Key Bills Summary (2019)

MAG PRIORITY: HEALTH INSURANCE

Sen. Chuck Hufstetler (R-Rome) introduced legislation (S.B. 56) that would have 1) resulted in greater transparency for elective procedures and 2) established a patient/physician mediation process for bills that are related to “unexpected events” that take place during elective medical procedures and 3) established a standard physician payment model for out-of-network emergency care – a combination of the 80th percentile of charges and the 95th percentile of allowed amounts from the independent/neutral ‘FAIR Health’ database. The House Insurance Committee replaced these provisions with the transparency language from H.B. 84 and a standard physician payment for out-of-network emergency care of the greater of 150 percent of Medicare or the contracted rate. MAG’s PositionOpposed with the new languageOutcomeDid not pass.

Sen. Renee Unterman (R-Buford) introduced a bill (S.B. 118) that will amend portions of the ‘Georgia Telemedicine Act’ – including prohibiting insurers from requiring their customers to use telemedicine and providing pay equity for health care providers using telemedicine. MAG’s PositionSupportedOutcomePassed.

Sen. Larry Walker (R-Perry) introduced a bill (S.B. 142) that will require insurers to note that an insured person is fully-insured on their health insurance identification card. MAG’s PositionSupportedOutcomePassed.

Sen. Marty Harbin (R-Tyrone) introduced a bill (S.B. 145) that would have required insurers to 1) use greater transparency in the process they use to select and deselect and tier health care providers/physicians and 2) allowed patients to continue to see a provider at the in-network rate for the duration of the plan year if the physician was advertised as in-network when the patient enrolled in the plan but was dropped during the plan year and 3) continued to offer patients the drugs that are advertised on a formulary when the patient enrolls in a plan for the duration of the contract year – and for no more than the price that was advertised when the patient selected the plan. MAG’s PositionSupportedOutcomeDid not pass.

Sen. Greg Kirk (R-Americus) introduced a bill (S.B. 184) that will 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’s PositionNeutralOutcomePassed.

Sen. Chuck Hufstetler (R-Rome) introduced a bill (S.B. 195) that would have 1) established transparency standards for formularies and 2) streamlined the prior authorization process by requiring the use of a standard form by setting timelines for insurers to respond to the form and ensuring the continuity of care when a patient switches their health insurance plan. The prior authorization language was stripped out of this bill and replaced with language related to travel insurance. MAG’s PositionSupportedOutcomeDid not pass.

Sen. Jennifer Jordan (D-Atlanta) introduced a bill (S.B. 206) that would have limited the definition of a “pre-existing condition” that can be used in a short-term health benefit policy. MAG’s PositionSupportedOutcomeDid not pass.

Rep. Sharon Cooper (R-Marietta) introduced a bill (H.B. 63) that will create exceptions to the state’s step therapy protocols. MAG’s PositionSupportedOutcomePassed.

Rep. Richard Smith (R-Columbus) introduced a bill (H.B. 84) that mirrored his 2018 “out-of-network” bill (H.B. 678) that 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 establish a patient arbitration process to resolve any billing disputes. MAG and other physician and patient advocacy organizations opposed H.B. 84 because it wouldn’t result in a comprehensive solution for “surprise medical bills” (i.e., it was limited to transparency and elective procedures, physician pay 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, and it did not address emergency settings). MAG’s PositionOpposedOutcomeDid not pass.

Rep. Katie Dempsey (R-Rome) introduced a bill (H.B. 160) that would have extended the bariatric surgery pilot program for State Health Benefit Plan enrollees until 2024. MAG’s PositionSupportedOutcomeDid not pass.

Rep. Katie Dempsey (R-Rome) introduced a bill (H.B. 187) that will create a pilot program to treat obesity for patients who are enrolled in the State Health Benefit Plan. MAG’s PositionSupportedOutcomePassed.

Rep. David Knight (R-Griffin) introduced a bill (H.B. 233) that will 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’s PositionNeutralOutcomePassed.

Rep. Lee Hawkins (R-Gainesville) introduced a bill (H.B. 385) that would have required insurers to note that an insured person is fully-insured on their health insurance identification card. MAG’s PositionSupportedOutcomeDid not pass.

Rep. Trey Rhodes (R-Greensboro) introduced a bill (H.B 540) that was amended to include the “surprise health insurance coverage gap” provisions of a measure (S.B. 56) that was introduced by Sen. Chuck Hufstetler (R-Rome) that would have 1) resulted in greater transparency for elective procedures and 2) established a patient/physician mediation process for bills that are related to “unexpected events” that take place during elective medical procedures and 3) established 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’s PositionSupportedOutcomeDid not pass.

