State Legislative News

GAFP Workforce

Report 7 – March 17, 2008
The 149th Georgia General Assembly has utilized 31 of their 40 legislative days. They are scheduled to be in session March 18-20 and March 27th (Day 35).

Success! HB 342 – Direct Billing for Pathology Services Does Not Pass
Thanks to those of you who helped make between 800-1,000 phone calls earlier in the week, House Bill 342 did not make it on to the House calendar to be heard prior to the 30th Day .

HB 342 would give the pathologists a monopoly on pathology service codes and for those who bill for pathology service codes could lose their medical license. Having reached Crossover Day (Day 30) this bill is ostensibly dead for the year. However, we will continue to monitor bills that did successfully cross over to one chamber to make sure that the pathology language does not get amended onto another bill related to insurance billing.

Review of Legislative Priorities – Where Do We Stand After Crossover?

1. Increasing the state funding for family medicine residents’ salary capitation.
GAFP is still awaiting the House version of the Fiscal Year 2009 budget. However, legislative leaders have been supportive of increasing the current capitation rate from $19,000 up to $22,000 per resident. GAFP President, Dr. Bruce LeClair, has personally met with all of the House and Senate members who serve on the Appropriations Subcommittee on the Medicaid Budget.

The Governor has decreased the state’s expected revenues for the year, and asked the budgeteers to revise both the 2008 Supplemental budget and the Fiscal Year 2009 budget. We hope to hear something positive this week on the House budget.

2, Increasing Medicaid reimbursement for physicians
The Governor’s new revenue projections also affect increases in Medicaid for physicians. He has already asked the House leadership to reduce nursing home increases. However, he has not mentioned the need to withdraw his support of increasing both physicians and hospital payments. GAFP member, Dr. Wayne Hodges, was quoted in an article published in the Augusta Chronicle over the weekend emphasizing the need for higher Medicaid payments.

3. Oppose Direct Billing for Anatomical Pathology – House Bill 342 – see above

4. House Bill 367 – now called - Generic drugs; health insurance coverage
This bill has been drastically altered and is no longer a bill that will allow a pharmacist to change a physician's prescription. The current bill language will allow a pharmacist to fill the prescription with a 10 day supply (if not compliant with the formulary) to allow time for the physician to be contacted. This bill has passed the House and will now head to the Senate. The GAFP Legislative Committee has recommended to the Executive Committee to now support this bill with a request for leadership and staff to continue to work with the Georgia Pharmacy Association and the bill’s sponsor on additional clarifying language.

5. Support Medicaid Managed Care Reform Legislation - House Bill 1234
The GAFP Board has endorsed House Bill 1234 sponsored by Chairman Mickey Channell (R-Greensboro). It passed 165-1 on Cross Over Day. It now resides in the Senate Government Oversight Committee chaired by Senator Ronnie Chance of Tyrone.

6. Support a Standardized DNR (Physician Order for Life Sustaining Treatment) Form
This bill did not get finalized before Day 30. Senator Don Thomas, MD has agreed to work with us over the summer on legislation for 2009.

7. Support Requiring the Use of Seatbelts in Pickup Trucks – Senate Bill 86
This bill has passed in the Senate and is pending in the House Agriculture Committee. It is not expected out this session.

8. Support of Increasing the Tobacco Tax
The GAFP added on an additional legislative priority which is support of House Bill 1197. HB 1197 will increase the tobacco tax on cigarettes from $0.37 to $1.37. This bill died in committee.

9. Support of Senate Bill 338, Removal of Prior Authorization Bill
State Senator Jack Murphy has introduced a bill that would remove any prior authorization for a drug prescription. GAFP leadership has met with Senator Murphy to pledge our support to his bill. This bill died in committee.

March 20, 2008

Report 6 – March 7, 2008
The GAFP sends weekly updates during the Georgia legislative session. The 149th Georgia General Assembly has utilized 29 of their 40 legislative days. They are scheduled to be in session March 11-13. The 30th day (Tuesday, March 11) is the last day for bills to cross over from one chamber to the next to receive consideration this year.

Urgent – Contact Your State Representative on House Bill 342

HB 342 – Direct Billing for Pathology Services
We have heard that House Bill 342 will make it on to the House floor for consideration on Tuesday, March 11th. March 11th is the last day that this bill can be heard and have a chance to pass through the Senate before the end of the session.

It is vital that you take the time to call your state representative before Tuesday encouraging them to vote against House Bill 342. If passed, this will affect every family physicians practice throughout the state.

If you don’t know how to reach your state legislator do the following:
Go to this AAFP website http://capitol.aafp.org/
Plug in your zip code
Click on “state” which will take you to contact information for your state representative
Email them over the weekend
Call them on Monday and Tuesday.

What to say:
House Bill 342 is a bad bill.
It will allow pathologists to “own” a set of codes for billing purposes.
The pathologists have given no examples of over-billing in Georgia despite repeated requests.
This legislation will not lower the cost of healthcare.
It will outlaw the ability of a family physician to offer discounted billing for pathology services to self-pay or no-pay patients.
If passed, a physician could lose their license to practice medicine if they bill a patient for a pathology service.
This is a national push by the College of American Pathologists and will do nothing to improve healthcare – or the cost of healthcare – in Georgia.
Groups who also oppose this bill include: Medical Association of Georgia, American Academy of Dermatology, Georgia OBGyn Society, GA Chapter of the American College of Physicians, Georgia Society of Dermatologists, Georgia Medical Group Management Association

March 20, 2008

Report 5 - March 3, 2008
The GAFP sends weekly updates during the Georgia legislative session. The 149th Georgia General Assembly has utilized 26 of their 40 legislative days. They are scheduled to be in session this week on Tuesday, March 4th but have not come to agreement for the rest of the week. The 30th day of the legislative session as it is the last day for bills to cross over from one chamber to the next to receive consideration this year. All bills that have not crossed over on the 30th day will effectively be dead until the following year.

HB 342 - Direct Billing for Pathology Services Passes - Action Requested of Membership
One of our top priorities is to oppose House Bill 342, Direct Billing for Pathology Services. It is important to keep this bill in the Rules Committee until the 30th Cross Over Day (expected next week). Please take a moment and contact some of the leaders who serve on the House Rules Committee and let them know why we oppose this bill. We oppose this bill because:

This bill will increase costs to patients and decrease access to care in Georgia.
- Pathologists across Georgia currently charge more for many of these tests than the primary care physicians.
- The pathologists have given no documented examples of over-billing in Georgia despite repeated requests for the last three years.
- OBGyns in Georgia demonstrated that most give discounts to uninsured patients - not "markups". Pathologists do not give self-pay patient discounts.

Passage of this bill will create a monopoly for Pathologists.
- Decreasing competition in health care is inconsistent with the American Medical Association's position: "The AMA strongly supports and encourages competition as a means of promoting high-quality, cost-effective health care."
- Pathologists are now paid for every test they process. This legislation will increase what they are paid at the expense of other physicians and uninsured patients.
- This legislation does not lower the cost of healthcare.

