This week’s legislative highlights
The Georgia House of Representatives passed the FY 2017 Amended Budget (H.B. 43), which includes a $17.9 million increase in the primary care and OB-GYN codes for Medicaid. This is one of the Medical Association of Georgia’s (MAG) legislative priorities for 2017. The Senate will begin to consider the budget next week.
Rep. Allen Peake (R-Macon) introduced H.B. 65, a bill that would add six conditions to the state’s ‘Low THC Oil Patient Registry’ – including Tourette’s syndrome, autism spectrum disorder, intractable pain (i.e., severe, debilitating pain that has not responded to previously prescribed medication or surgical measures for more than three months, post-traumatic stress disorder), Alzheimer’s disease, human immunodeficiency virus, and acquired immune deficiency syndrome. Rep. Peake also introduced H.R 36, a measure that would result in a constitutional amendment that would, if it passed, allow the growth and sale of medical cannabis in Georgia. MAG is assessing the bills, which are in the House Judiciary Non-Civil Committee.
In a related development, Sen. Ben Watson, M.D. (R-Savannah) introduced a bill (S.B. 16) that would lower the amount of THC that is allowed in the cannabidiol oil that can be used by patients who are registered with the Georgia Low THC Oil Patient Registry from 5.0 percent to 3.0 percent. It would also add autism spectrum disorder to the list of qualifying conditions. MAG is assessing the legislation, which is in the Senate Health and Human Services Committee.
Rep. Richard Smith (R-Columbus) introduced a bill (H.B. 71) that would require physicians and health centers to disclose certain information about the other providers they expect to utilize and the fees they typically charge before any services are rendered. This legislation would also require physicians to participate in every health insurance plan that is offered by any hospital where they have privileges. MAG is opposing this bill because it will reduce the amount physicians are reimbursed by insurers as well as placing an undue burden on physicians. The measure is in the House Insurance Committee, which Rep. Smith chairs.
Sen. Renee Unterman (R-Buford) introduced S.B. 4, the ‘Enhancing Mental Health Treatment in Georgia Act,’ a bill that would create a Georgia Mental Health Treatment Task Force that would recommend ways to improve the state’s mental health care system. MAG is evaluating the legislation, which has been assigned to the Senate Health and Human Services Committee (HHS) – which Sen. Unterman chairs.
The Senate HHS is also considering Sen. Unterman’s ‘Surprise Billing and Consumer Protection Act’ (S.B. 8), which would create a payment system for out-of-network care and prohibit balance billing. Sen. Unterman has advised MAG that she will introduce a new version of the bill, which MAG will evaluate as soon as it’s available.
And Sen. Unterman introduced S.B. 81, an “omnibus bill” (i.e., several measures that are packaged together), which is designed to address the state’s prescription drug abuse epidemic.
Section 1 of S.B. 81 – the ‘Jeffrey Dallas Gay Jr. Act’ – codifies the emergency order that Georgia Gov. Nathan Deal recently issued to allow a standing order so naloxone is available on an over-the-counter basis in the state. The late Jeffrey’s Gay’s grandfather is Dallas Gay, who serves as the community chair of the MAG Foundation’s ‘Think About It’ campaign to reduce prescription drug abuse in Georgia. Jeffrey Gay died of a prescription drug and alcohol overdose in 2012. MAG supports this section.
Section 2 of S.B. 81 would change the state’s Prescription Drug Monitoring Program (PDMP) in several important ways, including requiring pharmacists to input prescription information every 24 hours instead of weekly; allowing prescribers to delegate their access to the PDMP to any office staff; and requiring prescribers to check the PDMP whenever they prescribe a Schedule II, III, IV or V controlled substance to a patient for the first time and at least every 90 days thereafter – prescriptions of three or less days notwithstanding. Under Section 2, prescribers would not be able to prescribe more than a five-day supply of a Schedule II, III, IV or V controlled substance to an adult they are seeing for the first time. Prescribers would also not be able to prescribe these drugs to a minor for more than a five-day period, and they would be required to discuss the risks associated with the drug with the minor and their parent(s) or guardian. The five-day restrictions would not apply when the prescriber determines that a longer prescription is necessary – and the prescriber would have to note the factors that warranted the longer prescription in the patient’s medical record, along with a statement that the prescriber determined that alternative treatments would not be appropriate. Under this legislation, a prescriber/delegate who failed to review or who disregarded the prescription information could be guilty of a felony – punishable by one to five years in prison and/or a fine of up to $50,000; they would also be reported to the applicable licensing board. Other than the requirement for dispensers to update prescription information more often and increasing the number or staff a prescriber can delegate to access the PDMP on their behalf, MAG opposes Section 2. MAG is educating members of the House and Senate about the potential consequences associated with Section 2 of S.B. 81.
Section 3 of S.B. 81 requires providers, coroners, and medical examiners to report instances of neonatal abstinence syndrome to the Georgia Department of Public Health (DPH). DPH would then be required to give an annual report to the president of the State Senate, the Speaker of the House of Representatives, and the chairs of the House and Senate Health and Human Services committees. MAG is evaluating this section of the bill.
Section 4 of S.B. 81 requires the Georgia Department of Community Health (DCH) to conduct an annual, onsite inspection of narcotic treatment programs in the state. This legislation would also require these programs to submit patient outcome to DCH on a monthly basis. MAG is also assessing this section of the bill, which has not yet been assigned to a committee.
Sen. Chuck Hufstetler (R-Rome) introduced S.B. 47, a measure that 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, which has been assigned to the Senate HHS Committee.
Sen. Hunter Hill (R-Atlanta) introduced the ‘Direct Primary Care Act’ (S.B. 50), which would exempt direct primary care agreements between physicians and patients for the provision of health care services for an agreed-upon fee and period of time from insurance regulations. MAG supports this legislation, which is in the Senate HHS Committee.
Sen. P.K. Martin (R-Lawrenceville) introduced S.B. 52, a bill that would remove the sunset provision on the state law that allows licensed professional counselors to be authorized to conduct emergency examinations on individuals who are mentally ill or drug- or alcohol-dependent. MAG is assessing the measure, which is in the Senate HHS Committee.
Sen. Josh McKoon (R-Columbus) introduced S.B. 55, legislation that would allow a competent adult or his/her agent to execute a psychiatric advance directive containing mental health care preferences, information, or instructions regarding his or her mental health care. MAG is assessing the legislation, which is in the Senate HHS Committee.
Sen. Josh McKoon (R-Columbus) introduced S.B. 56 – the ‘Accuracy and Transparency in Physician/Provider Profiling Act’ – a measure that would provide for standards, criteria, and disclosure requirements for profiling programs that compares, rates, ranks, measures, tiers, or classifies a physician's or physician group's performance, quality, or cost of care against objective or subjective standards or the practice of other physicians. MAG is assessing the legislation, which is in the Senate Insurance and Labor Committee.
Finally, Sen. Butch Miller (R-Gainesville) introduced S.B. 70, which would extend Georgia’s Medicaid Provider Fee – also known as the ‘bed tax’ – until June 30, 2020. MAG will monitor this legislation, which has been assigned to the Senate Finance Committee.