’s database should be updated on a regular basis to ensure that practices can determine if a patient/member’s coverage is up to date (e.g., they haven’t been suspended for failing to pay their premium).
– MAG members want to know how the state/insurers will handle patients/members who use the emergency department for non-emergency purposes (i.e., ensure that physicians aren’t penalized). This would be a significant challenge since much of the plan’s target population hasn’t received medical care on a regular basis.
– MAG encourages the state to incentivize eligible patients to participate in the plan’s ‘Early and Periodic Screening, Diagnostic, and Treatment’ (EPSDT) program by increasing the amount of money that is available for health care expenses in their ‘Member Rewards Account.’ 
– MAG encourages the state to increase physician reimbursement for Medicaid’s primary care codes (including obstetricians and gynecologists) to equal the 2018 Medicare rates, which will improve access to care.
– MAG believes that the plan’s premiums should be reduced to ensure that patients can obtain and maintain the benefits.
– MAG is concerned about the state’s request to eliminate the three-month retroactive Medicaid benefit. This might deliver the target savings goal of 2.2 percent per member/per month, but MAG believes that this will further strain the state’s struggling rural health care system – including physicians and hospitals.
MAG’s ‘Georgia Access’ (Section 1332 Waiver) comments included the following…
– The ‘Georgia Access’ Wavier is consistent with MAG Policy 290.968, which states that, “MAG supports Georgia seeking a waiver from the U.S. Department of Health & Human Services (HHS) Secretary to allow Georgia to use the Medicaid expansion funds to buy private insurance in the state health insurance exchange for eligible Georgia citizens at or below 138 percent of the federal poverty level.”
– MAG supports efforts to increase the number of Georgians who have health insurance and reduce the costs associated with purchasing that health insurance.
– MAG supports the goal of moving as many patients from Medicaid to commercial health insurance as possible.
– MAG believes that the current trajectory of rising health insurance premiums is unsustainable.
– MAG supports the need to continue to protect patients who have pre-existing conditions.
– MAG members have asked whether this proposal includes any “hold harmless” provisions (i.e., physicians would not be subjected to additional risk or liability).
– MAG believes that this plan should have a “robust” set of “essential” benefits. MAG is also concerned that a lot of patients/members may not understand what is included in a non-qualified health plan (i.e., they will purchase the cheapest plan without understanding the implications) – which is something the state/insurers should be prepared to address. The ‘Georgia Access’ model could allow health insurers and other private sector entities to market both non-eligible non-qualified health plans (QHPs) and eligible non-QHPs. MAG consequently encourages the state to work with MAG and state medical specialty groups and other applicable stakeholder groups to ensure that consumers/patients are protected under this plan.
– MAG is concerned about the plan’s lack of guidance or policies to ensure that it has adequate networks, which could undermine the Georgia Access and Reinsurance Program (i.e., patients could receive health insurance that physicians and hospitals do not accept).
– MAG is concerned about insurance carriers misrepresenting the size of their networks during the open enrollment period. MAG would consequently like the state to establish penalties to eliminate this common practice (e.g., reduce the coinsurance subsidy for health insurers’ inaccurate listings).
A MAG team – including CEO Donald J. Palmisano Jr., Legal Counsel Bethany Sherrer, and Corporate Relations Director Ryan Larosa – also met with the governor’s office in early December to discuss MAG’s views on the waiver applications.
MAG members can contact Larosa at rlarosa@mag.org with questions about the waiver applications. 
MAG leadership team attends AMA State Advocacy Meeting  
A Medical Association of Georgia (MAG) leadership team attended the American Medical Association’s annual State Advocacy Meeting, which took place in Bonita Springs, Florida on January 9-11. Pictured below from the left are Florida Insurance Commission Deputy Director John Reilly, MAG President Andrew Reisman, M.D., Georgia Insurance Commissioner John King, and MAG Council on Legislation Chair W. Scott Bohlke, M.D. Commissioner King gave a presentation on regulatory developments at the meeting. MAG Executive Director Donald J. Palmisano Jr. attended the meeting as well.  
MAG’s 2020 state legislative priorities 
The Medical Association of Georgia’s (MAG) priorities for the 2020 state legislative session include… 
Tort Reform
– Addressing the states declining tort environment
Tax Credits for Uncompensated Care
– Creating tax credits for physicians who provide uncompensated care
Medicaid
– Continuing to support the waiver process to ensure Georgians have access to health insurance
Scope of Practice
– Addressing issues that undermine patient safety
Health Insurance
– Developing a solution for “surprise medical bills”        
– Streamlining and improving the prior authorization process
– Promoting insurance coverage for non-narcotic alternative therapies        
– Ensuring patients have access to every physician who is advertised as “in-network” for the duration of a contract year to ensure the continuity of care
Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 678.303.9280 with questions related to MAG’s legislative priorities for 2020.
MAG encouraging members to register for ‘Physicians' Day at the Capitol’
The Medical Association of Georgia is encouraging it's members to register for the 2020 ‘Physicians Day at the Capitol’ which will take place at the State Capitol in Atlanta from 8 a.m. to 2 p.m. on Wednesday, February 19.
Physicians and legislators will be invited to attend a lunch that will be served at a venue that is at or within walking distance of the Capitol as soon as the General Assembly adjourns.
Contact Christiana Craddock at ccraddock@mag.org or 678.303.9271 with questions.
Register for ‘Physicians Day at the Capitol’
MAG encouraging members to register/reserve room for legislative seminar
The Medical Association of Georgia (MAG) is encouraging its members to register and reserve a room for MAG's 2020 ‘Legislative Education Seminar’ meeting, which will take place at the Brasstown Valley Resort & Spa in Young Harris on May 15-17. 
Call 800.201.3205 and mention the “MAG Legislative Education Seminar” 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. 
Contact Christiana Craddock at ccraddock@mag.org with questions related to lodging or registration.
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 questions related to the seminar.  
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 – 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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