Insurance companies currently pay a fixed fee for laboratory services regardless of who bills eliminating any possibility of overcharges.
- Pathologists selectively point to outdated Medicare (1984 and older) and AMA (1974) guidelines which were established before fixed reimbursement was in place. These are irrelevant to current billing policies in Georgia.

This legislation will prevent OBGyns, Family Physicians, Dermatologists and other physicians from receiving compensation for services they perform associated with lab procedures. For each test the doctor must:

Obtain and prepare the specimen, Maintain and update the patient's record, Send the test to the lab and track the results, Review and interpret the results from the lab, Process and file results within the office, Follow patients for all abnormal results, Order and stock lab supplies

Help patients with billing problems, Notify the patient of all results (as required by state law)

Medical Groups Opposing HB 342:
Georgia Academy of Family Physicians, Medical Association of Georgia, American Academy of Dermatology, Georgia OBGyn Society, GA Chapter of the American College of Physicians, Georgia Society of Dermatologists, Georgia Medical Group Management Association

Rules Chairman Earl Earhardt
HM-1 State Capitol
Atlanta, GA 30334
404.656.5141
404-463-2600 - Fax

House Majority Whip - Representative Barry Fleming
415 State Capitol
Atlanta, GA 30334
404.656.5024
404-657-8278 - Fax

House Majority Leader - Representative Jerry Keen
338 State Capitol
Atlanta, GA 30334
404.656.5052

House Speaker Pro Tempore - Representative Mark Burkhalter
340 State Capitol
Atlanta, GA 30334
404.656.5072
404-657-0498 - Fax

GAFP Supports Medicaid Managed Care Reform Bill - House Bill 1234
Medicaid Managed Care reform is one of the GAFP's top legislative priorities. House Bill 1234 is House Appropriations on Healthcare Chairman Mickey Channell's attempt at solving some of the more prominent problems with the current system. The bill includes the following:

Mandating payment of the Care Management Organizations (CMO) for emergency room visits at the non-contracted rate to hospitals that do not have a contract with a specific CMO.
Mandating that the CMO's fall under the authority of the Department of Insurance and they must comply with current regulations that private insurers are currently required to adhere to.
Outlawing the ability of the CMO's to offer all-product clause contracts with providers.
Mandating that a newborn infant is enrolled in the same plan as the mother.
Allowing for arbitration over denial of claims.
If the CMO denied payment incorrectly, payment will include 18 percent interest.
CMO's must update their patient rolls electronically at least monthly.
CMO's must pay for patients if they go off their plan within 78 hours of patient receiving healthcare.

This bill is currently in the House Insurance Committee. The GAFP will vigorously support this bill.

March 10, 2008

Report 4 – February 25, 2008
The GAFP sends weekly updates during the Georgia legislative session. The 149th Georgia General Assembly has utilized 22 of their 40 legislative days. They are scheduled to be in session this week from February 26th through February 29th and reconvening on Tuesday, March 4.

Budget – Action Requested by GAFP Members
On Tuesday, February 19th the House Health Sub-committee on Appropriations held hearings on the FY 09 Medicaid (Dept. of Community Health) budget which contains the proposed increase in the Medicaid physician reimbursement rate to 88.5 percent of the 2007 RBRVS. This is the first increase in physician payment in the Medicaid program that's been proposed by the Governor in eight years.

Board member Mitzi Rubin, MD of Kennesaw testified on behalf of the Chapter and on the importance of reasonable Medicaid reimbursement rates as well as the need for increases to the
capitation rates for the Family Medicine Residency programs.

Please take a moment and review the key legislators on the budget below. If any of them represent your district, please call or email them and ask that they include an increase in the family medicine residency capitation rate.

The $3,000 increase in the Family Medicine resident capitation rate (currently at $19,000 per resident) has been incrementally decreased over the last several years. This increase would be an investment in keeping a strong primary care physician network throughout the state. Research has shown that graduates tend to establish their practice within a 50-mile radius of where they completed their training.

The Georgia family medicine residency programs are held accountable to the funding as they must have - at a minimum - a 50 percent retention rate of trained family physicians to stay in Georgia or must return the capitation funds.

The federal government match the resident’s capitation funding through Medicaid and gives the state approximately $1.60 for every $1 in state capitation.

The request is a $3,000 increase for each of the 202 positions which would increase the capitation rate up to $22,000 per family medicine resident and would be a fiscal note of $606,000. This funding would go through the Georgia Board for Physician Workforce which is an attached agency of the Department of Community Health.

HOUSE APPROPRIATIONS SUB-COMMITTEE ON HEALTH

Mickey Channell, Greensboro mickey.channell@house.ga.gov 404-656-7856	Donna Sheldon, Dacula 404-656-8086 donna.sheldon@house.ga.gov
Mark Burkhalter, Alpharetta 404- 656-0213 mburkhalter@legis.state.ga.us	Carolyn Hugley, Columbus 404-656-5058 carolynl.hugley@house.ga.gov
Pat Gardner, Atlanta 404-656-0305 pat@patgardner.org	Chuck Sims, Ambrose 404-656-0287 chuck.sims@house.ga.gov
Larry O’Neal, Warner Robins 404-651-7737 larry.oneal@house.ga.gov	Richard Royal, Camilla richard.royal@house.ga.gov 404-656-5105
Penny Houston, Nashville penny.houston@house.ga.gov 404-656-0202	Ron Stephens, Savannah 404.656.0202 quickrxdrg@aol.com
Jay Shaw, Lakeland 404-656-0152 jay.shaw@house.ga.gov	Butch Parrish, Statesboro 404.656.0298 butch.parrish@house.ga.gov

HB 342 – Direct Billing for Pathology Services Passes out of House Insurance Committee
One of our top priorities is to oppose House Bill 342, Direct Billing for Pathology Services. Unfortunately, it passed out of the House Insurance Committee on a vote of 8-2 with two members opting not to vote. Our thanks go to Dr. Georgia Shannon of Columbus who came to the State Capitol with less than 12 hours of notice to testify against the bill. This bill is now in the House Rules Committee chaired by Representative Earl Earhardt. The GAFP will continue to ask the Rules Committee leadership to not put this bad piece of legislation on to the House floor for a vote.

Family Medicine Week at the Capitol’s Medical Aid Station
Thank you to Drs. Mitzi Rubin, Mitch Cook, George Shannon and D. Ann Travis Honeycutt who all agreed to take a day off of treating their patients to be the “Doctor of the Day” at the Medical Aid Station. Repeatedly we heard, “Oh good, a family physician - I only want to come down here when there's a REAL doctor on duty!!!"

February 28, 2008

Report 3 – February 15, 2008

The 149th Georgia General Assembly has utilized 18 of their 40 legislative days.

