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Eye care scope bill fails in House HHS Committee, another passes in Senate HHS Committee
A bill by Rep. Earl Ehrhart (H.B. 416) that would have allowed optometrists to administer pharmaceutical agents that are related to the diagnosis or treatment of diseases and conditions of the eye and adnexa oculi by injection (except for sub-tenon, retrobulbar, peribulbar, intraorbital nerve block, intraocular, or botulinum toxin injections) if they meet certain requirements did not pass the House Health and Human Services (HHS) Committee. The bill had been amended to add facial nerve block, injected local anesthetics, dermal filler, intravenous injections, and intramuscular injections to the list of pharmaceutical agents that an optometrist is not allowed to administer. This legislation would have also expanded the list of pharmaceutical agents an optometrist could administer. MAG opposed this legislation because it would have undermined patient safety in significant ways. In a related development, the Senate HHS Committee passed a bill (S.B. 221) by Sen. Renee Unterman (R-Buford) that would expand 1) the number of medications that optometrists are allowed to prescribe and 2) the pharmaceutical agents optometrists are allowed to administer around the eye – excluding sub-tenon, retrobulbar, peribulbar, intraorbital nerve block, intraocular, or botulinum toxin injections. The bill was amended to require that 1) 30 hours of required training be performed by a board certified ophthalmologist and approved by the Georgia Composite Medical Board before an optometrist could administer injections and 2) to add facial nerve block, subconjunctival anesthetic, dermal filler, intravenous injections, and intramuscular injections to the list of pharmaceutical agents that an optometrist is not allowed to administer. MAG opposes this legislation, which has moved into the Senate Rules Committee.
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House HHS chair addresses eye care bills on ‘Top Docs’ show
Georgia Rep. Sharon Cooper (R-Marietta) – the chair of the Georgia House of Representatives Health and Human Services Committee – discussed several bills that she believes would place Georgians at risk of blindness and other serious eye complications when she appeared on a special edition of the Medical Association of Georgia’s (MAG) ‘Top Docs Radio’ program on the Business Radio-X Network on February 23.
Rep. Cooper addressed her concerns surrounding H.B. 416 and S.B. 221, measures that would allow optometrists to perform a variety of extraocular injections.
MAG President Steven M. Walsh, M.D., shares Rep. Cooper’s concerns, stressing that, “MAG is opposing these measures because they would inappropriately expand optometrists’ scope of practice and they would undermine patient care.”
Rep. Cooper also notes that, “Medicine is effectively under attack these days, so it is imperative for doctors to get involved in the legislative process.”
She is encouraging physicians and patients to contact their legislators to oppose H.B. 416 and S.B. 221.
MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.
Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 404.274.4210 with questions related to H.B. 416 or S.B. 221.
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| House and Senate pass health care bills
The Georgia House of Representatives passed a bill (H.B. 157) by Rep. Trey Kelley (R-Cedartown) that would repeal 2016 legislation that limited a physician’s ability to advertise and publicize their medical specialty certification to specific certification boards. This bill will now go to the Senate. The Georgia Senate passed…
– S.B. 8 by Sen. Renee Unterman (R-Buford), which would 1) establish notification requirements for providers, health care facilities, and insurers regarding insurance coverage, scheduled providers, and cost information for elective procedures and 2) establish the 80th percentile of the FAIR Health database as the payment methodology for out-of-network procedures with a dispute resolution process if the parties disagree and 3) a task force to look at out-of-network payments for health care services. MAG will continue to work on this legislation to prevent negative implications for physicians. – H.B. 47 by Sen. Chuck Hufstetler (R-Rome), which would exempt a visiting sports team’s physicians from certain licensure requirements if they are licensed and in good standing in another state. MAG supports this legislation. – S.B. 50 by Sen. Hunter Hill (R-Atlanta), which would allow physicians to enter into direct primary care agreements without being subject to insurance regulations. MAG supports this legislation. – S.B. 88 by Sen. Jeff Mullis (R-Chickamauga), which would provide comprehensive regulations and a licensing process for narcotic treatment programs. MAG is neutral on this legislation. – S.B. 96 by Sen. Ben Watson, M.D. (R-Savannah), which would allow physician assistants, nurse practitioners, and registered nurses to pronounce an organ donor’s death in hospice settings. MAG is neutral on this legislation. – S.B. 106 by Sen. Greg Kirk (R-Americus), which would allow certified registered nurse anesthetists (CRNAs) to practice in a pain clinic without direct supervision. MAG opposes this legislation. – S.B. 109 by Sen. Butch Miller (R-Gainesville), which would create a three-tier cardiac care center designation system – similar to the one that’s used for stroke and trauma hospitals in the state. MAG supports this legislation. – S.B. 125 by Sen. Rick Jeffares (R-McDonough), which would allow a physician assistant (PA) to write five-day hydrocodone prescriptions if their supervising physician includes this authority in the PA’s written job description. MAG is neutral on this legislation.