MAG PRIORITY: RURAL HEALTH CARE

Sen. John Albers (R-Roswell) introduced a bill (S.B. 61) that would have exempted “integrated surgery centers” from the state’s certificate of need (CON) requirements. MAG’s PositionMonitoredOutcomeDid not pass.

Sen. Matt Brass (R-Newnan) introduced a bill (S.B. 74) that would have replaced the existing certificate of need (CON) requirements – with the exception of long-term care facilities – with a licensing program and that would increase transparency and bigger tax credits for rural hospitals. MAG’s PositionMonitoredOutcomeDid not pass.

Sen. Dean Burke, M.D. (R-Bainbridge) introduced a bill (S.B. 114) that would have changed the state’s certificate of need’ (CON) requirements. This measure would have 1) reinstated the state's Health Strategies Council and 2) increased the capital expenditure threshold and 3) added freestanding emergency departments to the definition of “health care facility” and 4) changed the out-of-state requirements for Cancer Treatment Centers of America and 5) exempted rural hospitals from paying the application fees for a CON application and 6) exempted replacing previously-approved equipment from the CON requirement. MAG’s PositionMonitoredOutcomeDid not pass.

Sen. Renee Unterman (R-Buford) introduced a bill (S.B. 115) that will establish a Georgia telemedicine license for physicians in other states. MAG’s PositionSupportedOutcomePassed.

Sen. Dean Burke, M.D. (R-Bainbridge) introduced the ‘Health Act’ (S.B. 151), which would have established an office of health strategy and coordination and convene a Georgia data access forum. MAG’s PositionNeutralOutcomeDid not pass.

Rep. Dave Belton (R-Buckhead) introduced the ‘Psychology Interjurisdictional Compact’ (H.B. 23), which will “facilitate telehealth and temporary in-person, face-to-face [care] across jurisdictional boundaries.” MAG’s PositionNeutralOutcomePassed.

Rep. Chuck Martin (R-Alpharetta) introduced a bill (H.B. 89) that would have exempted “integrated surgery centers” from the state’s certificate of need (CON) requirements. MAG’s PositionMonitoredOutcomeDid not pass.

Rep. Ron Stephens (R-Savannah) introduced a bill (H.B. 186) that included several certificate of need (CON) provisions that will 1) limit the “rival” health care entities that can oppose a CON application to those that are within a 35-mile radius of a proposed project and 2) create a pathway for Cancer Treatment Centers of America to add more beds and serve more patients in Georgia and 3) increase the financial thresholds for hospital construction and medical equipment. MAG’s PositionMonitoredOutcomePassed.

Rep. Matt Hatchett (R-Dublin) introduced a bill (H.B. 198) that would have replaced the existing certificate of need (CON) requirements – with the exception of long-term care facilities – with a licensing program and that would have increased transparency and resulted in bigger tax credits for rural hospitals. MAG’s PositionMonitoredOutcomeDid not pass.

MAG PRIORITY: PATIENT SAFETY

Sen. Larry Walker (R-Perry) introduced a bill (S.B. 121) that will 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’s PositionMonitoredOutcomePassed.

Sen. William Ligon (R-Brunswick) introduced a resolution (S.R. 217) that would have created a Senate study committee on prescribing patterns for anti-depressants and other psychotropic medications. MAG’s PositionOpposedOutcomeDid not pass.

Rep. Sharon Cooper (R-Marietta) introduced a bill (H.B. 62) that will require health care facilities that administer mammograms to notify every patient who has a dense breast issue finding. The bill includes the specific language that should be used in the notification. MAG’s PositionSupportedOutcomePassed.

Rep. John LaHood (R-Valdosta) introduced a bill (H.B. 112) that would have prohibited the sale of drug products that contain dextromethorphan to minors. MAG’s PositionSupportedOutcomeDid not pass (and a Senate version of this bill (S.B. 272) was introduced too late to be considered in 2019).

Rep. Ron Stephens (R-Savannah) introduced a bill (H.B. 214) that will remove the geographic restrictions on physicians who have vaccine protocol agreements with pharmacists. MAG’s PositionSupportedOutcomePassed as an S.B. 115 amendment.

Rep. Houston Gaines (R-Athens) introduced a bill (H.B. 217) that will create a needle exchange program within the Georgia Department of Public Health. MAG asserted that physicians should be able to prescribe syringes and needles to patients who have an injection drug addiction in conjunction with addiction counseling to help prevent the transmission of contagious diseases. MAG’s PositionSupportedOutcomePassed.