Primary Care Physicians Day at the Capitol a Success
Speaker Glenn Richardson was the keynote guest at our Day at the Capitol on February 7th. He talked about the importance of a Trauma Network and increasing Medicaid reimbursement. During the question and answer session, he indicated his opposition to any therapeutic substitution bill that would allow a pharmacist to change a prescription written by a physician.

Close to 100 family physicians, pediatricians and general internists were present to hear these remarks and meet with their legislators. State Senator Don Thomas, MD, a GAFP member and Senate Health Committee Chairman asked for continued support on his mandatory seatbelt bill in pick up trucks (currently stuck in the House Agriculture Committee).

GAFP Leadership at the State Capitol
GAFP President, Dr. Bruce LeClair, met with several legislators on February 6th and 13th. He met with State Representatives Carolyn Hugley (D-Columbus) and Pat Gardner (D-Atlanta), both members of the House Subcommittee on Health Appropriations to discuss increasing Medicaid reimbursement and the family medicine residency capitation rates.

On February 13th, Dr. LeClair met with State Representative Kathy Ashe (D-Atlanta) who in the Democratic response to the Governor’s State of the State had mentioned the need for “every family to have a family physician”. Although there is no current Democratic plan at the state level to encourage that activity, she hopes to work on increasing health insurance to more Georgians over the next several years. State Representative Joe Wilkinson (R-Atlanta) stated his long-standing support of family medicine. He serves on both the House Health and Insurance Committees. He and Dr. LeClair were able to discuss the Academy’s opposition to the Therapeutic Substitution Bill and the Direct Billing to Pathology Bill.

Update on Legislative Priorities
1. Increasing the state funding for family medicine residents’ salary capitation.
Background: The Georgia Academy is meeting with Appropriations leadership seeking the family medicine capitation rate be included in the House version of the FY ’09 budget, which would increase the current rate of $19,300 to $22,000.

2, Increasing Medicaid reimbursement for physicians
Background: The Georgia Academy of Family Physicians supports Governor Perdue’s requested Medicaid increase physician payment. The increase will include Medicaid fee-for-service, Medicaid Managed Care and PeachCare to 88.5 percent of 2007 Medicare RBRVS (Resource-Based Relative Value Scale).

3. Oppose Direct Billing for Anatomical Pathology – House Bill 342
Background: HB 342 would interfere with long established contractual relationships between family physicians and pathologists who perform laboratory services. Family physicians often contract with a pathologist to read all anatomical slides for all their patients. They pay the pathologist an agreed amount for each study ordered. The family physician collects the pathology sample, submits one bill for the entire service, and informs the patient of the pathology results. This bill is in the House Insurance Committee.

4. Oppose Therapeutic Substitution – House Bill 367
Background: This bill permits pharmacists to substitute prescribed drugs without physician’s direction. HB 367 is currently in the House Insurance Committee although there is discussion of a new substitute bill being proposed by the bill sponsor.

5. Support a Standardized DNR (Physician Order for Life Sustaining Treatment) Form
Background: No legislation currently pending, however, State Senator Don Thomas, MD has indicated support to sponsor legislation. GAFP is working with Senator Thomas’ aide and Legislative Council to have a draft bill for Senator Thomas’ review.

6. Support Requiring the Use of Seatbelts in Pickup Trucks – Senate Bill 86
Background: Passed in the State Senate in 2007. Currently it is pending in the House Agriculture Committee. This bill, sponsored by Senator Don Thomas, MD, GAFP member, will require seat belts to be buckled in pickup trucks. Georgia is the only state that does not have this law.

7. Support Medicaid Managed Care Reform Legislation
Background: No legislation currently pending. However, State Representative Mickey Channell (R-Greensboro) has indicated that he is currently drafting legislation which should be available for review next week.

Tobacco Tax Increase Bill Introduced
Georgia’s tobacco tax, which was last raised five years ago, is due for another increase, according to two House members who are proposing a $1 per pack tax hike on the sale of cigarettes. Rep. Ron Stephens (R-Garden City) and Rep. Virgil Fludd (D-Fayetteville) have introduced House Bill 1197, which would raise the tax from the current 37 cents a pack to $1.37 a pack.

Report 2 – February 1, 2008
The 149th Georgia General Assembly convened Monday, January 28, 2008 for the 40-day legislative session after taking the week before off for the MLK Holiday and budget hearings. The legislature was in session through Thursday, January 31st having utilized 9 of their 40 legislative days.

Speaker Glenn Richardson Confirms as Keynote Speaker
Speaker Glenn Richardson has confirmed as the Keynote Speaker at the Georgia Academy’s Day at the Capitol to be held next Thursday, February 7th. He will speak at 9:00 am during breakfast to family physicians and our other primary care physician colleagues – general internists and pediatricians. If you are able to come to the Capitol next Thursday, please contact the GAFP office and speak with either Cassandra Harris or Fay Brown (404-321-7445).

Therapeutic Substitution
One of the Georgia Academy’s top legislative priorities is to continue to oppose House Bill 367 the Therapeutic Substitution bill that would allow pharmacists to substitute a physician’s prescription across classes. The pharmacists would have 72 hours to inform the physician of the change. Last year, Dr. Rick Wherry, Legislative Co-Chair, met with the bill sponsor Representative Buddy Carter (a pharmacist). The Georgia Academy has asked the Georgia Pharmacy Association for different language that might relieve the hassle factor but not at the expense of patient safety.

The bill is currently in the House Insurance Committee which is chaired by State Representative Tom Knox (R-Cumming). The Georgia Pharmacists Association has been working with the bill sponsor, Rep. Carter, on a substitute version of the bill. The GAFP has not reviewed the proposed substitute but will continue to monitor this situation closely. The pharmaceutical company continues to also oppose this bill.

GAFP Leadership at the State Capitol
GAFP President, Dr. Bruce LeClair, met with several legislators on Wednesday, January 27th. House Health and Human Services Chairman Sharon Cooper (R-Marietta) told Dr. LeClair that she was introducing a bill focusing on lead screening for children. Senator Ed Tarver (D-Augusta) and Dr. LeClair had a lively discussion on the importance of increasing family medicine residency capitation rates. Senator Tarver is very involved in discussions on Georgia physician workforce.

Governor Pushes a High-Deductible Health Policy
Representative Mickey Channell (R-Greensboro) and Senator Judson Hill (R-Marietta) will be introducing legislation, backed by the Governor, which will promote the sale of health savings accounts and high-deductible health plans. A news release from Perdue’s office estimated that offering these forms of health insurance would result in 500,000 more people becoming insured (there are about 1.7 million Georgians without health insurance).

Report 1 – January 22, 2008
The Second Session of the 149th Georgia General Assembly convened Monday, January 14, 2008 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 28, 2008. The House and Senate Appropriations Committees will hold joint hearings next week on the proposed FY08 supplemental appropriations act and the FY09 budget.