These bills will now move into the House.
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Senate HHS passes key bills
The Senate Health and Human Services Committee passed several key bills this week, including...
– S.B. 121 by Sen. Butch Miller (R-Gainesville), which would codify Gov. Nathan Deal’s executive order to make naloxone – which counteracts the effects of prescription drug overdoses – available in the state on an over-the-counter basis. MAG supports this legislation.
– S.B. 166 by Sen. Renee Unterman (R-Buford), which would establish a multi-state licensure compact for nurses. MAG is watching this legislation.
– S.B. 220 by Sen. Unterman, which would repeal 2016 legislation that limited a physician’s ability to advertise and publicize their medical specialty certification to specific certification boards.
– S.B. 241 by Sen. Unterman, which would move the administration of the Georgia Prescription Drug Monitoring Program (PDMP) from the Georgia Drugs and Narcotics Agency to the Georgia Department of Public Health. MAG's efforts on this front have been focused on improving the PDMP’s use, reliability, and accessibility.
– S.B. 200 by Chuck Hufstetler (R-Rome), which would require insurers to cover prescriptions that are dispensed for less than 30 days at a “prorated daily cost-sharing rate” when it is in the best interest of the patient or when it is for the purpose of synchronizing the insured patient's medications for chronic conditions. MAG has not taken a position on this legislation.
These bills have moved into the Senate Rules Committee.
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Lawmakers considering PDMP omnibus bill
A subcommittee of the House Judiciary Non-Civil Committee passed an omnibus bill (H.B. 249) by Rep. Kevin Tanner (R-Dawsonville) that includes a provision that would require prescription drug dispensers to update the state’s Prescription Drug Monitoring Program (PDMP) every 24 hours, as opposed to the current requirement of every seven days. MAG supports this provision.
MAG also supports a H.B. 249 provision that would enable prescribers to have up to two practice staff access the PDMP on their behalf. These delegates could include 1) licensed physician assistants, advanced practice registered nurses, or registered nurses who complete a one-time registration process or 2) unlicensed practice staff who complete an annual registration process. It is worth noting that the delegating prescriber or dispenser could be held civilly liable and/or criminally responsible for “the misuse of prescription information obtained by his/her delegates.”
And MAG supports a H.B. 249 provision that would codify the executive order that Georgia Gov. Nathan Deal recently issued that made naloxone available on an over-the-counter basis. In a related development, Sen. Butch Miller has introduced a similar measure, the ‘Jeffrey Dallas Gay Jr. Act’ – S.B. 121 – which is in the Senate Health and Human Services Committee.
Finally, H.B. 249 would require every prescriber who has a U.S. Drug Enforcement Agency prescribing license to register as a PDMP user by January 1, 2018. The Georgia Drugs and Narcotics Agency (GDNA) would then query the database on a random basis. GDNA would be required to certify that the state’s PDMP meets industry standards in June. If that certification requirement goes into effect, prescribers would be required to check the PDMP before they prescribe benzodiazepines or opiates or opioids or opioid analgesics or opioid derivatives. The legislation includes exemptions for prescriptions that are written for three days or less, prescriptions that are written for 10 days or less following a surgery, inpatient care, and hospice care. The regulatory boards that oversee their respective prescriber groups would be responsible for enforcement. MAG took an active role in developing this compromise with Rep. Tanner.
