State Legislative News
GAFP Workforce
2010 State Legislative Session Wrap Up Report
The Georgia General Assembly adjourned Sine Die on Friday, April 29, 2010 as the gavels struck around midnight, ending the 2010 Legislative Session. The GAFP was able to obtain an almost total sweep of its legislative agenda. Thank you to the GAFP leadership, Legislative Committee and our legislative consultant – Chuck McMullen with Piedmont Public Affairs for the long hours that were devoted to protecting family medicine and our patients.Legislative Priorities:
State Budget - Despite some interest in cutting physician payment to Medicaid (2-20 percent), there were no physician payment cut in either the amended FY 2010 and FY11 budget. With the state continuing to have close to a billion dollar deficit, this is considered a major success.
POLST passed! – Although, House Bill 999 did not move forward, in a last minute bit of maneuvering, Senate Bill 367 was amended to include language to mandate a statewide standard Physician Order for Life Sustaining Treatment Form. POLST passed the Senate 47-1.
Prompt Pay (House Bill 342) - passed! On the last day of the session both the House and Senate agreed to a conference committee report that included the prompt pay legislation. Led by the Medical Association of Georgia, virtually all physician organizations supported this bill that will expand current prompt pay issues to third party payors.
Abortion/Physician Coercion (Senate Bill 529) – failed! In the waning hours of Day 40, a compromise bill that would have removed most of the physician criminalization of the bill did not move forward and Senate Bill 529 did not move forward in the House for final passage.
Tobacco Tax (House Bill 39) – failed! Although there was a strong grassroots effort that the Georgia Academy participated in – increasing the tobacco tax by an additional one dollar did not ever get legislative leadership buy in and support. This proposal will be back next year.
Scope of Practice/Prescribing– House Bill 1250 – failed! House Bill 1250 would have allowed nurse practitioners and physician assistants to write Schedule II drugs under a physician protocol. The GAFP and 11 other physician groups met with Representative Kevin Levitas (bill sponsor) to voice concern and opposition to the bill. No hearing on the bill was ever scheduled and the bill died on Day 30.
Pathology – House Bill 403 – failed! This bill would have allowed for a monopoly on pathology billing for pathologists remained bottled up in the House Insurance Committee with no apparent push for it to receive another hearing or a vote to move it along in the process. The GAFP opposed the bill and remained vigilant that it did not get amended on to any other legislation throughout the session.
Seatbelts in Pickup Trucks – passed! Although Senate Bill 5 passed out of the Senate last year, it did not move forward in the House. Therefore, GAFP member, State Senator Don Thomas, MD, introduced the same bill (Senate Bill 458) where it passed the Senate (45-2) and the House (132-29).
Other health related bills:
HB 217 – Rep. Jimmy Pruett (R-Eastman). Authorizes the use of flu vaccine orders and provides for flu vaccine protocol agreements between physicians and pharmacists or nurses. There were numerous attempts by biotech and pharmaceutical companies to expand the scope of the type of flu vaccine to be dispensed and administered by pharmacists to include "flu-mist" or other FDA approved vaccines. However, all of the expansion attempts were thwarted.
STATUS: Signed by Governor 4/28/09
HB 999/SB 367 - The bill requires the Georgia Department of Community Health to develop and make available a Physician Order for Life Sustaining Treatment. The purpose of the order is to allow an end of life directive to become transportable (i.e. between nursing homes, hospitals, home health, and hospice settings). Twenty seven others states have already passed similar legislation or are currently seeking to pass legislation.
STATUS: SB 367, as amended by the House HHS Committee was agreed upon by the Senate; awaits Governor's signature.
HB 1040 – Rep. Jimmy Pruett (R-Eastman). Relating to exceptions to the operation of the "Georgia Registered Professional Nurse Practice Act," provides that the performance of health maintenance activities by a designated caregiver under certain conditions shall not require licensure as a registered professional nurse.
STATUS: House agrees to Senate amendment 4/27/10
SB 163 – Sen. Don Balfour (R-Snellville). Authorizes the commissioner of human resources to appoint a diabetes coordinator and provides for the department to service as the central repository of diabetes treatment and prevention data.
STATUS: Passed Senate 3/4/09; Passed House by substitute 4/1/09; Senate disagrees with House substitute 4/3/09; Recommitted H: HHS committee 4/3/09
SB 244 – Sen. Renee Unterman (R-Buford). Under the Georgia Registered Professional Nurse Practice Act provides that the performance of health maintenance activities by a designated caregiver shall not be prohibited.
STATUS: House Conference Committee Report Adopted 4/29/10
SB 252 – Sen. Don Thomas (R-Dalton). Provides for the certification of polysomnographic technologists and provides for applications to be made to the Composite State Board of Medical Examiners to obtain certification to practice polysomnography.
STATUS: Senate Agrees to House Amendment 4/29/10
SR 277 – Sen. Greg Goggans (R-Douglas). Imposes a charge on certain motor vehicle registrations in this state which shall be transferred to the state treasury for the purpose of funding the Georgia Trauma Trust Fund.
STATUS: Senate Agrees to House Amendment 4/29/10
SR 664 – Sen. Don Thomas (R-Dalton). Acknowledges the importance of a comprehensive approach to providing patient centered care and creating the Senate Study Committee and the Patient Centered Medical Home.
STATUS: Passed Senate 4/1/09
INSURANCE
Health Insurance Reform
SB 407/ HB 1184 - Interstate Health Insurance Sales
SB 407 sponsored by Sen. Judson Hill (R-Marietta) and HB 1184 sponsored by Rep. Matt Ramsey (R-Peachtree City) authorizes insurers to offer individual accident and sickness policies in Georgia that have been approved for issuance in other states.
STATUS: SB 407 House Insurance Committee Favorably Reported 4/21/10; HB 1184 Senate Insurance & Labor Committee 4/14/10
SB 316 – Medicare Supplement guaranteed issue for under age 65 ESRD and disabled patients. This bill requires Medicare Supplement carriers to guarantee issuance of Medicare Supplement plans to the disabled under age 65 who are enrolled in Medicare, including ESRD patients.
STATUS: This bill was passed by the Senate on February 13th and by the House on April 27th and now awaits the Governor's signature.
SB 330 –Sen. Preston Smith (R-Rome); This bill would prohibit insurers from rescinding policies or denying claims for misstatements or omissions unless directly related to the omission. The bill also prohibits lifetime or annual caps, and extends the dependent age to 25 for non-students.
STATUS: The bill was favorably reported by the Senate I&L Committee, but failed in Rules.
SB 331 –Sen. Preston Smith (R-Rome), allows parents to keep their dependents on their health insurance plan up to age 25 even if the dependents are not full-time students.
STATUS: The bill was favorably reported by the Senate I&L Committee, but failed in Rules.
SB 411 – The Healthy Georgia Act/Federal Reform "Non-compel". The original version of this bill exempts certain insurer-operated wellness and health promotion programs, disease management and health risk assessment programs from the unfair trade practices laws related to illegal inducements, unfair discrimination or rebating. The bill was amended on the last day of session to include the language from S.B. 317, which prohibits government from compelling a person or entity to purchase health care coverage.
STATUS: Adopted by the House and Senate; Awaits Governor's signature.
SB 481/ HB1268 - Continuation of Coverage Time Period Extended. This bill extends the time period for 31 to 90 days by which a person can elect to continue coverage after the death of the contract holder or a divorce to comply with federal COBRA requirements. This bill was amended on the Senate floor on April 21st to include an amendment that requires insurers to notify members about premium taxes on member bills.
STATUS: This bill was passed in both the House and Senate on April 29th and now awaits the Governor's signature.
Report – April 21, 2010
The Georgia General Assembly is in the final two weeks of the session. They are in session this week, April 20 and 21 and the final two days will be next week – April 27 and 29. Of the 5,188 pieces of legislation introduced during this two-year term of the General Assembly, most of the ones that fail simply never make it out of the committees they were assigned to. Even though bills like a $1 boost in the per-pack cigarette tax received broad public support, or like tuition vouchers for foster children and military dependents that was the subject of heavy lobbying, legislative leaders are reluctant to bring bills to the floor for a vote if they're not certain they'll pass.
In the first year of a two-year term, bills that don't pass by the 30th day in the 40-day session can still be considered the next year. This year, however, is the second year, and they will die until re-introduced next year.
Budget
Both the House and Senate version of the amended FY 2010 budget and the FY2011 budget have no decreases to physician Medicaid reimbursements. During a year, where almost all regular line items in the state budget received some type of “across the board” cut, this is considered a victory.
The removal of proposed cuts were helped by the passage of House Bill 307, which enacts a 1.45 percent hospital provider fee to be deposited in the Indigent Care Trust Fund. As negotiated with the hospitals, the fee will sunset after three years (at the end of FY 2013) and will be used to fund base operations as well as hospital reimbursement rate increases in Georgia's Medicaid program.
GAFP Opposes SB 529 - Violates Physician-Patient Relationship
The Executive Committee recently approved the Legislative Committee's recommendation to oppose Senate Bill 529, as it is currently worded, due to the potential criminalization of discussing termination options to a pregnant patient.
SB 529, which would make abortion a criminal offense sending physicians to prison for up to 10 years, passed the Senate 33-14. The bill says the medical procedure is a “criminal abortion” is “coerced” into having one. Doctors would also be guilty of criminal abortion if they perform the procedure because of the race or gender of the unborn child, with the offense punishable by up to 10 years in prison. It would not allow a signed patient document of non-coercion to be used in court. The patient could pursue tort related damages to the physician related to the loss of the child.
The bill that passed the State Senate and now sits in a subcommittee of the House Judiciary Committee. President-Elect Harry Strothers, MD testified against the bill last week. No vote was taken on the bill but it is still pending before the House Judiciary Committee and an additional hearing is expected this week.
The GAFP is opposing the bill, not because the procedure involved is abortion, but because if passed, the bill would disrupt the basic relationship between a physician and a patient.
Requiring Seatbelts in Trucks
SB 5 & SB 458 – Requiring the Use of Seatbelts in Pickup Trucks
GAFP member, Senator Don Thomas, MD, introduced Senate Bill 5 in 2009 and it passed last year with a vote of 49-4.
A similar version of the bill was introduced by Senator Thomas, SB 458 and it was adopted by the Senate 45-2, and referred to the House Health & Human Services Committee where it as voted out unanimously. There is indication by the leadership that this will come to a vote on the House floor next week. Senator Don Thomas has announced that he is retiring at the end of this year and will not seek re-election.
Prompt Pay
HB 321, HB 342, and SB 62 – Prompt Pay
The GAFP joins many other physician groups including the Medical Association of Georgia who are the lead in seeking passage the bill to require third party payers to comply with Georgia’s prompt-pay statute.
Status: HB 321 Pending House/Senate Agree/Disagree; HB 342 House Insurance Committee; SB 62 House Appropriations Committee
Medicare to Begin Processing April Claims
On April 15th, President Obama signed into law the Continuing Extension Act of 2010. This legislation extends through May 31, 2010, the zero percent update to the Medicare Physician Fee Schedule (MPFS) which was in effect for claims with dates of service from Jan. 1, 2010, through March 31, 2010. The law is retroactive to April 1, 2010.
The Centers for Medicare & Medicaid Services (CMS) has instructed Medicare contractors to begin processing claims under the new law for services provided by physicians, non-physician practitioners (NPPs) and others paid under the MPFS. Most claims with dates of service April 1 and later were held by Medicare in anticipation of congressional action. If Congress had not acted, payment rates for these services by physicians, NPPs and others who are paid under the MPFS would have been reduced, as required by a formula specified in the Medicare law.
State Senate and House Resolutions Recognizing Family Physicians
Both State Senator Don Thomas, MD and House Representative Sharon Cooper presented resolutions to honor family physicians on our day at the Capitol (February 4th). Over 100, family physicians, pediatricians, internists, and obstetrician-gynecologists met with their legislators to discuss our priorities for the 2010 legislative session. The resolution honoring our group stated, in part:
Commending Georgia physicians and recognizing February 4, 2010, as Patient-Centered Physician Coalition of Georgia Day at the state capitol; and for other purposes.