GAFP Legislative Priorities for 2008
The Executive Committee of the GAFP approved the Legislative Committee’s requested legislative priorities for the 2008 session. This session is expected to be a bit contentious so the Legislative Committee recommended keeping a narrow focus for 2008. The following was approved:

Increasing the salary capitation for family medicine residents
Increasing Medicaid reimbursement for physicians
Oppose Direct Billing for Anatomical Pathology
Oppose Therapeutic Substitution
Support POLST (Physician Order for Life Sustaining Treatment) legislation (Congress of Delegates Resolution)
Support Requiring Seatbelts in Pickup Trucks
Support Medicaid Managed Care (CMO) Legislation

Support of Grady Hospital
As reported in last months Briefly Stated, the GAFP Executive Committee approved a statement of support for Grady specifically for its training programs and neighborhood clinics. To review the entire statement go online to the January newsletter or contact the GAFP office 404-321-7445.

Governor’s Budget – Good News
The Governor approved DCH Commissioner Rhonda Medows, MD request to increase physician payment for Medicaid FFS, Medicaid Managed Care and PeachCare up to 88.5 percent of 2007 Medicare RBRVS. He also included a 2.5 percent increase for Healthcheck and a 2.5 percent increase in global maternity delivery rates by 2.5 percent.

Unfortunately, the Governor did not increase capitation rates for family medicine residents’ salaries, one of the GAFP top legislative priorities.

Daily Dose
If you would like to receive daily emails of political articles printed in local newsletters throughout Georgia, email gafp@gafp.org and request the Daily Dose. This is a service provided by our legislative consultants, Piedmont Public Affairs.

2009 State Budget
Governor Sonny Perdue unveiled his fiscal year 2009 budget proposal to the General Assembly Wednesday during his State of State Address. Perdue proposed a $21.4 billion budget for the upcoming fiscal year, a roughly $1 billion increase over the current year's spending plan. The budget proposal incorporates nearly $1.2 billion in state bonds to pay for the construction of new highways and other state facilities.

Some of the other items in the governor's budget proposal:

$6.4 million in Lottery funds to add 79,000 slots to the pre-kindergarten program.
$14.25 million to launch a program aimed at reducing truancy by public school students.
$14.5 million to expand the high school graduation coach program.
$6.5 million in additional funds for Georgia Gwinnett College, the state's newest public college.
$7.1 million to expand the Medical College of Georgia course offerings to regional campuses.
3% consumer price index-related increase for DJJ community non-secure commitment programs
2.5% consumer price index-related increase in the per diem rate for the state’s three contracted private prisons.
Provide 12 months of funding for capacity maximized additions at private prison facilities adding 64 beds.
Provide one month operating expenses for construction expansions at private prisons.
Provide Medicaid and Peachcare physician fee rate increases to 88.5% of the 2007 RBRVS.
Increase Healthcheck reimbursement rate by 2.5 %.
Northwest Campus Infrastructure constructions funds for the University of West Georgia.

February 19, 2008

Q&A with Georgia Insurance Commissioner John Oxendine
Georgia has a prompt pay standard that applies to health insurance and to the State Merit System Health Benefits Plan. The citation for the law is O.C.G.A. Section 33-24-59.5. This law is not intended for and does not apply to capitated contracts under managed care. Within this law, insurers have 15 working days after receipt of a claim to pay or deny health insurance benefits. If the insurer cannot pay a claim because it does not have the information necessary within the claim, it has to respond to the claimant with a letter or notice stating the reasons the insurer cannot pay all or part of the claim. Insurers must pay the parts of any claims that are not in dispute or that are not lacking documentation. Insurers must give the person filing the claim a written itemization of any documents or other information necessary to process the claim or parts not being paid within that 15-working-day performance standard.

Q: Does this law apply to all types of health coverage in Georgia?
A: No. State laws like this one apply in many health coverage situations, but only within the context that the Georgia Insurance Code details in O.C.G.A. Section 33-24-59.5. This law does not apply to employer self-funded ERISA health benefits plans.

Q: When insurers fail to meet the prompt payment of claims deadline, what is the interest penalty assessed?
A: The law requires insurers failing to meet this payment deadline to pay interest calculated at the rate of 18 percent per annum.

Q: What should I add to the language in my claims paperwork or claims correspondence sent to insurers that lets them know I am aware of this Georgia law?
A: You may want to consider placing a reference in your correspondence reflecting O.C.G.A. Section 33-24-59.5, which contains these prompt payment of claims standards and penalties. If you choose to summarize portions of this law in any standard claims correspondence you utilize, you should qualify the reference to this law so that it is understood that you realize this Georgia law may not apply in all cases in which you have provided covered health benefits, such as in ERISA self-funded employer group health benefits plans.

Q: Will the Office of the Commissioner of Insurance help me with problems or patterns of slow health claims payment issues I have with particular insurers?
A: Yes. We can help medical providers and consumers that have been treated under coverage to which this law applies. Please contact our Managed Care Section of the Life and Health Division if it is a provider issue at (404) 657-6041, or, if you have an insured who is having an issue, refer them to the Consumer Services Division at (404) 656-2070. Our toll-free number is (800) 656-2298 for consumers out of the local Atlanta area in Georgia. We have specific forms that we can send you to help us work with you on batches of claims from a particular insurer that you or the provider is having issues with.

Q: What is the history of this law?
A: This law, or versions of it, has existed in Georgia individual and group health insurance laws since the early 1980s. At that time, many insurer and physician provider office practices were different, but consumers needed protection in getting claims settled in a timely manner. Separate group health and individual health insurance code citations applied. In many, if not most, cases in the 1980s, consumers paid their physician providers at the time of service, and many consumers filed their own claims to be reimbursed directly from the insurer. The earlier versions of this law reflected those older business practices. Today, virtually all health benefits are handled by assignment of coverage to the physician provider, so it is the physicians who, because their covered patients have assigned health insurance benefits to them, end up having payment of claims delays or documentation disputes with insurers.

Q: You said that this law doesn’t apply to capitated contracts. Why is that?
A: Capitation is a specific type of business relationship between a managed care insurer and some classes of health care providers. Capitation usually involves primary care physicians or others with predictable patterns of delivery of care to a covered population within an HMO. In those cases, there are specific medical provider contracts that pay a provider a set amount each month for each covered patient, regardless of incidence of care or treatment. Providers that are under capitated arrangements do not submit claims for specific care for patients. The law regarding prompt payment of claims does not apply in those situations.

Q: When insurers or the State Merit System Health Benefit Plan uses a claims administrator, can the insurer say that it did not receive the claim, so it does not have to follow this law and pay claims on time?
A: No. The law recognizes that administrators may be part of an insurer’s operations and says receipt of a claim by the administrator is the same as receipt by the insurer. The prompt payment of claims “clock” works just the same as if the insurer received claims directly.

Q: Does the prompt payment of claim law define or set any standard for a “clean claim”?
A: No. There is no specific definition of a clean claim in this citation or in other Georgia insurance or health laws. We believe this is due, at least in part, to the complex nature of medical coding within the context of the specific use of standardized claims forms that insurers routinely accept.