H.B. 249 will now move into the full House Judiciary Non-Civil Committee.
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This week’s other legislative highlights The Senate Insurance and Labor Committee passed a bill (S.B. 164) by Fran Millar (R-Atlanta) that would limit copays, coinsurance, and deductibles for physical therapy, occupational therapy, and chiropractic visits to what patients pay for primary care visits. MAG opposes this legislation, which is in the Senate Rules Committee.
Rep. Sharon Cooper (R-Marietta) introduced H.B. 426, a bill that would increase the number of advanced practice registered nurses (APRNs) that a physician can delegate their authority to from four to 10 – including no more than four at any single point in time. The measure would also add county and municipal emergency medical services with a full-time medical director to the list of organizations that are exempt from limiting the number of APRNs their physicians can supervise. MAG is opposing this legislation, which is in the House Health and Human Services (HHS) Committee.
Rep. Mark Newton, M.D. (R-Augusta) introduced H.B. 427 – the ‘Physicians and Health Care Practitioners for Rural Areas Assistance Act’ – which would add dentists, physician assistants, and APRNs to the list of practitioners who are eligible for the service cancelable loan program that is administered by the Georgia Board for Physician Workforce. These funds are already in the budget for FY 2018. MAG is watching this legislation, which passed the House HHS Committee and is now in the House Rules Committee. A subcommittee of the House Public Safety and Homeland Security Committee passed a bill (H.B. 163) by Rep. Betty Price, M.D. (R-Roswell) that would outlaw the use of cell phones by adding drivers who are over 18 (i.e., those who are under 18 are already covered) and bus drivers other than on a hands-free basis – certain exceptions (e.g., calling 911) notwithstanding. This legislation was the result of a resolution that was passed by MAG’s House of Delegates in 2016. The bill is now eligible for a vote by the entire House Public Safety and Homeland Security Committee. MAG supports this legislation, which is one of its patient safety priorities for this year’s legislative session.
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Thanking this week’s ‘Doctor of the Day’ volunteers MAG is thanking and applauding its ‘Doctor of the Day’ volunteers for the week of February 13, which include… Snehal C. Dalal, M.D.
Xavier A. Duralde, M.D.
Todd A. Schmidt, M.D.
O. Scott Swayze, 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.
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| Save June 23-25 for MAG’s ‘Legislative Education Seminar’
MAG is encouraging member physicians to save June 23-25 for its 2017 ‘Legislative Education Seminar’ meeting, which will take place at Brasstown Valley Resort in Young Harris.
More than 50 physicians and 25 state leaders attended the event in 2016.
Monitor www.mag.org for details, and contact Derek Norton at dnorton@mag.org or 678.303.9280 with any questions related to MAG’s 2017 ‘Legislative Education Seminar.’
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| MAG’s 2017 state legislative priorities
The Medical Association of Georgia’s priorities for the 2017 state legislative session include…
Out-of-Network Billing & Network Adequacy
MAG will 1) support reforms that will require appropriate network adequacy standards for health insurers and 2) call for health insurers to be more transparent in their contracts with physicians’ practices and 3) support legislation that will result in physician payment methodologies that are adequate and sustainable for out-of-network emergency care.
Medicaid Payment Parity
MAG will be an advocate for the General Assembly to continue to fund the Medicaid parity payment program for all areas of primary care. Maintenance of Certification (MOC)
MAG will 1) work to ensure that Maintenance of Certification is not a condition of licensure or a condition of hospital credentialing and 2) support efforts that will alleviate the costly and burdensome aspects of MOC for physicians. Patient Safety
MAG will be an advocate for legislation that improves 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 2017.
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