WHEREAS, the Patient-Centered Physicians Coalition is made up of Georgia's most committed physicians who care for Georgia families and include members of the Georgia Academy of Family Physicians, the Georgia Chapter of the American Academy of Pediatrics, the Georgia Chapter of the American College of Physicians, the Georgia Osteopathic Medical Association, and the Georgia Obstetrician/Gynecologists Society; and
WHEREAS, private practice physician offices create more than 180,000 jobs in Georgia, provide over $10 billion in personal income, create nearly $20 billion in total economic activity, and generate more than $2.7 billion annually in state and local government revenues; and
WHEREAS, there is a decreasing number of medical school graduates entering primary care specialties, including a ten-year decrease from 20 percent to 4 percent between 1999 and 2009 in family medicine and a 13 percent decrease in pediatrics, despite state population increases of over 18.3 percent in the same time period; and
WHEREAS, according to the United Health Foundation and the American Public Health Association, Georgia is ranked 43rd in overall health and 47th in determinants of health including access to primary care, immunizations, and insurance; and
WHEREAS, in 2006, the Georgia Board for Physician Workforce reported deficiencies in one or more of the core physician specialties including family medicine, pediatrics, internal medicine, and obstetrics/gynecology; and
WHEREAS, decreased physician reimbursement rates have been proven to increase costs by limiting access and diverting patients to more expensive sites for care such as emergency rooms and often more costly unnecessary treatment modalities; and
WHEREAS, the State of Georgia is committed to providing medical assistance promptly and assuring that payments to physicians are sufficient to enlist enough providers to care for our families; and
WHEREAS, the contributions and efforts of the physicians and the individuals working in their practices to increase the overall health and wellness of Georgians and stimulate economic growth are applauded.
NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES that the members of this body recognize Georgia physicians and their practices as critical to the overall health and economic vitality of this state and declare February 4, 2010, as Patient-Centered Physicians Coalition of Georgia Day at the state capitol.
Mark your calendars now to attend next year on Thursday, February 10, 2011.
Report – March 30, 2010
The GAFP sends frequent updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
The Georgia General Assembly is in session this week March 30, 31, and April 1. They are schedule to take next week off and reconvene on Monday, April 12th which would be Day 34. Please note that this schedule is subject to change.
Georgia Supreme Court Overturns Malpractice Caps on Non Economic Damages (7-0)
On Monday, March 22, the Georgia Supreme Court struck down the 2005 state law that would cap pain and suffering on malpractice cases in the amount of $350,000.
In the opinion, Chief Justice Carol Hunstein stated, “The Georgia Constitution states plainly that 'the right to trial by jury shall remain inviolate. The right to a trial by jury “includes the right to have a jury determine the amount of . . . damages, if any, awarded to the [plaintiff].”
The justices said their decision applies retroactively to the court case in question and any other cases that are pending, including those that have not completed the appeals process.
Most state legislators, who worked on behalf of tort reform in 2005, believe the next recourse will be a Georgia Constitutional amendment to restore the caps – something that cannot be accomplished during the 2010 legislative session. The leadership of the GAFP will continue to work on this issue as it was one of our highest legislative priorities in 2005.
Cross Over Day – Friday, March 26th – Has Come and Gone
Traditionally, no new business is considered by both the State House and State Senate once they have reached Day 30 out of a possible 40 days of the state legislative session. Day 30 was last Friday and the budget was not voted out of the House, so they will have to suspend the rules to send the State Senate the FY 2011 budget when it is finalized.
Other bills that the GAFP were monitoring include the following:
House Bill 999 – Physician Order for Life Sustaining Treatment Form
Failed to pass out of House Judiciary Committee
House Bill 1250 – Allowing Schedule II Drugs to Be Written by Midlevels
Failed to pass out of House Health and Human Services Committee
House Bill 39 – Increase the Tobacco Tax by $1.00
Failed to pass out of House Ways and Means Committee – However, if the budget discussions fall apart between the Legislature and the Governor it could be included in an omnibus bill to help balance the budget.
Mandating Seatbelts in Pickup Trucks Has Movement
GAFP member, State Senator Don Thomas, MD introduced an identical bill to Senate Bill 5 that passed 45-4 last year to mandate seatbelt usage in pickup trucks. This bill got bogged down last year in the House Committee on Agriculture. This latest version, Senate Bill 452 passed last week with a margin of 45-2 and has been assigned by Speaker Ralston to the House Health and Human Services Committee. This is wonderful news and the GAFP will continue to push this as one of our legislative priorities for the year!
Budget – House Passes House Bill 307 Hospital User Fee
In a compromise, the Georgia Hospital Association endorsed House Bill 307 to impose a user fee on hospitals that will raise $169 million in state dollars to match with federal funds. This was a tensely negotiated agreement and took off the table the possibility of hospitals losing their state sales tax exemption. The GAFP hopes that this compromise will shield physician payment cuts to Medicaid. The budget story is changing minute-by-minute as we get down to the final days and we will keep you informed.
Report 6 – March 18, 2010
The GAFP sends frequent updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
The Georgia General Assembly is in session this week (Monday, Tuesday, Wednesday) and next week Monday, March 22 (Day 28), Tuesday, March 23 (Day 29) and Thursday, March 25 (Day 30). The last day for bills to crossover from one chamber to the other is Day 30. Please note that this schedule is subject to change.
Continue to Contact Legislators Encouraging Passage of Tobacco Tax
Last week, GAFP President, Dr. Leonard Reeves, sent out a special alert, asking GAFP members to contact Lt. Governor Casey Cagle encouraging him to support the tobacco tax.
We ask that you continue this outreach as well as sending a fax or email directly to your State Representative and State Senators. A special alert on the AAFP and GAFP Speak Out Advocacy Center is now available. Go to http://capitol.aafp.org/aafp/home/ and enter either GA as your state or input your zip code. That will direct you to a letter that you can edit as you see fit to encourage state legislators to support a tobacco tax. This issue is urgent and pressing – please find time to email your legislator no later than Monday, March 22.
Governor Proposes 10.25 Percent Medicaid Cut to all Providers
Last Thursday, March 11th, the Governor held a press conference to announce new budget instructions that he is sending to House and Senate Appropriations leadership asking them to consider a 10.25 percent reduction in Medicaid payment for all providers along with a removal of sales tax exemption from all hospitals.
The GAFP responded immediately by having President Leonard Reeves, MD personally meet with Senate Appropriations Chairman Jack Hill and House Appropriations Chairman Ben Harbin to inform them personally of the effects of any cut to Medicaid payment. He also hand delivered a letter that stated, in part:
On behalf of the Georgia Academy of Family Physicians representing over 2,500 family physicians and medical students we want to immediately express our shock and dismay over the Governor’s proposed 10.25 percent provider cut to the FY 2011 Medicaid budget.
This cut would be fatal and decimate the state’s provider network of primary care physicians who take care of the bulk of the Medicaid population of children and aged/blind and disabled adults.
When adjusted for inflation, the proposed 10.25 percent would be a 40 percent cut to our rates and we cannot sustain and continue to see Medicaid patients at a rate that is so flagrantly below the cost of the care of the patients.
We are also concerned about what a cut of this magnitude would do to the provider network for Medicaid patients. We are deeply engaged in the need for adequate Medicaid reimbursement for all providers and specifically for primary care physicians. We ask the legislature to reject the Governor’s proposal.
State Tort Reform Upheld on Emergency Room Provisions!
The Georgia Academy applauds the Georgia Supreme Court in their recent decision to support the tort reform provisions as it relates to emergency room malpractice. The court's 4-3 ruling was a blow to plaintiff's attorneys and other critics of the legislation who argued the higher standard of proof required by the law made it almost impossible for patients injured by emergency room workers to win malpractice claims.
Critics of the law took another hit Monday when the court released a separate ruling, this one by a 5-2 vote, that upheld a provision that allowed one side in a lawsuit to pay the other side's legal fees in some cases. They had argued the practice could discourage many victims from bringing legitimate claims to court.
The court will likely issue a third ruling this month on a lawsuit that challenges the law's $350,000 limit on jury awards for malpractice victims' pain and suffering damages.
The court's majority opinion, penned by Justice George Carley, found that it was "entirely logical" for lawmakers to approve the legislation in hopes of stemming the rising cost of medical malpractice insurance. He was joined by Justices P. Harris Hines, Harold Melton and David Nahmias. A dissent written by Justice Robert Benham criticized the new legislation for leaving patients with a "lower standard of care and a higher burden of proof." He was joined by Chief Justice Carol Hunstein and Justice Hugh P. Thompson.
The second ruling, which centered on a case involving a former Atlanta Falcons player, upheld a part of the law designed to discourage frivolous lawsuits with new incentives for patients to settle out of court. The "offer of settlement" provision required some plaintiffs to pay the other side's attorney's fees if they lose their case or if they win only a portion of a settlement offer.
Federal Health Care Reform
The Georgia Academy of Family Physicians along with the Georgia Chapter of the American College of Physicians sent a letter in support of federal health care reform to the entire Georgia Congressional Delegation as votes are expected within the next two weeks. The letter was a reminder to the Georgia delegation about the basic tenets of health care reform that the GAFP support which include:
- Coverage for all Americans.
- Major insurance reforms that eliminate pre-existing conditions and provide for first dollar coverage of preventive care.
- New payment methods that align incentives based on quality and coordination of care for patients, such as the Patient Centered Medical Home.
- Incentives to bolster the primary-care workforce that multiple studies show provides higher quality care with lower costs.
- Ending the annual cycle of physician payment cuts resulting from the SGR formula that threatens access to seniors and has no relationship to the actual cost of care.
- Medicaid payment parity with Medicare so more physicians will be able to treat Medicaid patients.
- Medical liability reform in a way that will protect patients’ access to quality care and slow the growth of health-care costs.
Report 4 – March 8, 2010
GAFP Joins “Pass the Buck” Coalition to Support Tobacco Tax Increase (House Bill 39)
On Tuesday, March 2, the Campaign for Tobacco Free Kids and the American Cancer Society released the results of a poll that clearly shows strong support for a $1 increase in the tobacco tax.
Their joint press release noted that,
"A new poll released shows that 73 percent of Georgia voters support raising the tobacco tax by $1 per pack to cut the state's budget deficit and help preserve Medicaid funding in the state. This support comes from a broad-based coalition of voters, including 72 percent of Republicans, 79 percent of Democrats, and 65 percent of Independents. Even half of smokers (50 percent) support the tobacco tax increase to preserve health care funding."
The survey of 500 registered voters was funded by the Robert Wood Johnson Foundation. Additionally the poll found 60 percent of voters are more likely to support candidates who favor the proposal, while just 19 percent are less likely to do so, and 77 percent favor taxing other tobacco products such as cigars and smokeless tobacco at a rate comparable to cigarettes.
In addition to providing needed revenue of approximately $350-400 million for Georgia, a new tobacco tax would have other major benefits. Studies show that increasing taxes on tobacco products reduces tobacco usage among teens and contributes to better birth outcomes for babies whose mothers stopped smoking during or before pregnancy.
Georgia is currently at .37 cents a pack.
State Budget
Governor Sonny Perdue is expected to reduce the FY2010 budget another $300 million based on actual revenue collections in February: State revenues through January ran 12.9 percent behind FY2009 revenue collections. The Governor’s FY2010 revenue estimate is based on a 7.3 percent decline. Revenues need to increase by 4.3 percent from 2009 levels over the remaining five months of the fiscal year in order to meet this estimate. The Georgia State University Economic Forecasting Center February Forecast projects an FY2010 revenue decline of 8.5 percent. This would result in an FY2010 shortfall of approximately $210 million.
Amended FY2010 and FY2011
FY2010 Amended Budget
The House passed their version of the Amended FY2010 budget (HB 947) on February 11th, while the Senate passed their version on February 18th. The House and Senate versions of the budget have mostly minor differences.
The House and Senate are waiting for the February revenues numbers to be released (1st week of March) to finalize the Conference Committee agreement. An additional $300 million cut is expected later this week.