Q: Does the Office of the Commissioner have any regular activity in these prompt payment of claims issues and areas?
A: Yes. The Office of the Commissioner of Insurance has established a system of regular reporting and review of the claims’ prompt-payment performance for the state’s major health insurance carriers. These carriers report to our office on a quarterly basis. We follow these performance reports closely because they represent a very important regulatory compliance tool through which our office dedicates examination resources and attention. Insurers routinely achieve relatively high performance percentage-of-claims standards on their prompt payment of claims processing. When the performance of an insurer is unsatisfactory, we may heighten our regulatory attention on that insurer, examine it further and perhaps even establish fines for patterns of slow claims-paying performance. The Office of the Commissioner of Insurance is working very hard to keep all the players compliant and protect the interests of consumers and providers who have health coverage in Georgia.

December 19, 2007

We Need Your Voice at the Capitol Feb. 7
The GAFP needs your voice throughout the upcoming legislative session and especially Feb. 7 – Primary Care Physicians’ Day at the Capitol.

Family physicians, pediatricians and internists will storm the state Capitol, coming together to hear top legislators discuss key items of interest to primary care physicians, including Medicaid, the state budget, scope of practice and Medicaid managed care. No fee will be charged to attend the event, and the GAFP encourages all members, including residents and students, to participate.

GAFP staff members and your colleagues will help you contact your state representatives to discuss key topics that are vital to family medicine and to your patients, and a training session will prepare physicians who are unfamiliar with the political process.

Your voice is needed.

The Day at the Capitol program has been a free event since 2003. However, the GAFP requests that you preregister so we will have materials ready for you.

Primary Care Physicians’
Day at the Capitol

Return to: Georgia Academy of Family Physicians
3760 Lavista Rd, Ste. 100
Tucker, Ga. 30084
Phone: (404) 321-7445 Fax: (404) 321-7450

Registration type:

Practicing Physician Resident Student

Name__________________________________________

Address_________________________________________

E-mail__________________________________________

Phone _________________________________________

Fax____________________________________________

I’m bringing a guest

My guest’s name is______________________________________________

Fax this form to the GAFP office at (404) 321-7450
You will receive a confirmation.

December 19, 2007

Save the Date - February 7th - Day at the Capitol

Clear your calendar and plan on attending the Georgia Academy's Day at the Capitol on Thursday, February 7, 2008 in Atlanta. You will hear briefings by our elected officials and get up-to-the-minute reports on pending state legislation. There will also be an orientation on how to interact with your legislators and they will be invited to join you for both breakfast and lunch. Although this event is free for all GAFP members, a registration form will be sent to you in early December.

December 13, 2007

Georgia Academy Provides Media Training for State Legislators

On October 10th, a group of elected officials huddled uncomfortably around a television monitor watching an unauthorized videotape. They were nervous and apologetic about the contents. No, the content on the videotape isn't going to ruin their political career but it could hurt their chances for re-election.

The Georgia Academy sponsored a media training session for the Senate Democratic Caucus with national consultant Pat Clark who, at the beginning of the day, tapes a mock "Good Day Atlanta" program and asks the senators probing questions. "I ask questions that will lead them away from their message and show how easy it is for a reporter to take advantage of the unprepared," affirms Ms. Clark, a former AMA staffer.

This is the fourth time over the last three years that the Georgia Academy has offered this program to state officials. The Georgia Academy has hosted two programs open to all state legislators, one for the House Republican Freshmen and October's Democratic State Senate Caucus. State Senate Democratic Caucus Chairman, Senator David Adelman, was appreciative of this outreach and remarked that "The Georgia Academy is smart to offer this unique program to elected officials who should be taking advantage of learning techniques to help them reach out to their constituents."

December 13, 2007

GAFP Workforce

November 14, 2007

GAFP Will Produce Legislative Videos
The Georgia Academy of Family Physicians, in collaboration with the Texas Academy, is in the process of producing short videos about our work on health care reform and legislative advocacy at the state Capitol. The videos will contain interviews with family physician leaders and U.S. Rep. Tom Price, MD, and State Senate President Pro Tempore Eric Johnson.

GAFP members Wayne Hodges, MD; Beulette Hooks, MD; Alice House, MD; Bruce LeClair, MD; Susan Margletta, MD; Howard McMahan, MD; George Shannon, MD; Harry Strothers, MD; and Beverly Ann Townsend, MD; related their experiences of working with GAFP on the importance of family medicine in Georgia and explained why it is critically important for members to be involved and to advocate for their practice and their patients.

October 8, 2007

GAFP Supports Continued Funding for PeachCare
The Georgia Academy has signed on to a joint letter from the Department of Community Health Commissioner Rhonda Medows, MD and other Georgia healthcare provider organizations to the U.S. Congressional leadership and the Georgia Congressional Delegation to request continued funding for PeachCare or as it is nationally known SCHIP (State Children's Health Insurance Program). If Congress does not take action by September 30th, PeachCare will cease to exist and thousands of children will lose access to health care.

The Georgia Academy and Commissioner Medows are asking for continued funding so as not to disrupt the 280,000 Georgiachildren currently using PeachCare. We are also asking for a new federal formula to determine state allotments be updated to provide states, like Georgia, with the appropriate funding so that shortfalls do not occur. GAFP leadership will continue to closely monitor this situation.

September 10, 2007

Report of Medical Association Summit
On Saturday, July 21, the Medical Association of Georgia held a summit to discuss House Bill 342, a bill that would mandate direct billing for pathologists, circumnavigating the patients physician. The GAFP opposes this bill and has testified against it. It currently resides in a study committee with the House Insurance Committee.

Invited groups included the GAFP, Georgia Association of Pathology, the Georgia Society of OB Gyn, the Georgia Chapter of theAmerican College of Physicians and the Georgia Society of Dermatology. GAFP President Alice House, MD, Legislative Co Chair Rick Wherry, MD and Executive Director Fay Brown attended on our behalf.

Each group had an opportunity to present their side. The Georgia Association of Pathology opted not to make a presentation. Dr. House spoke on behalf of the Georgia Academy; some of her points were:

HB 342 would interfere with long established contractual relationships between family physicians and pathologists who perform laboratory services. Family physicians often contract with a pathologist to read all anatomical slides for all their patients. They pay the pathologist an agreed amount for each study ordered. The family physician collects the pathology sample, submits one bill for the entire service, and informs the patient of the pathology results.

This physician-to-physician collaboration ensures patients receive quality care that is timely and cost-effective, and provides convenient access to services. Pathologists enter into these agreements voluntarily and agree to a discounted fee because their overhead is significantly reduced by not having to support billing and collection functions.

The Summit lasted over six hours and there was much discussion from all sides.