Rep. Micah Gravely (R-Douglasville) introduced a bill (H.B. 324) that will allow for the cultivation, distribution, and purchase of low THC oil in Georgia. During its meeting in January, MAG’s Board of Directors adopted a policy that states that, “MAG should support any actions that will lead to the production of safe and quality-controlled cannabinoid extracts within the scope of current Georgia law that can be produced within Georgia for patients who are on the state ‘medical marijuana registry.” MAG’s PositionNeutralOutcomePassed.

H.B. 551 by Rep. Dewayne Hill (R-Ringgold) was amended with a provision that will change the penalty for physicians who fail to register with the state’s Prescription Drug Monitoring Program (PDMP) – a requirement that is enforced by the Georgia Composite Medical Board (GCMB). As a result, physicians who fail to register with the PDMP will still be subject to a fine, but GCMB will not file a public consent order against them (i.e., it will not be reported to the National Practitioner Data Bank). MAG did not advocate for this amendment. MAG’s Position: Monitored. Status: Passed. 

Rep. Teri Anulewicz (D-Smyrna) introduced a bill (H.B. 615) that would have allowed 16 and 17-year-old patients to obtain certain vaccinations without their parents’ consent. MAG’s PositionSupportedOutcomeDid not pass.

Rep. Sharon Cooper (R-Marietta) introduced a resolution (H.R. 448) that would have resulted in the creation of a ‘House Study Committee on the Safe Staffing of Nurses in Georgia.’ MAG’s PositionNeutralOutcomeDid not pass.

Rep. Mark Newton (R-Augusta) introduced a resolution (H.R. 589) that will result in the formation of a ‘House Study Committee on Maternal Mortality.’ MAG’s PositionSupportedOutcomePassed.

Rep. Karen Bennett (D-Stone Mountain) introduced a resolution (H.R. 590) that will result in the formation of a ‘House Study Committee on Georgia's Barriers to Access to Adequate Health Care to look at Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS).’ MAG’s PositionNeutralOutcomePassed.

MAG PRIORITY: MEDICAID

Sen. Blake Tillery (R-Vidalia) introduced Georgia Gov. Brian Kemp’s health care bill (S.B. 106), which will 1) authorize the Georgia Department of Community Health (DCH) to submit a Section 1115 waiver to the Centers for Medicare & Medicaid Services (CMS) to expand the number of Georgians who are insured by Georgia’s Medicaid program and 2) enable Gov. Kemp 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’s PositionSupportedOutcomePassed and signed into law by Gov. Kemp.

MAG PRIORITY: SCOPE OF PRACTICE

Sen. Larry Walker (R-Perry) introduced a bill (S.B. 109) that would have 1) expanded the number of advanced practice registered nurses (APRNs) a physician can oversee under a protocol agreement from four to eight and 2) allowed physicians to supervise up to four of these APRNs at any one time and 3) allowed APRNs to order radiographic imaging. MAG’s PositionOpposedOutcomeDid not pass.

Sen. Lester Jackson (D-Savannah) introduced a bill (S.B. 267) that would have created a license for certified community midwives who would be “authorized to deliver care during essentially normal pregnancy, labor, delivery, postpartum, and newborn periods – including administering oxytocin, performing episiotomies, and administering other medications for the care of both mother and baby.” MAG’s PositionOpposedOutcomeDid not pass (introduced too late to be considered in 2019).

Sen. Chuck Hufstetler (R-Rome) introduced a resolution (S.R. 202) that will result in the formation of a joint study committee that will look at ways to simplify the physician oversight process for mid-level health care providers, including the number of each type of mid-level provider that a physician can supervise. MAG’s PositionSupportedOutcomePassed.

Rep. Rick Williams (R-Milledgeville) introduced a bill (H.B. 330) that would have allowed physicians and podiatrists to form professional corporations together. This measure would have also changed Georgia podiatrists’ scope of practice in several key ways, including the inclusion of “ankles” to their scope of practice and allowing them to perform surgery – including foot amputations – in a hospital or ambulatory surgery center on patients who are under anesthesia that is administered by a certified registered nurse anesthetist (CRNA) who is under the supervision of a physician or a podiatrist. MAG’s PositionOpposedOutcomeDid not pass.

Rep. Sharon Cooper (R-Marietta) introduced a bill (H.B. 370) that will allow emergency medical services (EMS) systems that have a full-time medical director to enter into a protocol agreement with up to eight advance practice registered nurses (APRNs) – supervising up to four of them at any one time. These APRNs will be limited to ordering up to a 14-day supply of non-narcotic drugs in an emergency care setting. MAG’s PositionOpposedOutcomePassed as an S.B. 168 amendment.  