FY2011 Budget
The FY2011 budget proposed by the Governor places a 1.98 cut on Medicaid providers and a 1.6 percent premium tax on hospitals. The 1.98 percent cut is roughly $40 million reflected in the budget. The General Assembly is deciding whether to balance the state budget shortfall based on 100 percent budget cuts or a more balanced approach of some combination of budget cuts and revenue increases (i.e. increase the cigarette tax).
Report 3 – March 1, 2010
The GAFP sends frequent updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
The Georgia General Assembly is in adjournment through Friday, March 5th to focus on the state budget. They will reconvene on Monday, March 8th and are currently scheduled to meet through Thursday, March 11 (Day 24). Please note that this schedule is subject to change.
President Reeves Testifies Before Joint Appropriations Committee
On Thursday, February 25th, President Leonard Reeves, MD testified before a joint hearing on the appropriations dealing with Medicaid. He outlined the GAFP’s opposition to additional Medicaid cuts and the hospital tax. He stated (in part):
We are sensitive to the tough times that we are all experiencing and also aware of the added pressures of current state revenue situation.
However, physicians have not received an increase in payment from Medicaid in over nine years – which I believe – we are the only group that receives payment from Medicaid that can claim that dubious recognition.
Family Physicians – who practice in practically every corner in the state – are also small businessmen and women. Here in Georgia, 65 percent of our members, run practices with 3 or fewer physicians. As small business owners, we must juggle the same day-to-day operations as the local insurance agent, clothing and restaurant owners.
As we all know, over the last 9 years – there have been increases – increases in rent, salaries, benefits, supplies, office equipment….those of you who are small business owners know the situation. A continuous flat line in payment by Medicaid – makes additional cuts – even during the downturn in the state’s economy – even more difficult to bear.
As small business owners – we sign not just the back of the checks – but the front of them as well. Each family physician who owns a practice here in Georgia supports the state’s economy with over $1 million dollars in economic support annually.
I can’t conclude my comments without mentioning the most important point – we – for the most part are small business owners – but we are also doctors – dedicated to saving lives and keeping our neighbors healthy. We ask that you look for alternatives to the provider cut and the hospital tax – and look for new revenue streams such as increasing the tobacco tax by an additional dollar.
Rep. Kevin Levitas Introduces Bill to Allow Mid-levels Schedule II Drugs
House Bill 1250 has been introduced by Rep. Kevin Levitas (R-Decatur). This bill would allow nurse practitioners and physician assistants to write Schedule II drugs under an approved protocol by their supervising physician. It would also allow them to order radiographic imaging for patients without prior physician consent. The bill would also allow them to sign off on many health certificates such as worker’s compensation, sports physicals without having a supervising physician review or sign off on the form.
The Legislative Committee is reviewing this bill and has forwarded it on to the Executive Committee. Staff will meet this week with Rep. Levitas and the organizations supporting the bill to seek additional information about the need for the expanded scope. In a meeting on Feb. 24th, eleven physician groups met with Rep. Levitas to voice strong concerns about the bill.
Report 2 – February 19, 2010
The GAFP sends frequent updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
Georgia legislators convened Tuesday, February 16th for the 18th legislative day and remained in session through Thursday, February 18, 2010. The Georgia General Assembly is in adjournment Friday, February 29th through Friday, March 5th to focus on the state budget. Joint Appropriations Committee meetings are scheduled for Monday, February 22, 2010 through Friday, February 26, 2010
State Budget Review
Governor Perdue has proposed a fee on hospitals and a fee on the managed care industry to address the state's Medicaid deficit. Without these funds, the Georgia Department of Community Health says that all Medicaid providers would be subject to a 16.5 percent cut in Medicaid payments. But even with the fees, physicians would be subject to a 1.98 percent cut in Medicaid payments. The Georgia Academy has taken an official policy against any Medicaid cut and the hospital tax, as many hospitals would lose funding on the tax.
The Georgia Academy has endorsed increasing the tobacco tax by $1.00 to help offset the current state deficit. Georgia currently has one of the lowest tobacco taxes – and a $1 tax on tobacco products would raise enough money to address the Medicaid shortfall. Over the past twelve months, state revenues have drastically declined and cuts of an additional $1.2 billion from the FY 11 budget have been recommended.
The House Appropriations Special Subcommittee on HB 307 met, Wednesday, February 17, 2010 to consider public testimony on Governor Sonny Perdue's proposal to levy a tax on Georgia's hospitals and expand premium taxes paid by health insurers.
Over 30 stakeholders, including the Georgia Academy testified during the hearing with a majority of interests opposing the measure. Hospitals, physicians, health plans, other health care providers and anti-tax groups strongly opposed the proposal offering alternatives including an increase in user fees on tobacco, taxing lottery transactions and increasing the securitization of GEFA bonds.
Physician Order for Life Sustaining Treatment Form – House Bill 999
House Majority Leader, Representative Ed Lindsey, introduced House Bill 999 that would mandate a statewide portable medical order which would allow a physician order to be transportable between facilities to inform clinicians of patient’s end-of-life wishes in an easy to read one-page document. The Georgia Academy has been meeting with stakeholders on this bill since the summer. Representative Lindsey held a meeting with stakeholders on Friday, February 12th and a Subcommittee of the Judiciary Committee held a hearing on Monday, February 15th.
GAFP President, Dr. Leonard Reeves, led the testimony and framed the discussion on the need for a mandated portable medical order. Twelve organizations testified on the bill with the following groups supporting the bill: Georgia Academy of Family Physicians, Medical Association of Georgia, Georgia Hospital Association, and the Alzheimer’s Association. Representative Lindsey continues to work with interested parties on the bill.
Health Care Bills (Recent Activity)
SB 306 – Use of Hands-free Device While Driving
Sponsored by Sen. Bill Heath (R-Bremen), SB 306 allows for the use of Bluetooth-type devices while driving.
SB 317 – Health Care System Participation
Sponsored by Sen. Judson Hill (R-Reidsville), SB 317 provides that no law or rule or regulation shall compel any person, employer, or health care provider to participate in any health care system, and to authorize persons and employers to pay directly for lawful health care services without penalties or fines.
SB 329 – Group/Accident Policy Insurance for Dependents
Sponsored by Sen. Judson Hill (R-Reidsville), SB 329 provides that an insured under group/accident policy can include dependents up to age 25.
SB 330 – Lifetime Medical Benefits Cap
Sponsored by Sen. Preston Smith (R-Rome), SB 330 would prohibit insurers from putting a cap on the amount of lifetime medical benefits a policyholder can receive and would prohibit insurers from canceling a policy because of a misstatement or omission by the policy holder in the original application for coverage, unless the misstatement directly relates to the illness that produced the claim.
SB 331 – Health Insurance for Dependents
Sponsored by Sen. Preston Smith (R-Rome), SB 331 would allow parents to keep their dependents on their health insurance plan up to age 25 even if the dependents are not full-time students.
SR 795 – Health Care Systems
Sponsored by Sen. Seth Harp (R-Midland), SR 795 would amend the constitution to prohibit any law that restricts citizens from choosing private health insurance, interferes with citizen’s right to pay directly for lawful medical services or penalizes those who choose not to purchase health care coverage.
SB 50 – Transparency of Provider Networks
Sponsored by Sen. Ralph Hudgens (R-Hull), SB 50 would require all contracts that a health insurance provide might enter into with a third party be available to all relevant parties. The contract must also align with all original stipulations in the contract between the provider and the consumer.
SB 235 – Microchip Implants
Sponsored by Sen. Chip Pearson (R-Dawsonville), SB 235 would make it a misdemeanor offense to implant microchips in humans without their consent. The bill would also allow persons who involuntarily have microchips implanted in their bodies to file a civil lawsuit and try to recover damages. Senators passed the measure 47-2 and it now moves to the House for consideration.
SB 315 – Emergency Volunteer Assistance
Sponsored by Sen. Preston Smith (R-Rome), SB 315 allows out-of-state, licensed emergency personnel to assist the state in the event of a disaster. The bill aims to ensure organization and rapid medical attention during an emergency. The bill unanimously passed the Senate and is now in the House Health and Human Services Committee.
Report 1 – January 19, 2010
The GAFP sends weekly updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
The Second Session of the 150th Georgia General Assembly convened Monday, January 11, 2010 for the 40-day legislative session. The legislature met through Thursday using up the first four (of 40) days of the session. The legislature will be in recess until Monday, January 25, 2010. The House and Senate Appropriations Committees will hold joint hearings next week on the proposed FY10 supplemental appropriations act and the FY11 budget.
GAFP Legislative Priorities for 2010 The Executive Committee of the GAFP approved the Legislative Committee’s requested legislative priorities for the 2010 session. This session is expected to be focused on state budgetary cuts due to falling state revenues and the current economic slowdown. The following was approved:
Highest Tiered Priority
1. Protect Medicaid Budget for provider/physician cuts.
Current Status: Succeeded in 2009, Uncertain for 2010
A. Support increasing the tobacco tax up to $1.00 a pack (House Bill 39)
The GAFP continues to work with the “Pass the Buck” coalition in support of increasing the tax.
Current Status: Pending
B. Support budget language for Patient Centered Medical Home pilot study.
2. Protect Tort Reform
The GAFP has a long standing policy to support and defend the current tort reform that passed in 2005. The law is currently under legal appeal. If the Georgia Supreme Court overturns the law, it will be hotly contested at the State Capitol in 2010.
Status: None – awaiting Georgia Supreme Court Decision
3. Support Adoption of Physician Order for Life Sustaining Treatment Form
A legislative priority from 2008 that has resurfaced as members of the House Judiciary Committee has agreed to carry the bill. GAFP has a coalition that have pledged to work together to support the bill.
Status: To be introduced in January 2010
Other Priorities
While important, these bills are not likely to move during the 2010 session.
1. Oppose direct billing for pathology service – House Bill 403
A subcommittee of House Insurance heard testimony on House Bill 403 which would give pathologists a monopoly on certain office-based lab codes. A vote to pass the bill was taken and there was a tie, which re-commits the bill to the subcommittee, pending further action.
Current Status: Pending
2. Support Requiring the Use of Seatbelts in Pickup Trucks – Senate Bill 5
The State Senate passed this bill in early February with a vote of 49-4. The bill is not popular in the House of Representatives where it is now pending in the House Agriculture Committee. It has encountered resistance over in the House, as House leadership and the governor have indicated opposition to this legislation.
Current Status: Pending
3. Support Removal of Prior Authorization for RX drugs
No current legislation pending that the GAFP currently supports. Staff will continue to have leadership review any bills related to this topic.
4. Support Prompt Pay
Last year during the session, the Medical Association asked for the GAFP’s support of their Prompt Pay initiative. Several bills are pending (HB 321, HB 342, and SB 62).
Status: Pending
5. Change in Resident Licensure (Legislation Required)
Legislation to allow IMG residents to gain licensure earlier than currently allowed by law. Legislative Committee will review legislation once it has been drafted.
Budget – Medicaid Cuts Looming
During his State of the State address Wednesday, Governor Perdue made one budget announcement: to commit an additional $20 million in FY2010 and more than $50 million in FY2011 for the mentally challenged and developmentally disabled.
On January 15th, Governor Perdue unveiled the state’s $17.4 billion Amended FY2010 (down from $18.6 billion) and $18.2 billion proposed FY2011 budgets. He is proposing a 1.86 percent cut on all Medicaid providers in FY2011 budgets along with a bed/sick tax on all Georgia hospitals.
Cuts Related to Health Care
Hospitals & Managed Care Organizations: 1.6 percent fee on hospital revenues and managed care organizations that treat Medicaid patients. The fee would raise an estimated $344 million a year.
Advocacy Training and Day at the Capitol – February 3-4
You asked for it – you got it! Please see the registration for our Legislative Advocacy Training Session (that has a concentration on Patient Centered Medical Home) and Day at the Capitol. Please see the information below.
Wednesday, February 3 - Legislative Advocacy and the Patient Centered Medical Home - Dinner
Hilton Garden Inn Downtown Atlanta
6:00 - Registration and Reception
6:30 - Dinner Served
Patient Centered Medical Home – Successful State Projects - Robert Graham, MD
7:30 - 9:30 - "Dirty Little Secrets Your Mother Never Told You" - How to Talk to Legislators – Kim Ross
Speakers:
Dr. Robert Graham is currently Professor of Family Medicine, and Robert and Myfanwy Smith Endowed Chair, in the Department of Family Medicine at the University of Cincinnati School of Medicine, a position he has held since March 2005.