In June, the Georgia Academy wrote a letter to the Georgia Association of Pathology seeking examples of the egregious billing which they claim is the genesis for this legislation. GAP did respond but continues to refuse to show examples of incorrect pathology billing.

We will continue to oppose this legislation and be open to working with our pathology colleagues on alternative solutions.

September 10, 2007

Letter from Stuart T. Brown, M.D. about the Georgia HIV Pregnancy Screening Act of 2007 click here.

July 3, 2007

Wrap Up Report – May 15, 2007

The Georgia General Assembly adjourned the First Session of the 2007-2008 sine die, Friday, April 20, 2007. Governor Sonny Perdue announced on May 8th that he will reverse his veto of the midyear state budget to avoid the need to call a special session of the Legislature. Instead, Perdue said he will line-item veto the disputed $142 million property tax rebate from the midyear budget and then sign the overall document, which will provide funds for state government to operate through the rest of the fiscal year that ends June 30.

The first of two sessions, this term is complete meaning all bills failing to receive a constitutional majority vote in both chambers is available for consideration during the 2008 General Assembly without having to be re-filed.

Budget Highlights:

Despite key budget leaders agreeing to the importance of increasing family medicine capitation rates, this line item did not get into the FY ’08 budget that would increase residency capitation rates from $19,000 to $23,000. This will continue to be a priority of the Georgia Academy.

$300,000 to the Department of Community Health to implement a Regional Health Information Technology pilot partnership with the Medical College of Georgia to improve the quality and efficiency of healthcare.

The budget conference committee failed to adopt a line-item mandating the Georgia Department of Community Health to implement a managed care program for the Aged, Blind and Disabled Medicaid population in the Atlanta region to become effective January 1, 2008.

$245,000 to increase local assistance funds to the City of Augusta for the Southeastern Firefighters Burn Foundation at the Joseph M. Still Burn Center.

$350,000 for Department of Human Resources to implement a pilot program to promote smoking cessation by use of appropriate prescription smoking cessation medication along with counseling.

Healthcare – Legislative Activity

Certificate of Need (CON) Legislation
Every attempt to revise the state's certificate of need law that regulates the construction of healthcare facilities and offer certain kinds of medical services fell short.

SB 17 – Optometrists Prescriptive Authority
Status: Adopted by the House and the Senate; awaits Governor’s signature.
The bill gives optometrist’s prescriptive authority for drugs to treat eye diseases and ocular conditions. The Georgia Academy opposed this bill.

SB 148 – Life Sciences Research
Status: Adopted by the House and the Senate; awaits Governor’s signature.
The bill will promote stem cell research that doesn't involve the use of embryonic tissue. The bill also authorizes a network of medical facilities that collect and store placentas, umbilical cords, and amniotic fluids donated by women who have given birth. Stem cells derived from these materials would be used in medical research. The Georgia Academy supported this bill.

SB 155 – Mandating HPV Vaccinations
Status: Passed Senate Health Committee, pending in Senate Rules Committee.
The bill will require all 6th grade girls to get the HPV vaccine prior to 6th grade entry, effective July 2008.

SB 286 - Medical Liability
Status: Available for action in a Senate committee next year.
The bill would make it less difficult to pursue malpractice lawsuits against emergency room doctors by lowering the standard of proof required. Currently, emergency room doctors are immune from civil liability unless "gross negligence" is involved. SB 286 would eliminate the "gross negligence" requirement and require a patient to prove that a "provider failed to meet the applicable standard of care."

HB 127 – Anti-Epileptic Drugs
Status: Available for consideration by Senate committee next year.
The bill would prohibit pharmacists from interchanging an anti-epileptic drug or formulation of an anti-epileptic drug without prior notification and informed consent from the doctor and patient.

HB 147 – Abortion
Status: Adopted by the House and the Senate; awaits Governor’s signature.
The Legislature passed HB 147, which would require that women seeking an abortion be given the opportunity to view the results of a sonogram or ultrasound scan of the fetus.

HB 342 – Direct Billing for Pathologists
Status: Available for consideration by House committee next year.
The bill would statutorily require direct billing of anatomic pathology services. The Georgia Academy opposes this bill.

HB 340 – PeachCare Eligibility
Status: Available for possible action next year.
The bill by Speaker Glenn Richardson lowered the income eligibility level for PeachCare, a change that would make about 22,000 children ineligible for the program's health insurance coverage. The Senate substituted its own version of the bill, but neither version received a final vote.

HR 350 - Joint Study Committee on State Health System
Status: Adopted by the House
The resolution creates a Joint Study Committee on the State Health System to review all aspects of healthcare delivery.

HB 429 – HIV Testing
Status: Adopted by the House and the Senate; awaits Governor’s signature.
The bill requires doctors to offer HIV tests to pregnant women and refer those infected with the disease to counseling and medical services.

Insurance – Legislative Activity

HB 28 – High Risk Pool
Status: Available for consideration by House committee next year.
Creates the Georgia Assignment Pool Underwriting Authority which will provide an alternative coverage mechanism for the availability of individual health insurance. The Georgia Chamber of Commerce opposes this bill because the funding mechanism to-date for similar proposals have only included raising taxes or imposing fees on businesses already providing health insurance to their employees.

HB 242 – High-Deductible Health Plan Exemption
Status: Adopted by the House and the Senate; awaits Governor’s signature.
The bill would give insurers an exemption from state premium taxes equal to 2.25 percent of the premiums collected from Georgia residents for high-deductible health plans sold or maintained in connection with a health savings account.

SB 73 – Continued Access to Care
Status: Available for consideration by House committee next year.
The bill ads hospitals to Georgia’s continuity of care laws; allows the Commissioner of Insurance to extend continuity period an additional 120 days; and allows all enrollees to continue their coverage after termination of a contract between plans and providers.

SB 102 – Chiropractors’ Scope of Practice
Status: Adopted by the House and the Senate; awaits Governor’s signature.
A compromise version of the bill will increase chiropractors’ scope of practice to include providing vitamins and dietary supplements among other things. The Georgia Academy opposed this bill. This bill that passed was extensively watered down with the most egregious expansions taken out (such as referrals for MRIs, lab tests and the ability to do health certificates.)

SB 109 – Prompt-Pay Requirements for TPAs
Status: Available for consideration by House committee next year.
The original bill as introduced and adopted by the Senate required third party administrators contracted by self-funded ERISA plans to comply with Georgia’s prompt-pay laws

SB 150 – Data Transparency
Status: Available for consideration by Senate committee next year.
The bill requires pharmacies to submit certain performance and cost data to the Department of Community Health and establishes a website to provide consumers with information on the cost and quality of health care in Georgia.

SB 151 – High Risk Pool
Status: Available for consideration by Senate committee next year.
The bill creates the Georgia Health Security Underwriting Authority to provide alternative mechanism coverage for the availability of individual health insurance.