Rep. Alan Powell (R-Hartwell) introduced a bill (H.B. 409) that would have 1) allowed advance practice registered nurses (APRNs) to order radiographic imaging in non-emergency situations and 2) increased the number of APRNs a physician can supervise under a protocol agreement from four to eight. MAG’s PositionOpposedOutcomeDid not pass.

Rep. Matt Dollar (R-Marietta) introduced two bills (H.B. 666 and H.B. 700) that would have created a license for surgical assistants. MAG’s PositionMonitoredOutcomeDid not pass (introduced too late to be considered in 2019).

Rep. Mark Newton (R-Augusta) introduced a bill (H.R. 261) that will result in the formation of a study committee that will look for ways to simplify the physician oversight process for physician assistants and advance practice registered nurses (APRNs). MAG’s PositionSupportedOutcomePassed.

OTHER

Sen. Kay Kirkpatrick, M.D. (R-Marietta) introduced a bill (S.B. 16) that will allow Georgia to join the Interstate Medical Licensure Compact to make it easier for physicians to obtain licenses in other participating states. MAG’s PositionSupportedOutcomePassed.

Sen. Kay Kirkpatrick, M.D. (R-Marietta) introduced a bill (S.B. 18), that will allow physicians to enter into direct primary care agreements with their patients without being subject to health insurance regulations. MAG’s PositionSupportedOutcomePassed.

Sen. Bill Cowsert (R-Athens) introduced a bill (S.B. 155) that would have limited actions to recover damages from death or injury to the actual amounts that are paid for health care services or treatment. MAG’s PositionSupportedOutcomeDid not pass.

Sen. Bill Cowsert (R-Athens) introduced a bill (S.B. 189) that would have established penalties for physicians who do not respond to requests for medical records within 30 days and cap how much a physician can charge to produce those records. MAG’s PositionOpposedOutcomeDid not pass.

Sen. Dean Burke, M.D. (R-Bainbridge) introduced a bill (S.B. 207) that will change the name of the Georgia Board for Physician Workforce to the Georgia Board of Health Care Workforce and change its composition to include one advanced practice registered nurse, one physician assistant, and one dentist – in addition to physicians, hospital representatives, and one consumer. Physicians will still make up at least 10 of the 15 board positions. MAG’s PositionNeutralOutcomePassed.

Rep. Dave Belton (R-Buckhead) introduced a bill (H.B. 26) that will “facilitate telehealth and temporary in-person, face-to-face [care] across jurisdictional boundaries.” MAG’s PositionNeutralOutcomePassed.

Speaker David Ralston (R-Blue Ridge) introduced H.B. 31 – the state’s FY 2020 budget – which includes funds to bolster primary health care and recruit and retain physicians in Georgia (e.g., funding for 112 new residency slots in primary care, 54 new slots in OB/GYN residency programs, and Augusta University's Rural Surgery Initiative). MAG’s PositionSupportedOutcomePassed.

Rep. Dave Belton (R-Buckhead) introduced a bill (H.B. 39) that will make it easier for physical therapists from another state who are in the Physical Therapy Licensure Compact to get a license to practice physical therapy in Georgia. MAG’s PositionSupportedOutcomePassed.

Rep. Deborah Silcox (R-Sandy Springs) introduced a bill (H.B. 128) that will exempt “low” payments under high-low agreements in medical malpractice agreements from the requirement to report settlements to the Georgia Composite Medical Board. MAG’s PositionSupportedOutcomePassed.

Rep. Deborah Silcox (R-Sandy Springs) introduced a bill (H.B. 166) that will create a licensure requirement for genetic counselors under the Georgia Composite Medical Board. MAG’s PositionSupportedOutcomePassed.

Rep. Jodi Lott (R-Evans) introduced a bill (H.B. 321) that will extend the sunset on the hospital provider fee, which is an important tool for funding indigent care in the state. This measure will also result in additional financial disclosure requirements for non-profit hospitals. MAG’s PositionNeutralOutcomePassed.

Rep. Ed Setzler (R-Marietta) introduced a bill (H.B. 481) that will 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 will also “create a civil cause of action for a woman upon whom an abortion is performed against the physician who performs it.” MAG’s PositionOpposedOutcomePassed.

Rep. Kasey Carpenter (R-Dalton) introduced a resolution (H.R. 256) that would have let Georgians decide if the state’s Constitution should be amended to authorize the General Assembly to enact a law to limit jury awards in all civil cases. MAG’s PositionSupportedOutcomeDid not pass.

Sen. Steve Gooch (R-Dahlonega) introduced a resolution (S.R. 433) that will result in the formation of a ‘Senate Reducing Georgia’s Cost of Doing Business Study Committee’ to assess the state from medical malpractice and tort reform standpoints. MAG’s PositionSupportedOutcomePassed.