Kim Ross - "I regard myself as a partially rehabilitated lobbyist and now am a public affairs consultant. In a previous incarnation, I coordinated political, legislative, legal and regulatory matters for the 36,000-member Texas Medical Association as their Vice President for Public Policy.”
Location:
Wednesday, February 3, 2010
Hilton Garden Inn Downtown Atlanta (across the street from Georgia Aquarium)
267 Marietta St NW · Atlanta, GA 30313
Phone: 404-577-2001
Room Rate: $139
Group Code: Physicians Day at the Capitol - Room rate expires on Jan. 26
Thursday, Feb. 4th - Day at the Capitol
8:30-9:45 am..........Breakfast with legislators
10:00-10:30............ "How to Lobby in 5 minutes or Less" - How to Successfully Interact with Legislators
10:30 - 11:00..........Prep for Legislator Meetings at Capitol
11:30 a.m.-12:30.....Meet with legislators at Capitol
12:30-1:30 pm.........Lunch with legislators and Press Conference on Medicaid Funding
Location: Floyd Building (Top Floor) and the State Capitol
Wednesday, February 3 - Patient Centered Medical Home and Advocacy Training Dinner Thursday, February 4 – Day at the Capitol
Registration for GAFP Members (Deadline – January 29, 2010):
_____ $30.00 for Wednesday Night
_____ $30.00 for Thursday Morning
_____ $45.00 to Attend Both Events
FAX BACK: 404-321-7450 MAIL: GAFP, 3760 LAVISTA ROAD, SUITE 100 TUCKER, GEORGIA 30084
Checks, Visa, MasterCard, Discover and American Express are accepted.
Circle Donation Type: Check Visa MasterCard Discover American Express
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Credit Card Number__________________________________________
Expiration Date__________________________________________
Name________________________________________________________
Amount ____________________________
Address_______________________________________________________
City__________________________ Zip_____________________
Click here for the 2009 Legislative Wrap Up Report
The GAFP PAC Board has listened to member requests to make GAFP PAC donations easier.
We are proud to announce that you can now donate directly online from the GAFP website (http://www.gafp.org/pac.asp).
We continue to hear that a special session in the fall is very likely and cuts to Medicaid providers will be on the line. We will need to utilize our PAC contributions over the summer to help with our friends in the General Assembly.
Please donate to the GAFP state political action campaign committee.
Elected legislators make decisions about your financial survival and providing a medical home for your patients. These decisions are made in the chambers of the Georgia House and Senate, not in the exam room.
Georgia’s GAFP PAC is an investment in your profession. You invest in your home, family, food, clothing and transportation. You also invest in your education and your retirement. We would like to thank the following 48 GAFP members who made contributions totaling $10,899.12:
Catherine Andrews, MD
Thomas Bat, MD
Bonnie Brinson, MD
Mitch Cook, MD
William Cornwell, MD
Loy Cowart, MD
Martha Crenshaw, MD
Shashikant Daya, MD
Thomas Fausett, MD
Donald Fordham, MD
Marti Gibbs, MD
James Hagler, MD
Wayne Hodges, MD
Wayne Hoffman, MD
Greg Hopkins, MD
Beulette Hooks, MD
Alice House, MD
Steven House, MD
D. Ann Travis Honeycutt, MD
John Kludt, MD
Paul LeBlanc, MD
Bruce LeClair, MD
Connie Lee
Nancy Lefever, MD
Jack Liao, MD
Susan Margletta, MD
Howard McMahan, MD
Brian Nadolne, MD
Ralph Peeler, MD
Rick Pierzchajlo, MD
Belkis Pimentel, MD
James Pugh, MD
Eddie Richardson, MD
Thad Riley, MD
Reuben Roberts, MD
Patrick Roche, MD
Richard Rosenberger, MD
Mitzi Rubin, MD
Saria Carter Saccocio, MD
Michael Satchell, MD
Ted Scoggins, MD
Edwin Scott, MD
George Shannon, MD
Roslyn Taylor, MD
Beverley Ann Townsend, MD
Rodney Tyson, MD
Michael Walsh, MD
State Senate Agrees to Study Medical Home
One of the GAFP’s top legislative priorities this past session, was to seek state legislative authority to study the concept of the patient centered medical home. Senate Resolution 664 does just that. Key members of the state senate, along with representatives from Georgia’s primary care physician organizations will meet over the summer to commence the study.
The bill was sponsored by the following State Senators:
State Senate Health and Human Services Chairman – Don Thomas, MD (Dalton)
State Senator Greg Goggans, DDS – (Douglas)
State Senator Lee Hawkins – (Gainesville)
State Senator Renee Unterman – (Buford)
The GAFP thanks the legislators who supported this resolution. The resolution says, in part: Acknowledging the importance of a comprehensive approach to providing patient centered care and creating the Senate Study Committee on the Patient Centered Medical Home; and for other purposes.
WHEREAS, medical homes will provide patient centered care that is accessible, continuous, and coordinated with a focus on maintaining a healthy lifestyle for patients with preventive and ongoing health services; and
WHEREAS, the primary care provided at medical homes would be respectful of, and responsive to, individual patient preferences, needs, and values; and
WHEREAS, personal physicians in medical homes would be eligible for case management fees and incentive payments for providing “medical home” services; and
WHEREAS, personal physicians would be responsible for providing ongoing support, oversight, and guidance to implement an integrated, coherent, cross-discipline plan of care developed in partnership with patients and any of their other medical providers; and
WHEREAS, the use of health information technology would be required of physicians in medical homes, and patients would be encouraged to engage in management of their own health through education and support systems; and
WHEREAS, evaluation would be on the extent to which the medical home coordinated health care services, provided safe and high-quality care, encouraged long-term patient and provider relationships, engaged and educated consumers, and encouraged innovation in payment methodologies.
NOW, THEREFORE, BE IT RESOLVED BY THE SENATE that there is created the Senate Study Committee on the Patient Centered Medical Home to be composed of seven members to be appointed by the President of the Senate.
The GAFP is working with Chairman Thomas and Lt. Governor’s Cagle’s office to confirm the appointment of the Study Committee. Typically study committees meet over the summer and into the fall and make a recommendation to the State Senate no later than December for potential legislation. GAFP leadership will keep members informed throughout the year.
Stimulus Funding for Family Physicians
In February, President Barack Obama signed the American Recovery and Reinvestment Act (ARRA) of 2009 (ARRA 2009) into law. The Web site, www.dch.georgia.gov/stimulus, will be the vehicle that the Georgia Department of Community Health (DCH) utilizes to keep Georgians informed about stimulus funds as it relates to this Department.
DCH will be the state agency to receive health information technology (HIT) funds available through the ARRA of 2009. The designation extends DCH’s leadership role in the HIT community.
"DCH’s designation as the states resource for HIT funding is a testimony to the huge strides Georgia has made in the advancement of electronic health information through DCH leadership and collaborative efforts" said Dr. Carladenise Edwards, Chief of Staff of DCH and DCH’s lead for stimulus funding. "We will use this designation as an opportunity to continue the charge to transform health care through the use of technologies aimed at improving health care quality, access and affordability.”
The ARRA includes over $20 billion for HIT provisions nationwide. Collectively referred to as the Health Information Technology for Economic and Clinical Health (HITECH) Act, the HITECH Act would provide financial incentives for HIT use among health care practitioners.
There will be funding dedicated to assisting states and primary care physicians with improving their practice. The GAFP will be closely monitoring this activity and reporting back to the membership. There will be a lecture held during the Summer CME Meeting in Hilton Head to discuss “What Family Physicians Need to Know About Stimulus Money Dedicated for Primary Care.” Please don’t miss this opportunity to be informed about funding availability (www.gafp.org – click on Summer Meeting registration)
May 20, 2009
State Legislative Wrap Up
The first half of the 2009-2010 Legislative Session concluded on April 3, 2009. Below is a report of health-related legislation as well as a review of our legislative priorities:
GAFP Legislative Priorities
1. Protect Medicaid and work with the Access Coalition to insure no additional provider cuts.
This priority took the most amount of time among GAFP leadership, GAFP staff, and grassroots support as the governor revised projected state revenues with a downturn of $3.1 billion. He recommended to the General Assembly a cut of Medicaid providers of between 6-10 percent to help offset the budget deficit. Both the House and Senate leadership worked diligently to avoid such a draconian cut. The legislature adopted a balanced budget by enacting severe cuts to state agencies and leveraging more than $1.4 billion in federal stimulus funds. GAFP will continue to closely monitor this issue as state revenues are still weak.
Current Status: Succeeded
2. Oppose direct billing for pathology service – House Bill 403
A subcommittee of House Insurance heard testimony on House Bill 403 which would give pathologists a monopoly on certain office-based lab codes. GAFP President Howard McMahan, MD testified against this bill. A vote to pass the bill was taken and there was a tie, which re-commits the bill to the subcommittee, pending further action.
Current Status: Pending
3. Support increasing the tobacco tax up to $1.00 a pack (House Bill 39)
The GAFP continues to work with the “Pass the Buck” coalition in support of increasing the tax. GAFP co-hosted a press conference on the issue in February and generated grassroots calls to House leadership in March. House Bill 39 currently resides in the House Ways & Means Subcommittee where it will be available for consideration in 2010.
Current Status: Pending
4. Support Requiring the Use of Seatbelts in Pickup Trucks – Senate Bill 5
The State Senate passed this bill in early February with a vote of 49-4. The bill is not popular in the House of Representatives where it is now pending in the House Agriculture Committee. It has encountered resistance over in the House, as House leadership and the governor have indicated opposition to this legislation.
Current Status: Pending
5. Support legislation to require retail health clinics to limit the number of nurse practitioners that one physician can supervise; and require the clinics to post and publicize who the supervising physician is at each location and on their follow up referral forms to the patient's personal physician. This issue will be discussed during the 2010 legislative session.
Current Status: In Development
6. Support legislation to form a study committee on the Patient Centered Medical Home
Senate Resolution 664 passed on April 1. It was sponsored by the Senate Health and Human Services Chairman, Don Thomas, MD, and the bulk of his committee. This study committee will be appointed over the summer with a report due to the State Senate no later than December 2009.Status: Succeeded
7. Support Removal of Prior Authorization for RX drugs
Senate Bill 3 will remove prior authorization; however, it also requires that all PeachCare children receive generic prescriptions. GAFP Legislative Committee does not believe that Senate Bill 3, in its current form, can be supported.