SB 153 – Consumer Driven Health Insurance Plans
Status: Available for consideration by Senate committee next year.
The bill provides for the development of consumer driven health insurance plans by the Commissioner of Insurance; allows such plans to include wellness and health promotion programs; and to provide that such programs shall not be considered unfair trade practices.

SR 517 – Childhood Obesity Study Committee
Status: Read and adopted.
Establishes a Senate study committee to consider solutions to childhood obesity, including Type II diabetes.

Pharmacy Issues – Legislative Activity

SB 78 – Mail Order Drugs
Status: Available for consideration by Senate committee
The bill provides that the use of the mails or other common carriers to sell, distribute, and deliver a prescription drug directly to a patient under certain circumstances shall not be considered grounds for sanctioning the license of a pharmacist.

SB 205 – Pedigree Bill
Status: Adopted by Senate and House; awaits Governor’s signature.
The bill creates the "Prescription Medication Integrity Act to provide for pedigrees for prescription drugs to decrease drug “counterfeiting.”

SR 619 – Study Committee on Prescription Drugs
Status: Available for consideration by Senate committee next year.
The resolution creates the Senate Study Committee on Prescription Drugs

HB 180 – Prohibition of Prior Authorization for GA-based companies
Status: Available for consideration by House committee next year.
Provides that certain prescription drugs and other health care products sold by Georgia biotechnology, biopharmaceutical, or pharmaceutical companies shall not be subject to certain access restrictions or supplemental rebates for purposes of coverage under the state health benefit plan, medical assistance program, PeachCare for Kids, or any other health benefit plan or policy administered by or on behalf of the state.

HB 367 – Therapeutic Interchange
Status: Available for consideration by House committee next year.
The bill permits pharmacists to substitute prescribed drugs without physician’s direction. The Georgia Academy opposes this bill.

HB 454 – Prescription Drugs; Approximate Retail Price
Status: Available for consideration by House committee next year.
The bill requires every retail pharmacist shall include the approximate retail price of an outpatient prescription drug on the receipt for that prescription drug.

HB 455 Georgia Prescription Monitoring Program
Status: Available for consideration by House committee next year.
The bill creates the "Georgia Prescription Monitoring Program Act" to provide for the establishment of a program for the monitoring of prescribing and dispensing Schedule II, III, or IV controlled substances by the Georgia Drugs and Narcotics Agency.

HB 556 – Controlled Substances; Practitioner’s Name Printed
Status: Available for consideration by House committee next year.
The bill requires prescriptions for controlled substances and dangerous drugs to have the practitioner's name printed below the practitioner's signature on such prescriptions.

HB 798 – Pharmacy Consumer Protection and Transparency Act
Status: Available for consideration by House committee next year.
The bill creates the "Georgia Pharmacy Practice Act," to provide for registration of any person or entity acting as a pharmacy benefits manager; to provide requirements for registration; to provide for the review of contracts; to provide for a fidelity bond; to provide that a pharmacy benefits manager shall not intervene in the delivery of prescriptions; to provide for the dispensing of a substitute prescription drug; to provide that a pharmacy network provider shall be protected in the event of a dispute with a pharmacy benefits manager; to provide the duties of a pharmacy benefits manager; to provide for the dispensation of certain payments; to provide for the protection of certain information; to provide for audits; to provide for contracts; to provide for notification; to provide for penalties for violations; to provide for rules and regulations.

SR 650 - Urge DCH to increase efforts to address diabetes in GA
Status: Read and Adopted.
The resolution urges the Department of Community Health to increase efforts to address diabetes in Georgia, including factors such as body mass index.

Public Safety

SB 86 – Seatbelts in Pickup Trucks
Status: Passed the Senate, Available for consideration by House committee next year.
This bill, sponsored by Senator Don Thomas, MD, GAFP member, passed the Senate this year. It was the first time that a bill requiring seat belts to be buckled in pickup trucks had been passed by either the House or Senate during the years that this issue has been debated. The Georgia Academy supports this legislation.

June 5, 2007

Report 8 – April 4, 2007

Legislative Session
This legislature will be in recess April 2-9, 2007.

Crossover Day
Crossover Day is also known as the 30th day of the legislative session. If a piece of legislation has not been adopted by at least one chamber when the session passes this day, it cannot move forward to the other chamber for the remainder of the legislative session without waiving the rules. Although there was major action in both chambers on this day, some bills did not make it to the floor of either chamber for a vote.

Requested Action for all GAFP Members – Seatbelts in Pickup Trucks (SB 86)
Sponsored by Sen. Don Thomas, MD (R-Dalton), SB 86 requires the use of seatbelts in pickup trucks, just as they are now required in automobiles and SUVs. The Senate approved the measure on March 1 by a vote of 45 to 10. The bill has been assigned to the House Agriculture Committee but Senator Thomas has been told that there will be a hearing and a vote on the legislation. Please call members of the House Agriculture Committee and ask them to vote “yes” on Senate Bill 86. This is one of the Georgia Academy’s top legislative priorities this year.

Chairman Tom McCall (Elberton) - 404-656-5115
Vice Chair Terry England (Auburn) - 404-656-0183
Rep. Gene Maddox (Cairo) - 404-656-0152
Rep. Ellis Black (Valdosta) - 404-656-0287
Rep. Joe Burns (Newington) - 404-656-0213
Rep. Mack Crawford (Concord) - 404-656-0213
Rep. Winfred Dukes (Albany) - 404-656-0126
Rep. Carl Epps (LaGrange) - 404-656-7859
Rep. Penny Houston (Nashville) - 404-656-0202
Rep Lynmore James (Montezuma) - 404-656-0116
Rep. Kevin Levitas (Atlanta) - 404-656-0116
Rep. Dubose Porter (Dublin) - 404-656-5058
Rep. Jay Roberts (Ocilla) - 404-656-5025
Rep. Tony Sellier (Ft. Valley) - 404-656-0265
Rep. Chuck Sims (Ambrose) - 404-656-0287
Rep. Tommy Smith (Nicholls) - 404-656-5105

Major Senate Action Related to Health Care
SB 102- Chiropractors Scope of Practice
Sponsored by Chairman Don Balfour (R-Snellville), SB 102 expands the scope of practice for chiropractors. This Bill adds language that would allow chiropractors to provide health certificates and may refer patients for diagnostic imaging, neurodiagnostic studies, and laboratory tests; provided, however, that such referral shall be made in compliance with Chapter 1B of this title, the 'Patient Self-referral Act of 1993. All five attempts to amend this bill failed. The bill passed with a vote of 40-12.

SB 73 – Continuous Coverage of Insured Patients
SB 73, sponsored by David Shafer, will allow patients to continue receiving continuous coverage even if there is a temporary lapse in insurance due to contract negotiations between hospitals and insurance companies. This bill passed on crossover day by a margin of 48-1.

SB 109-Insurance Prompt Pay Requirements
Sponsored by Sen. Ralph Hudgens (R-Hull), SB 109 extends the prompt pay statute to third party administrators. This Bill passed the Senate 48-1.