Status: Pending
Additional Healthcare Legislation
HB 217 – Rep. Jimmy Pruett (R-Eastman). Authorizes the use of flu vaccine orders and provides for flu vaccine protocol agreements between physicians and pharmacists or nurses. There were numerous attempts by biotech and pharmaceutical companies to expand the scope of the type of flu vaccine to be dispensed and administered by pharmacists to include “flu-mist” or other FDA approved vaccines. However, all of the expansion attempts were thwarted. Status: Signed by the Governor on April 28, 2009
HB 346 – Rep. Debbie Buckner (D-Junction City) Amends the definition of “Health Care Facility” to include hospice licensed under Chapter 7 of Title 31 without regard to whether it provides hospice care in the patient’s home or on an outpatient or short-term inpatient basis. Status: House HHS Committee 2/11/09
HB 350 – Rep. Chuck Martin (R-Alpharetta). Provides conditions for claiming exemptions by hospitals and other organizations that provide emergency health care services to inmates. The provisions of HB 350 were added to HB 464. Status: Passed House 3/12/09; Senate Approps Committee 3/17/09
HB 475 – Rep. Sharon Cooper (R-Marietta). Revises certain provisions of the Georgia Registered Professional Nurse Act relating to requirements for registered professional nurses in nontraditional nursing education programs. Status: Passed and sent to Governor 4/14/09
HB 509 – Rep. Sharon Cooper (R-Marietta). SB 509 was a comprehensive rewrite of the medical practice act governing the regulation of physicians, acupuncture, physician’s assistants, cancer and glaucoma treatment, respiratory care, clinical perfusionists, and orthotics and prosthetics practice and requires to notify the board upon the conviction of felony, provides for the suspension and reinstatement under certain circumstances of a license, permit or certificate. Status: Passed sent to Governor 4/15/09
HB 675 – Rep. Joe Wilkinson (R-Sandy Springs). Provides for the certification of polysomnographic technologists and provides for applications to be made to the Composite State Board of Medical Examiners to obtain certification to practice polysomnography. Status: House withdrawn, recommitted 4/3/09
HB 774 – Rep. Pat Gardner (D-Atlanta). Provides for guidelines relating to the incidence and treatment options of autism. Status: House HHS Committee 3/23/09
HB 862 – Rep. Jay Neal (R-LaFayette). Provides for the licensure of orthopedic physician assistants and for applications to be made to the Composite State Board of Medical Examiners. Provides for authorized services which may be performed by an orthopedic physician assistant in accordance with an approved job description. Status: House HHS Committee 4/3/09
HR 316 – Rep. Mickey Channell (R-Greensboro). Urges the Department of Community Health to work in conjunction with statewide medical organizations representing pediatric physicians to obtain or prepare and disseminate written materials, at appropriate literacy levels, containing information about the possible complications, proper care, and support for pre-term infants, and for other purposes. Status: House withdrawn, recommitted 4/3/09
SB 163 – Sen. Don Balfour (R-Snellville). Authorizes the commissioner of human resources to appoint a diabetes coordinator and provides for the department to service as the central repository of diabetes treatment and prevention data. Status: Passed Senate 3/4/09; Passed House by substitute 4/1/09; Senate disagrees with House substitute 4/3/09; Recommitted to House: HHS Committee 4/3/09
SB 201 – Sen. Don Balfour (R-Snellville). Relating to control of hazardous conditions, preventable diseases, and metabolic disorders, provides for voluntary contributions through individual income tax returns and other mechanisms for cancer research. Status: Senate sent to Governor 4/8/09
SB 233 – Sen. Doug Stoner (D-Smyrna). Relating to emergency medical services, requires the board to administer or approve examinations which conform to the respective scopes of practice for purposes of certifying emergency medical technicians, paramedics, and cardiac technicians. Status: Passed Senate 3/10/09; House HHS Committee 3/17/09
SB 244 – Sen. Renee Unterman (R-Buford). Under the Georgia Registered Professional Nurse Practice Act provides that the performance of health maintenance activities by a designated caregiver shall not be prohibited. Status: Passed Senate 3/12/09; Passed House by substitute 3/30/09; Senate disagrees with House substitute 3/30/09; Senate conference committee appointed 4/3/09; House conference committee appointed 4/3/09; Recommitted House: HHS Committee 4/3/09
SB 252 – Sen. Don Thomas (R-Dalton). Provides for the certification of polysomnographic technologists and provides for applications to be made to the Composite State Board of Medical Examiners to obtain certification to practice polysomnography. Status: Passed Senate 3/12/09; House HHS Committee 3/18/09
SR 257 – Sen. Don Thomas (R-Dalton). Calls for the creation of the Alzheimer’s Disease and Other Dementias Task Force. Status: Passed Senate 3/10/09; Passed House 3/30/09
SR 664 – Sen. Don Thomas (R-Dalton). Acknowledges the importance of a comprehensive approach to providing patient centered care and creating the Senate Study Committee and the Patient Centered Medical Home. Status: Passed Senate 4/1/09
INSURANCE
Autism
SB 161 & HB 426 by Sen. Johnny Grant (R-Milledgeville) and Rep. Katie Dempsey (R-Rome) respectively, mandate insurance coverage of autism spectrum disorders, including applied behavioral analysis. Status: Senate tabled 3/12/09; House Ins Committee 2/18/09
SR 672, HR 824 & HR 650 by Sen. Johnny Grant (R-Milledgeville), Rep. Katie Dempsey (R-Rome) and Rep. Pat Gardner (D-Atlanta) create Senate and House study committees on autism. Status: Passed Senate 4/1/09; HR 824 House Rules Committee 4/1/09; HR 650 House Ins Committee 3/19/09
Prompt-Pay
HB 321 – Rep. Steve Davis (R-McDonough). Relating to “group accident and sickness insurance” provides for changes in the definitions of the terms. Language from SB 62 was added in Senate. Status: Passed House 3/12/09; Passed Senate by substitution 4/3/09; House disagrees with Senate substitution 4/3/09; Recommitted Senate: Insurance & Labor Committee 4/3/09
HB 342 – Rep. Carl Rogers (R-Gainesville). Includes plan administrators in prompt pay requirements. Status: House withdrawn, recommitted 4/3/09
SB 62 – Sen. Ralph Hudgens (R-Hull). Includes plan administrators in prompt pay requirements. Status: Passed Senate 2/17/09; House Approps Committee 2/19/09
Other Insurance Related Bills
HB 89 – Rep. Alan Powell (D-Hartwell). Requires physicians who participate in the state employees’ or board of regents’ health insurance plan to also participate in the Medicaid program. Status: House HHS Committee favorably reported 3/12/09
HB 305 – Rep. Tom Knox (R-Cumming). Removes a participation requirement before the extension of group life policy coverage to dependents of employees or members. Status: Passed by House on 3/10/09; Senate Insurance & Labor favorably reported 3/18/09; Recommitted by Senate: Insurance & Labor Committee 4/3/09
HB 403 – Rep. Bill Hembree (R-Winston). Prohibits physicians from charging a markup, commission or profit on the actual amount paid or to be paid for an anatomic pathology service performed or supervised by another physician. No patient, insurer or third party payor is required to reimburse a licensed practitioner for charges or claims for anatomic pathology services that are not in accordance with the provisions of law regarding payment. Status: House Ins Committee 2/17/09
HB 410 – Rep. Tom Knox (R-Cumming). Makes certain technical corrections with regard to certain exemptions from insurance premium taxes for high-deductible health insurance products. Status: Passed sent to Governor 4/14/09
HB 411 – Rep. Tom Knox (R-Cumming). Removes a participation requirement before the extension of group life policy coverage to dependents of employees or members. Status: House Ins Committee 2/17/09
HB 412 – Rep. Tom Knox (R-Cumming). Provides that the Commissioner of Insurance shall be authorized to allow certain health reimbursement arrangement only plans that encourage employer financial support of health insurance or health related expenses to be approved for sale in connection with or packaged wit otherwise approved individual health insurance policies. Language was added to SB 94 in House. Status: House passed 3/10/09; Senate Insurance & Labor Committee favorably reported 3/18/09; Recommitted Senate: Insurance & Labor 4/3/09
HB 417 – Rep. Jay Neal (R-LaFayette). Provides in the event of a dispute or complaint involving material not in English, the English version of the material shall control the resolution of the dispute or complaint. STATUS: House passed 3/12/09; Senate Committee on Insurance & Labor favorably reported 3/26/09; Recommitted Senate: Insurance & Labor Committee 4/3/09
HB 450 – Rep. Doug McKillip (D-Athens). Changes the provisions relating to an insurer’s liability for a bad faith refusal to pay for a loss covered by insurance. Status: House Ins Committee 2/19/09
SB 50- Sen. Ralph Hudgens (R-Hull). “Rental Networks - Silent PPOs.” Prohibits access to a provider’s health care services and contractual discount by certain contracting entities under certain circumstances. The senate adopted a study committee resolution (SR 628) on April 1, 2009 creating a study committee to consider the issue and submit a report the Senate Insurance Committee with recommendations prior to the 2010 General Assembly. Status: Senate I&L Committee 1/27/09
SB 94 – Sen. Judson Hill (R-Marietta). Relating to insurance, provides that an insured under a group accident and sickness policy may include dependents up to age 25. SB 94 was changed in the House and again in the Senate. The final version does not include the dependents up to age 25 language. The passed version includes HB 412 language and extends state continuation benefits to 9 months for assistance eligible individuals under the American Recovery and Reinvestment Act of 2009. Status: Passed sent to Governor 4/13/09
SB 105 – Sen. Judson Hill (R-Marietta). Allows certain health reimbursement arrangement only plans that encourage employer financial support of health insurance or health related expenses to be approved for sale in connection with or packed with otherwise approved individual health insurance policies. Status: Passed by Senate 2/24/09; House Insurance Committee favorably reported 3/30/09; Recommitted to House: INS 4/3/09
SB 182 – Sen. Judson Hill (R-Marietta). The bill changes the age for continuation coverage under certain group accident and sickness insurance plans from 60 to 55 and provides for the coverage of dependents under group and individual accident and sickness policies up to and including 25 years of age if such dependent is a dependent for state income tax purposes for such policyholder or group member. Status: Senate I&L favorably reported 3/5/09
SB 245 – Sen. Don Thomas (R-Dalton). Requires that a health benefit plan that provides coverage for cancer chemotherapy shall provide coverage for orally administered cancer medication. Status: Senate I&L Committee
SR 331 – Sen. Judson H ill (R-Marietta). Calls for the creation of a Joint Study Committee on Health Care Transformation. Status: Passed by Senate on 3/12/09; House HHS Committee 3/18/09
Report 9 - March 20, 2009
The General Assembly is scheduled to meet March 23, 25, and 26 which will commit 37 out of the potential 40 day schedule. The current schedule for next week for the General Assembly is Monday, March 30 (Day 38), Wednesday, April 1 (Day 39) and Friday, April 3 (Day 40 - Sine Die). *Schedule subject to change.
Action Needed: Take Six Minutes This Week to Avoid a Six Percent Medicaid Cut
Last week, the State House passed the 2010 State budget restoring the cuts to both physicians (6 percent) and hospitals (10 percent). However, our work is not done. Governor Perdue has communicated his concern over increasing patients on the Medicaid roles dues and has cautioned the State Senate that provider cuts may still be needed as they consider the 2010 budget.
Please contact your state senator, along with the senator leadership listed below. Take six minutes (two phone calls) and let the state senate know that family physicians cannot afford additional cuts to Medicaid payments.
You can find your state senators phone number on this website: http://capitol.aafp.org/aafp/state/main/?state=GA&view=myofficials
Also, call at least one of the following state senate leadership listed below:
Lt. Governor Casey Cagle - (404) 656-5030
President Pro Tempore - Senator Tommy Williams (Lyons) - (404) 656-0089
Senate Majority Leader - Senator Chip Rodgers (Woodstock) - (404) 463-1378
Senate Appropriations Committee Chairman - Senator Jack Hill (Reidsville) - (404) 656-5038
Talking points:
- Support the House version of the 2010 budget that stops the fee cuts for physicians.
- Georgia physicians have not received an increase in Medicaid payments for 8 years, while the cost of living increases annually.
- Family physician offices are small businesses that cannot operate at a loss and remain open.
- Physicians have already taken a cut in payment, when last year's increase was never implemented.
- GAFP supports a tobacco tax to help fund healthcare in Georgia.
When Subcommittee Chairman Mickey Channell (R-Greensboro) reported his recommendations on the Medicaid budget he cited the work of the ACCESS Coalition and the front page article from the Augusta Chronicle as two critical pieces of information that showed physicians and hospitals would be unable to care for Medicaid patients if additional cuts were made to the budget.
GAFP is a member of the ACCESS Coalition and both GAFP President Howard McMahan, MD and GAFP leader Wayne Hodges, MD were prominently featured in the newspaper article.
Major House and Senate Action - Healthcare News
HB 228 - Rep. Mark Butler (R-Carrollton). The House approved legislation Tuesday that will restructure the state's Department of Human Resources. The proposal splits DHR into two new agencies: a Department of Public and Behavioral Health and a Department of Human Services. The bill retains the Department of Community Health (DCH) in close to its current form. Lawmakers had been demanding a restructuring of DHR, a giant agency that has 11,000 employees and a budget of nearly $4 billion, because of long-standing administrative problems and issues with mental health treatment. The bill was favorably reported March 19, 2009 by the Senate Committee on Government Oversight.
HB 523 - Rep. John Lunsford (R-McDonough). Prohibits a pharmacist from engaging in drug product selection or substitution for a patient undergoing immunosuppressive therapy to prevent transplant rejection without prior consent of the patient and prescribing physician. The bill failed to meet the requisite constitutional majority of votes necessary for passage (91) on March 10, 2009. The motion to reconsider final passage was adopted March 12, 2009, but the bill was recommitted to the Rules Committee. The bill will be eligible for consideration next session.
HB 614 - Rep. Sharon Cooper (R-Marietta). Enacts the Georgia Prescription Monitoring Program Act, which is a program for the monitoring of prescribing and dispensing Schedule II, III, IV, or V controlled substances by the Georgia Drugs and Narcotics Agency. The bill requires dispensers to submit certain information regarding the dispensing of certain drugs. The bill was favorably reported by the House Committee on Health and Human Services March 5, 2009. The House of Representatives passed the bill March 12, 2009 161-9 and it was referred to the Senate Committee on Regulated Industries and Utilities.
HB 736 - Rep. Ron Stephens (R-Savannah). Requires public schools to provide parents or guardians of sixth grade female students' information concerning the infection and immunization against the human papillomavirus.
INSURANCE
SB 161 - Sen. Johnny Grant (R-Milledgeville). Expands autism insurance mandate to cover ABA therapy. The bill was tabled by the Senate on Thursday, March 12, 2009 and is eligible for consideration in 2010.
SR 626 - Sen. John Douglas (R-Social Circle). Opposes the requirement of private health insurers to pay for the treatment of veteran's service connected injuries and disabilities.
March 24, 2009
Report 8 – March 9, 2009
The General Assembly is scheduled to meet Monday, Tuesday and Thursday of this week which will commit 30 out of a potential 40 day schedule. The last day for bills to crossover from one chamber to the other is Day 30, scheduled for Thursday, March 12. The schedule for next week is for the General Assembly to meet Tuesday, March 17th through Friday, March 20th (Days 31-34). The new adjournment resolution has sine die (last day of session) scheduled for Friday, April 3rd.
Medicaid Cut Looming for FY 2010
The GAFP sent out a legislative alert last week asking members to contact their legislators concerning the Governor’s recommendation to cut Medicaid providers an additional 6 – 10 percent. Please continue to contact your legislator about this proposed cut. You can locate your state legislator at http://capitol.aafp.org/aafp/state/main/?state=GA&view=myofficials
GAFP Vice President, Harry Strothers, MD, testified in opposition to the Medicaid cut on March 6th in front of a joint hearing of the Medicaid Appropriations Subcommittee. His testified in part:
We have heard about the Governor’s recommendation to cut Medicaid provider rates for the FY 2010 budget. This will be devastating to our safety net – devastating to our patients – and devastating to the ability of me and my colleagues to continue to see Medicaid patients.
As you already know, Medicaid payments are well below what it costs to care for Medicaid patients. In July 2008, the Department of Community Health cut provider rates by seven percent – this new and additional cut which we’ve heard could be between 6 – 10 percent will force many of my colleagues to abandon long time patients because they will be forced to drop Medicaid.
This is a top legislative priority for the GAFP and senior GAFP leadership will continue to fight against this new round of proposed cuts.
Prompt Pay – House Bill 342 and Senate Bill 62
Over the weekend, the GAFP Board of Directors voted to add prompt pay legislation to our list of top legislative priorities. The prompt pay bills (HB 342 and SB 62) will require third party administrators to comply with Georgia’s prompt pay statute.
Senate Bill 62 has passed out of the Senate and currently resides in the House Appropriations Committee. House Bill 342 has passed out of the House Insurance and Labor Committee and currently resides in the House Rules Committee.
Major House and Senate Action Related to Health Care
HB 523 – Rep. John Lunsford (R-McDonough). Prohibits a pharmacist from engaging in drug product selection or substitution for a patient undergoing immunosuppressive therapy to prevent transplant rejection without prior consent of the patient and prescribing physician.
HB 614 – Rep. Sharon Cooper (R-Marietta). Enacts the Georgia Prescription Monitoring Program Act, which is a program for the monitoring of prescribing and dispensing Schedule II, III, IV, or V controlled substances by the Georgia Drugs and Narcotics Agency. The bill requires dispensers to submit certain information regarding the dispensing of certain drugs. The bill was favorably reported by the House Committee on Health and Human Services March 5, 2009.
HB 681 – Rep. Charlice Byrd (R-Woodstock). Prohibits the substitution of anti-epileptic drugs except under certain conditions.
HB 229 (Rep. Brooks Coleman, 97th) would create the SHAPE (Student Health and Physical Education) Act. Beginning in 2011-12, students in grades 1-12 enrolled in physical education would have to have an annual fitness assessment approved by the State Board of Education. Passed the House and is assigned to Senate Education & Youth.
HB 337 (Rep. Donna Sheldon, 105th) would instruct Public Health to create, career track, recruit and retain nurses. Implementation dependent on funding. House Health & Human Services.
HB 351 (Rep. Barry Loudermilk, 14th) would prohibit any family planning services for unemancipated minors. Passed House Judiciary. Assigned to House Rules.
HB 474 (Rep. Pat Gardner, 57th) would increase PeachCare eligibility from 235% of Federal Poverty Level to 300%. Assigned to House Appropriations.
INSURANCE
SB 215 – Sen. Ed Tarver (D-Augusta). Provides for an independent review of certain health insurance decisions and provides for requirements of an independent review organization.
SB 245 – Sen. Don Thomas (R-Dalton). Requires that a health benefit plan that provides coverage for cancer chemotherapy shall provide coverage for orally administered cancer medication.
March 10, 2009
Special Legislative Report – Report 7
Thursday, March 5, 2009
Immediate Action Needed Now!
Medicaid Cut Looming – Your Calls Needed
Yesterday, the Governor announced that he was recommending to the Georgia General Assembly an additional 6-10 percent cut on Medicaid providers for the State’s 2010 budget. The General Assembly will work on the budget over the next week and your calls are needed to sway legislators to look for other avenues to avoid another cut in Medicaid (last cut occurred in July 2008).
Please call the legislators on the list below, who serve on the Appropriations Medicaid Subcommittees and let them know how an additional cut will affect your ability to continue to see Medicaid patients in your practice. Talking points can include:
- The federal stimulus package calls for Georgia to receive an additional $790 million for Medicaid. More Medicaid cuts will have devastating consequences to patients & the physicians who serve them.
- For every dollar that the state cuts from its Medicaid program, more than two federal matching dollars are left on the table resulting in a “triple cut” to Georgia Medicaid.
- The result of repeated cost-shifting is annual double-digit insurance premium increases for Georgia businesses, forcing many companies to drop health coverage altogether.
Senate Appropriations Community Health Subcommittee
Chair Senator Greg Goggans, DDS (Douglas) - (404) 463-5263, greg.goggans@senate.ga.gov
Vice Chair Senator Cecil Staton (Macon) - (404) 656-5039, cecil.staton@senate.ga.gov
Senator Tim Golden (Valdosta) - (404) 656-7580, tim.golden@senate.ga.gov
Senator Bill Heath (Bremen) - (404) 651-7738, billheath@billheath.net
Senator Chip Rogers (Woodstock) - (404) 463-1378, chip.rogers@senate.ga.gov
Senator Valencia Seay (Riverdale) - (404) 656-5095, valencia.seay@senate.ga.gov
Senator Don Thomas, MD (Dalton) - (404) 656-6436, don.thomas@senate.ga.gov
Senator Renee Unterman (Buford) - (404) 463-1368, renee.unterman@senate.ga.gov
Senator Tommie Williams (Lyons) - (404) 656-0089, tommie.williams@senate.ga.gov
House Appropriations Community Health Subcommittee
Chair Representative Mickey Channell (Greensboro) - 404.656.7856
Secretary Representative Donna Sheldon (Dacula) - 404.656.5025, donna.sheldon@house.ga.gov
Representative Mark Burkhalter (Johns Creek) - 404.656.5072, mark.burkhalter@house.ga.gov
Representative Carolyn Hugley (Columbus) - 404.656.5058, carolyn.hugley@house.ga.gov
Representative Jay Shaw (Lakeland) - 404.656.7859, jay.shaw@house.ga.gov
Representative Matt Dollar (Marietta) - 404.656.0254, matt.dollar@house.ga.gov
Representative Ed Rynders (Albany) -404.656.7855, erynders@bellsouth.net
Representative Ron Stephens (Savannah) - 404.656.5099, quickrxdrugs@yahoo.com
Representative Pat Gardner (Atlanta) - 404.656.0265, pat@patgardner.org
March 10, 2009
Report 6 – March 2, 2009
The General Assembly is scheduled to meet Tuesday – Thursday of this week which will commit 27 out of a potential 40 day schedule. Traditionally, the last day for bills to crossover from one chamber to the other is Day 30, currently scheduled for Thursday, March 12.
Amended Budget - 2009
The House passed an amended budget of $18.9 billion by a vote of 165-5 on February
26, 2009.
- Cuts $2.6 billion in state revenues for the current fiscal year
- $428 million for homeowner tax relief grants
- Cuts $6 million for local assistance grants
- Restores $1.3 million to the State Department of Revenue
- Redirects $804,856 from the Department of Corrections RFP contract funds to eliminate the population drawdown at private prisons
- Uses nearly $150 million in federal stimulus dollars to offset cuts to school districts
- Adds in $465 million in federal stimulus dollars for Medicaid
Pathology – House Bill 403 – Remains in Subcommittee Last week, GAFP President Howard McMahan, MD testified against House Bill 403 which, if passed, would allow pathologists to have a monopoly on certain codes for billing lab specimens. This bill was heard in an Insurance Subcommittee Chaired by the bill’s sponsor, Representative Bill Hembree (R-Winston). Testimony was limited by the Chairman but opposing the bill included the GAFP, Georgia OBGyn Society, Georgia Chapter – American College of Physicians, and the Georgia Medical Group Managers Association. The subcommittee voted to a 4-4 tie which means the bill will remain in subcommittee. Staff will continue to monitor any additional movement on this bill.
Thank you to President McMahan and all GAFP members who took the time to voice our opposition to this bill.
Medical Practice Act – House Bill 509
Representative Sharon Cooper (R-Marietta) is sponsoring an update of the Medical
Practice Act (House Bill 509). The Legislative Committee has reviewed the 110-page
bill and voiced several concerns about the MPA revisions as it relates to the
supervision of physician assistants. The areas of concern include the following:
- De-linking the Physician Assistants Licensure with the Physician
- Informing the Patient of their right to see a Physician
- Removal of Record Reviews & Countersignatures for Prescriptions
- Removal of Requirement for Physician to Personally See the Patient
This bill has passed out of the House Health and Human Services Committee. However, Chairman Cooper has indicated her willingness to continue to work with the GAFP on this bill.
Tobacco Tax Bill – House Bill 39 – Grassroots Calls Needed
Although a hearing was held on House Bill 39 which would increase the state
tax on tobacco by $1.00, no vote was taken. The GAFP supports this bill and
encourages members to contact the legislators listed below asking that the
subcommittee vote out House Bill 39. Tell your legislators that increasing
Georgia’s Tax on Cigarettes by $1.00 is a:
WIN for public health because it will reduce the prevalence of smoking, particularly among adolescents;
WIN for the State of Georgia’s finances because it would generate a consistent and significant stream of new revenue, and reduce the $537 million in annual Medicaid expenditures attributable to tobacco related illness;
WIN for lawmakers to support a measure that is favored by more than 75 percent of Georgia voters.
WAYS AND MEANS PUBLIC FINANCE AND POLICY SUBCOMMITTEE
Rep. Chuck Martin, Co-Chairchuck@martinforgeorgia.com
404.463.2247
Rep. Tom Rice, Co-Chair
tqgrice@aol.com
404.656.5912
Rep. David Knight, Alt Co-Chair
david.knight@house.ga.gov
404.656.0152
Rep. Rick Austin
rick.austin@house.ga.govd
404.656.0287
Rep. Sharon Beasley-Teague
sharon.beasley-teague@house.ga.gov
404.656.0220
Rep. Ellis Black
blackellis@bellsouth.net
404.656.0287
Rep. Mike Glanton
mikeglanton@mikeglanton.com
404.656.0202
Rep. Allen Peake
allen@allenpeake.com
404.656.0188
Rep. Jay Powell
jpowell@camillaga.net
404.656.0177
Rep. Austin Scott
404.656.5132
Rep. Mickey Stephens
mickeystephens@gmail.com
404.656.0117
Rep. Willie Talton
willie.talton@house.ga.gov
404.656.0254
Rep. Rashad Taylor
rashadjtaylor@gmail.com
404.656.0220
Rep. Roger Williams
roger.williams@house.ga.gov
404.656.3904
MAJOR HOUSE AND SENATE ACTION RELATED TO HEALTH CARE
FINANCE
SR 335 – Sen. Curt Thompson (D-Norcross). Amends the Constitution to provide for the imposition of a state sales and use tax of 1 percent where the proceeds will be used exclusively to build on the PeachCare for Kids program to provide healthcare coverage for all Georgia children, thus creating the Penny for the Kids Trust Fund.
HEALTH CARE
SB 156 – Sen. Cecil Staton (R-Macon). Abolishes the Georgia Trauma Trust Fund and establishes the State Office of EMS/Trauma. The bill also revises the duties of the Georgia Trauma Care Network Commission and provides for duties of the State Office of EMS/Trauma relating to the state-wide trauma network. Senators passed the measure 49-0 February 26, 2009. It now moves to the House for consideration.
SB 165 – Sen. Greg Goggans (R-Douglas). Authorizes the Department of Community Health to obtain income eligibility verification from the Department of Revenue for applicants for Medicaid and PeachCare for Kids Program. The bill was passed by the Senate 48-0 February 26, 2009 and now moves to the House for consideration.
HB 509 – Rep. Sharon Cooper (R-Marietta). Changes the provisions relating to the regulation of physicians, acupuncture, physician’s assistants, cancer and glaucoma treatment, respiratory care, clinical perfusionists, and orthotics and prosthetics practice and requires to notify the board upon the conviction of felony, provides for the suspension and reinstatement under certain circumstances of a license, permit or certificate. HB 509 was favorably reported by the House Committee on Health and Human Services on February 25, 2009.
INSURANCE
SB 123 – Sen. Lee Hawkins (R-Gainesville). Provides for regulation and licensure of pharmacy benefits managers by the Commissioner of Insurance. The bill provides that a pharmacy benefits manager shall not have to be licensed as an administrator. The bill was favorably approved by the Senate Committee on Insurance & Labor on Wednesday, February 18, 2009. Senators passed SB 123 51-0 on February 25, 2009. It now moves to the House for consideration.
SB 209 – Sen. Lee Hawkins (R-Gainesville). Limits a pharmacist from substituting a drug as part of immunosuppressive therapy.
HB 560 – Rep. Margaret Kaiser (D-Atlanta).Provides that entities submitting a bid for certain contracts must disclose whether they will maintain health insurance for their employees during the project for which the bid was submitted.
March 3, 2009
Report 5 – February 23, 2009
The General Assembly reconvened Tuesday, February 17, 2009 for the 19th legislative day and remained in session through Thursday, February 19, 2009 (Day 21). They are scheduled to meet February 24 – 26th which will commit 24 out of a potential 40 day schedule.
Pathology Billing Monopoly Bill – GAFP Opposes House Bill 403
Representative Bill Hembree (R-Winston) once again introduced a bill that would allow a pathologist to own a monopoly on the codes associated with pathology lab billing. If passed, the bill would also give authority to the Composite Board to revoke a physician’s license for incorrectly billing a patient.
The GAFP opposes this bill and is one of our legislative priorities. On Wednesday, February 18th, President Howard McMahan, MD was present to testify on this bill, but the subcommittee chairman Rep. Bill Hembree took no testimony.
This bill is scheduled to be heard on Wednesday, February 25th. Please take a moment to call members of the Insurance Committee and ask them to oppose House Bill 403.
House Bill 403 would create more hassle for patients and higher costs:
- Inconvenience: The patient would be referred to an independent pathologist who may not be conveniently located near the family physician.
- Additional Travel: The lab, in fact, may be located across town or, in the case of smaller communities, may even be a considerable distance away – in another city.
- Higher Costs: The pathologist may NOT be in the patient’s health plan network of physicians. In this case, the pathologists would receive a smaller amount from the patient’s insurance company. The patient is then stuck with much higher out-of-pocket expenses.
Rep. Tom Knox –Chairman - Forsyth County
404-656-6831
Rep. Jay Neal - Catoosa, Walker
404-656-0152 jay.neal@house.ga.gov
Rep. Mike Coan - Gwinnett
404-656-6801 repcoan@charter.net
Rep. John Meadows - Gordon, Murray
404-656-0298
Rep. Howard Maxwell - Haralson, Paulding
404-656-5143
Rep. Carl Rogers - Hall
404-463-2247 carl.rogers@house.ga.gov
Rep. Rich Golick - Cobb
404-656-5943 rich.golick@house.ga.gov
Rep. Matt Dollar - Cobb
404-656-0254 matt.dollar@house.ga.gov
Rep. Joe Wilkinson - Fulton
404-463-8143
Rep. Georgiana Sinkfield - Clayton, Dekalb, Fulton
404-656-6372
BILL SPONSOR
Rep. Bill Hembree - Douglas
404-656-5146 bill.hembree@house.ga.gov
Rep. Mike Jacobs - Dekalb
404-656-0152 repjacobs@comcast.net
Rep. Toney Collins - Newton, Rockdale
404-656-0265 toneycollins95@gmail.com
Rep. Melvin Everson - Gwinnett
404-656-0188 mjeverson@bellsouth.net
Rep. Steve Davis - Henry
404-656-0254 steve.davis@house.ga.gov
Rep. Doug Holt - Morgan, Newton
404-656-0152
Rep. Keith Heard - Clarke
404-656-0220 keith.heard@house.ga.gov
Rep. Ben Harbin - Evans
404-463-2247 ben.harbin@house.ga.gov
Rep. Quincy Murphy - Richmond
404-656-0265 quincy.murphy@house.ga.gov
Rep. Carl Epps - Meriwether, Troup
404-656-7859 carl.epps@house.ga.gov
Rep. Richard Smith - Muscogee
404-656-3904 richard@smithforgeorgia.com
Rep. Carolyn Hugley - Muscogee
404-656-5058 carolyn.hugley@house.ga.gov
Rep. David Lucas - Bibb
404-656-0220
Rep. Mickey Stephens - Chatham
404-656-0117 mickeystephens@gmail.com
Rep. Jerry Keen - St. Simons
jerry.keen@house.ga.gov
Major House/Senate Action on Health Care
SB 165 – Sen. Greg Goggans (R-Douglas). Authorizes the Department of Community Health (DCH) to obtain income eligibility verification from the Department of Revenue for applicants for Medicaid and PeachCare.
HB 194 – Rep. Fran Millar (R-Dunwoody). Provides that when a substitution of generic or brand name drugs is made, certain information related to the substitution must appear on the prescription label. The House has approved this unanimously and is now referred to the Senate Committee on Health and Human Services.
HB 509 – Rep. Sharon Cooper (R-Marietta). Updates the Medical Practice Act. Has certain provisions related to physicians assistants. GAFP Legislative Committee is reviewing the 110 page bill.
SB 161 – Sen. Johnny Grant (R-Milledgeville). Requires mandated insurance coverage of autism.
HB 426 – Rep. Katie Dempsey (R-Rome). Requires certain mandated insurance coverage of autism.
HB 489 – Rep. Pedro Marin (D-Duluth). Requires health benefit policy coverage for the diagnosis and treatment of infertility.
Vote for Lanny Copeland, MD – Past GAFP and AAFP Board Chair
Congratulations to Dr. Copeland who has been nominated for the 2009 Most Powerful Physician Executives recognition programs sponsored by Modern Healthcare. You can vote online to support Dr. Copeland’s nomination through March 6th. Click here to cast your vote http://www.modernhealthcare.com/section/50mostpowerful
Federal “Stimulus” Bill
According to news reports, Georgia would receive the following from the $787 billion measure (some estimate about $6 billion to the state):
- $1.73 billion for Medicaid program;
- $1.2 billion for education;
- $1.01 billion to build and repair roads and bridges;
- $333 million for special education programs;
- $90 million for public housing;
- $220 million in additional unemployment insurance trust fund dollars;
- $82 million for child care programs;
- $60 million for MARTA;
- $33 million for homelessness prevention; and
- $20 million for the Head Start program.
March 3, 2009
Report 4 - February 16, 2009
In fifteen legislative days, 924 bills and resolutions have been introduced. The General Assembly reconvened Tuesday, February 10, 2009 for the 16th legislative day and remained in session through Thursday, February 12, 2009 (Day 18). They are scheduled to meet Tuesday - Thursday of this week which will commit 21 out of a potential 40 day schedule.
Mandatory Seatbelts in Pickup Trucks Pass State Senate
On Thursday, February 12th, the State Senate passed Senator Don Thomas, MD's bill to require seat belt usage in pickup trucks. The vote was 49-4. The bill is not popular in the House of Representatives where it will now be sent for consideration if it's to pass and be considered for the Governor's signature. This is one of the GAFP's top legislative priorities.
Access Coalition Encouraging Legislators to use Stimulus Funds for Medicaid Budget
The Georgia Academy is a member of the Access Coalition which is comprised of physicians, hospitals, businesses and county officials all working together seeking adequate Medicaid payment.
Last week, the Coalition hosted a meeting with legislators who serve on the appropriations subcommittee that deal with Medicaid asking that whatever funds the federal government makes available to Georgia for health care in the stimulus package - at least as a temporary measure.
Joe Parker, president of the Georgia Hospital Association stated, "Taxing the state's hospitals while they're suffering from the recession could put some in a bind, he said, noting that a recent survey of 63 facilities showed that 73 percent will lay off staff and 62 percent will reduce the services they offer if Medicaid payment rates from the state are cut.
In a similar survey sent out to physicians, including family physicians, 60 percent of the respondents have indicated that their practices will need to close to Medicaid if any additional cuts are forthcoming.
Tort Reform
Judge Objects to Cap on Non Economic Damages
On Monday, February 9th, Fulton County State Court Judge Diane E. Bessen tossed out the provisions limiting to $350,000 against doctors, or $700,000 in cases against multiple medical facilities. In her decision, Bessen said the caps, part of the 2005 legislative package known as Senate Bill 3, violated the Georgia Constitution's guarantee of a right to jury trial since they strip juries of their ability to determine appropriate damages. This case will automatically be appealed to a higher court.
Additional tort reform legislation supported by Governor Perdue:
Senate Bill 101 (Senator Bill Cowsert) to provide liability protection for pharmaceutical manufacturers and medical device manufacturers in Georgia who meet or exceed federal safety standards. The measure applies only to defects in design, which undergo a strenuous federal Food and Drug Administration (FDA) approval process, but it does not cover defects that occur in the manufacturing process; and
Senate Bill 108 (Senator Bill Cowsert) which is a measure to discourage frivolous lawsuits dismissed in the earliest stages of litigation. "SB 108 will free up our courts to pursue justice in cases with merit, protect our existing businesses that provide jobs for Georgians and attract new investment," Gov. Perdue said on the bill's filing.
Sen. Lee Hawkins' Senate Bill 23, which would end Georgia's "gag rule" on the admissibility of the failure to wear seat belts in motor vehicle accidents in court when the failure to buckle is material to the case, passed the Senate Judiciary Committee February 6. Current law in Georgia expressly - specifically - prohibits judges and juries from considering evidence of the failure to wear safety belts as a contributory factor when awarding medical or compensatory damages. When enacted, these bills would bring significant cost savings to Georgia trauma care system and further encourage seat belt use by bolstering the notion of personal responsibility for one's own safety. State Rep. Harry Geisinger has filed companion legislation in the House, House Bill 200.
Trauma Care
Rep. Austin Scott has introduced House Bill 148 to establish a fee on vehicle tags to fund trauma care and Rep. Jim Cole has filed House Bill 160 to increase fines on "super-speeders," also to go to trauma funding. Gov. Perdue also has included in his state budget $60 million for trauma.
Require Schools to Assess Students' Physical Fitness
HB 229 which will require schools to assess student physical fitness annually passed out of the House Education Committee on February 12th. Notable amendments from the original Bill included the expansion of the overall scope of the bill to include grades 1-3(previously only covered 4-12), and a requirement that the physical fitness assessment be taken by a certified PE teacher. HB 229 next moves to the House Rules Committee
February 16, 2009
Report 3 – February 6, 2009
The GAFP sends weekly updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
The General Assembly reconvened Monday, February 2, 2009 for the 11th legislative day and remained in session through Friday, February 6, 2009 (Day 15 out of 40).
The House proposed (and Senate accepted) splitting the 2009 regular session of the General Assembly into two sessions. The General Assembly will maintain a schedule of being in session three days per week through March 25th and then adjourning until June 22, 2009. On and after June 22, 2009, the periods of adjournment of the 2009 session, if any, shall be as specified by subsequent resolution of the General Assembly. This will allow the General Assembly to recess after 35 days and leave 5 days to come back and make mid-year adjustments.
Huge Success – Day at the Capitol Includes Pass the Buck Press Conference
As part of our Day at the Capitol held on Thursday, February 5, over 93 physicians held a press conference with Cancer, Heart, and Lung Associations to push raising our state tobacco tax up to $1.00 (currently at $.25). President Howard McMahan, MD was prominently featured during the press conference and appeared on Lawmakers a Public Broadcast program which is a nightly review of the day’s events at the Capitol. To view the clip of the press conference, go to this link and forward on to minute 12: http://www.gpb.org/lawmakers-tv/2009/02/05 (Click on Watch)
Dr. McMahan was also quoted in the Friday issue of the Augusta Chronicle outlining the Georgia Academy’s support of House Bill 36 to increase the tobacco tax.
In addition to the press conference, both Insurance Commissioner John Oxendine and Medicaid Commissioner Rhonda Medows, MD spoke to the physicians attending the Day at the Capitol. The Georgia Academy members were joined by the other members of the Patient-Centered Physicians Coalition of Georgia which included the Georgia Chapter – American Academy of Pediatrics, Georgia Chapter – American College of Physicians, Georgia OBGyn Society and Georgia Osteopathic Medical Association.
Seatbelts in Pickup Trucks Pass Senate Public Safety Committee
GAFP member and State Senator Don Thomas, MD (R-Dalton) has introduced Senate Bill 5 that requires the use of safety belts in passenger vehicles, including, but not limited to, pickup trucks, vans and sport utility vehicles designed to carry ten passengers or fewer. The bill was adopted by the Senate Public Safety Committee on February 4, 2009 and now will be forwarded on to the Senate Rules Committee to be slated for a vote on the Senate floor. The GAFP supports this bill and is one of our legislative priorities for 2009.
Flu Vaccine Injections by Pharmacists
Representative Jimmy Pruett has introduced the Governor’s “Access to Flu Vaccines Act” legislation, House Bill 217 to the General Assembly. This legislation is a tightly crafted bill that will allow a pharmacist to administer flu vaccine injections as long as they have a protocol in place with a local licensed physician. To ensure quality control, physicians may issue no more than 10 standing orders with pharmacists and nurses within the same or adjacent county to the physician's primary place of business.
Under funding of Medicaid Survey – Your Response Needed
The GAFP in conjunction with other primary care physician groups and the Georgia OBGyn Society are conducting a brief (less than 2 minutes) survey to gather data on the affect of the current economic downturn and the cut in Medicaid funding.
Please go to this link:
http://www.surveymonkey.com/
Senate and House Bills of Note Related to Health Care
Senate Bill 3– Sen. Jack Murphy (R-Cumming). Provides for prior authorization requirements for prescription drugs and provides for the Commissioner of Insurance to establish oversight of the operation of pharmacy benefits managers and requires the Department of Community Health to modify the state insurance plan to require that certain circumstances only generic drugs shall be distributed to recipients of drugs under the state plan.
Senate Bill 5 – Sen. Don Thomas (R-Dalton). Requires the use of safety belts in passenger vehicles, including, but not limited to, pickup trucks, vans and sport utility vehicles designed to carry ten passengers or fewer. The bill was adopted by the Senate Public Safety Committee on February 4, 2009.
Senate Bill 62 - Sen. Ralph Hudgens (R-Hull). Requires third-party administrators that work for ERISA exempt self-funded plans comply with Georgia’s prompt payment laws. The bill was adopted by the Senate Committee on Insurance and Labor.
Senate Bill 92 – Sen. Judson Hill (R-Marietta) This legislation essentially would dismantle our existing Medicaid and PeachCare for Kids programs. If passed, the programs would be discontinued and while details are vague, the assumption is that the funding that would have gone to provide health coverage would instead be disseminated to families as premium assistance with the intent that this money would be used by low-income families to purchase private sector health insurance plans instead.
House Bill 80 - Rep. Howard Maxwell (R-Dallas). Seeks to change the minimum number of employees from 100 to 2 as required to be covered under an insurance contract or contracts held by a corporation or trustee.
House Bill 194 - Rep. Fran Millar (R-Dunwoody). Provides that when a substitution of generic or brand name drugs is made, certain information related to the substitution must appear on the prescription label and be affixed to the container or an auxiliary label. The bill was adopted by the House Committee on Health and Human Services on February 5, 2009.
House Bill 217 – Rep. Jimmy Pruett (R-Eastman). Authorizes the use of flu vaccine orders and provides for flu vaccine protocol agreements between physicians and pharmacists or nurses. The bill was adopted by the House Committee on Health and Human Services on February 5, 2009.
House Bill 229 - Rep. Brooks Coleman (R-Duluth) – The Physical Education Bill will promote healthier lives for school-age children in Georgia.
House Bill 273 – Rep. Ron Stephens (R-Savannah). Enacts the “Georgia Prescription Monitoring Program Act”- a statewide database to monitor the prescribing and dispensing of Schedule II, III, IV, or V controlled substances by the Georgia State Board of Pharmacy.
House Bill 307– Rep. Jim Cole (R-Forsyth). Provides for a fee to be imposed on hospitals, relating to the care and protection of indigent and elderly patients, to be used to obtain federal financial participation for medical assistance payments under Medicaid.
February 9, 2009
Report 2 – January 26, 2009
The GAFP sends weekly updates during the Georgia legislative session; please contact the GAFP office if you do not wish to receive these updates by calling 404-321-7445.
Georgia legislators recessed last week to attend the 2009 Session Joint Budget Briefings. The General Assembly reconvenes Monday, January 26, 2009 for the 6th legislative day and is expected to work through Friday, January 30th which would complete 10 out of a possible 40 days. * Schedule subject to change
House Bills of Note (Recently Introduced)
HB 89 – State employees' or board of regents' health insurance plan requires Medicaid participation
Sponsored by Rep. Alan Powell (D-Hartwell), HB 89 requires physicians who participate in the state employees’ or board of regents’ health insurance plan to also participate in the Medicaid program.
HB 22 – Safety belts in rear seats of vehicles
Sponsored by Rep. Mary Oliver (D-Atlanta), HB 22 requires passengers in the rear seats of vehicles, including pickup trucks to use safety belts. GAFP endorses this bill.
HB 39 – Excise tax on tobacco products
Sponsored by Rep. Ron Stephens (R-Garden City), HB 39 proposes to increase the excise tax on tobacco products with respect to cigarettes and loose or smokeless tobacco. GAFP endorses this bill
February 9, 2009
Report 1 - January 16, 2009
The First Session of the 150th Georgia General Assembly convened Monday, January 12, 2009 for the 40-day legislative session. The legislature met for the entire week using up the first five (of 40) days of the session. The legislature will be in recess until Monday, January 26, 2009. The House and Senate Appropriations Committees will hold joint hearings next week on the proposed FY09 supplemental appropriations act and the FY10 budget.
GAFP Legislative Priorities for 2009
The Executive Committee of the GAFP approved the Legislative Committee's requested legislative priorities for the 2009 session. This session is expected to be focused on state budgetary cuts due to falling state revenues and the current economic slowdown. The following was approved:
- Protect Medicaid and work with the Access Coalition to insure no additional provider cuts.
- Oppose direct billing for pathology service
- Support increasing the tobacco tax up to $1.00 a pack (House Bill 39)
- Support Requiring the Use of Seatbelts in Pickup Trucks
- Support legislation to require retail health clinics to limit the number of nurse practitioners that one physician can supervise; and require the clinics to post and publicize who the supervising physician is at each location and on their follow up referral forms to the patient's personal physician
- Support legislation to form a study committee on the Patient Centered Medical Home
- Support Removal of Prior Authorization for RX drugs
State of the State: Budget
During his State of the State address Wednesday, Governor Perdue announced his $19.2 billion Amended FY09 and $20.2 billion proposed FY10 budget. The Governor also asked lawmakers for an average 10 percent spending cuts throughout state government in response to the state's $2 billion deficit. Governor Perdue also proposes using $50 million in reserves this year and $408 million next year.
CUTS
* Hospitals & Health Insurance Plans: 1.6 percent fee on hospital revenues and health insurance plans to fill the state's $208 million hole in Medicaid.
* Tax Relief Grants would be eliminated. The loss of the grants could add $200 to $300 to homeowners' tax bills.
* State employees and teachers: No raises. Also, funding for school nurses and supplements to teachers who received national board certification would be eliminated.
* Public schools: Basic funding for k-12 schools would be cut $185.8 million this year and $197 million in fiscal 2010.
* DCH Grants: Defer $500,000 for the Southeastern Firefighter's Burn Foundation.
* Colleges and universities: Basic instruction funding would be cut by $176 million this year.
* Juvenile Justice: Closure of two programs.
* Prisons: Four state prison closures and elimination of the 2009 private prison Consumer Price Index (CPI) adjustment.
GAINS
* Trauma Network: $60 million
* Lawmakers: $6 million for pet projects remains in the budget.
* Construction industry: Would receive $1.2 billion in state borrowing for new schools, college buildings and other facilities. Governor Perdue projects 20,000 jobs would be created.
* Prisons: $11.7 million for the annualized cost of 75- private prison beds.
* Physician Payment Reimbursements: Aged, Blind and Disabled Medicaid ($4,542,253), Low-Income Medicaid ($8,808,522), PeachCare ($305,777).
User Fee - Hospital and Insurer Tax
A 1.6 percent fee on hospitals and health insurance plans "to fill the hole in Medicaid." But Kirk McGhee, Executive Director of the Georgia Health Plan Association warned in a recent commentary on the tax: "For health plans, costs for virtually every component of care rise dramatically every year. Like any other business facing a steep tax hike, health plans have no choice but to share some of the costs of new taxes with customers and suppliers."
New federal law going into effect later this year would require the state to charge private insurance companies the same fee it charges the HMOs that serve the state's Medicaid and PeachCare for Kids populations. Georgia charges its Medicaid HMOs a 5.5 percent fee on revenues. The state leverages the money from those fees to qualify for a federal match.
Rather than lose the federal match, making the Medicaid situation that much worse, Perdue opted to extend a 1.6 percent fee to hospitals and health insurance plans and resurrect the "super-speeder" idea, which would impose a fine of $200 on those found guilty of driving more than 15 mph over the speed limit. A similar plan failed in the final days of the 2008 legislative session.
GAFP Adds Strength in Advocacy Arena
To support its strategic plan to become more involved on the legislative and advocacy arena, the Georgia Academy has hired Piedmont Public Affairs (PPA) to serve as the Academy's full time contract lobbyists. Executive Vice President, Fay Brown, will also continue to lobby on behalf of the GAFP.
Chuck McMullen, who is the managing partner for PPA, will be the lead contact although all of the partners will work together to support the Academy's legislative objectives. Chuck McMullen served as Chief of Staff to Georgia's first Republican Senate Majority Leader, U.S. Representative Tom Price, MD (GA-06). McMullen also served as Chief of Staff to the Senate Republican Caucus.
McMullen is an Executive Committee Member of the Georgia Chamber of Commerce Government Affairs Council and serves on the Advisory Council of the Georgia Commission on the Holocaust. Chuck resides in Atlanta with his wife and two daughters.
January 19, 2009