Major House Action Related to Health Care

HB 340- Peachcare
Sponsored by Speaker Glenn Richardson (R-Hiram), HB 340 would tighten eligibility requirements for the PeachCare health insurance program for children by lowering the income eligibility level for PeachCare from 235 percent of the federal poverty rate to 185-200 percent – a change that could make thousand of children ineligible to qualify for health insurance coverage. The bill would also increase premiums for dental and vision benefits. The House voted 101-63 to pass HB 340. This bill has been referred to the Senate Rules Committee. Please contact Senate Rules Chairman Don Balfour at (404) 656-0095 or by e-mail don.balfour@senate.ga.gov and ask him to not move this legislation forward.

HB 626 – CME for Retired Physicians
On Thursday, March 27, House Bill 626 passed 160-0. This bill will require retired physicians who are providing uncompensated care to complete 20 hours of continuing medical education provided that they have an active license. If they have not had an active license for over 5 years, then they would be required to complete up to 40 CME hours.

HB 249, 568, 337 -Certificate of Need (CON)
All of these measures would have changed the current CON regulations. None of them made it through the House before crossover. There is still a slight chance that one of these measures might be amended onto a bill that has already been passed by one of the chambers.

SB 17-Optometrists’ Prescriptions
Sponsored by Sen. Seth Harp (R-Midland), SB 17 would give optometrists the authority to prescribe a limited number of drugs to treat their patients for certain eye conditions and has already passed the Senate. House Rules Chairman Earl Ehrhardt substituted a much wider ranging bill that opens up most of the PDR for optometry prescribing. The House of Representatives voted 149-11 to pass the bill on March 29. This bill now goes back to the Senate where a conference committee will be named to hash out a compromise between the two bills.

Report 7 – March 26, 2007

Budget – Both Amended 2007 and Fiscal Year 2008 Hits Impasse
On Tuesday, March 20 (day 29 of the session) the House and Senate clashed on the supplemental budget for 2007. The House of Representatives adopted the supplemental budget for the current fiscal year early in the afternoon, an action normally followed by the transmission of the budget document to the Senate so that the other chamber can start working on it. But Lt. Gov. Casey Cagle visited the House leadership and told them that the Senate wanted to strip out the extra items that Gov. Sonny Perdue and the House had added to the budget, then pass a trimmed-down version of the spending plan. That action necessitated the House leadership to “reconsider” the budget that had been adopted a few hours earlier. That parliamentary maneuver technically keeps the budget within the control of the House but brings the budget process to a halt. This leaves the PeachCare funding, which is predicted to run out of funds at the end of this month in limbo. The supplemental budget has $81 million in shifted funds to cover the shortfall until the funding is reauthorized by Congress.

PeachCare Funding – Fixed or Flawed?
Last week, Governor Sonny Perdue, Lt. Governor Casey Cagle and Speaker Glenn Richardson announced a temporary PeachCare solution that will keep Georgia’s children insured while Congress finalizes its funding proposal for the State Children’s Health Insurance Program (SCHIP). The solution will temporarily use state funds already in the budget for Medicaid to cover the shortfall in PeachCare until Congress appropriates the funding in the federal supplemental spending bill.

This would not move children into the Medicaid program; it would simply change state law to allow Georgia to borrow state funds already slated to be used to pay for Medicaid to cover PeachCare costs in this interim period. Any Medicaid funds expended would then be repaid from the Congressional shortfall funds when they are approved. However, this funding is now tied up in the tussle of the amended FY 2007 budget.

Meanwhile, Speaker Glenn Richardson has sponsored House Bill 340 to reduce PeachCare eligibility from 230 percent of the federal poverty level to 200 percent. PeachCare children would also lose coverage of dental and vision which could become an optional benefit (with a premium charged to the insurers). His bill will also give authority to the Department of Community Health Board to set the eligibility rate between 185 percent and 225 percent of the FPL depending on what Congress reauthorizes SCHIP (PeachCare) funding.

Major Senate Action Related to Health Care
SB 102 - Chiropractors' Scope of Practice
Sponsored by Sen. Don Balfour (R-Snellville), SB 102 would increase chiropractors' scope of practice. It passed the Senate Health & Human Services committee last Thursday by a vote of 5-3. The Georgia Academy opposed this legislation and past Board Chair, Dr. D. Ann Travis Honeycutt, testified on behalf of the GAFP. This bill will be on the Senate floor for consideration on Tuesday, March 27th.

SB 148- Saving the Cure Act
Sponsored by Sen. David Shafer (R-Duluth), SB 148 would create the Newborn Umbilical Cord Blood Bank for stem cell research and treatment. Senators passed the bill by a vote of 39 to 15.

Major House Action Related to Health Care
HB 147- “Woman’s Right to Know Act”
Sponsored by Rep. James Mills (R-Gainesville) HB 147 would require all women seeking an abortion, even if they are victims of rape or incest, to have an ultrasound before the procedure is performed. The patient would not be required to view the ultrasound, but a doctor who performed an abortion without an ultrasound would be punished for a misdemeanor criminal offense. The House passed the measure by a vote of 116 to 54. This bill will now be considered in the Senate Health and Human Services Committee.

HB 249- Specialty Acute Care Hospitals CON Regulations
Sponsored by Rep. Ron Stephens (R-Savannah), HB 249 provides for an exemption from CON regulations for specialty acute care hospitals that treat cancer and provides destination medicine. The House Special Committee Certificate of Need committee passed the bill last week.

HB 340- PeachCare
Sponsored by Speaker Glenn Richardson (R-Hiram), HB 340 would lower the threshold for eligibility in the PeachCare for Kids program to 200 percent of FPL, while granting the Board of Health the authority to revise this number to between 185 percent and 225 percent of FPL. The bill passed the House Health & Human Services committee last week and will be on the House floor on March 27th.

HB 429- Georgia HIV Pregnancy Screening Act of 2007
Sponsored by Rep. Sharon Cooper (R-Marietta), HB 429 would require care providers to screen pregnant women for HIV during prenatal care or immediately following delivery, unless the woman declines the test. The bill passed by a vote of 140 to 14.

Report 6 – March 6, 2007
The GAFP sends weekly updates during the Georgia legislative session. If you need more information on a legislative issue; please contact the GAFP office by calling 404-321-7445.

Legislative Session Halted – Waiting on Congress for PeachCare Reauthorization
The General Assembly reconvened Tuesday, February 27th for the 25th legislative day and remained in session through Thursday, March 1st. Legislators will convene Tuesday, March 19th for the 28th legislative day. The breaks have been scheduled hoping that Congress will reauthorize SCHIP funding so that PeachCare can be funded for the rest of this year, as well as for fiscal year 2008.

Schedule*
Monday, March 5th - Sunday, March 18th Recess
Monday, March 19th 28th legislative day
Tuesday, March 20th 29th legislative day
Wednesday, March 21st-Monday, March 26th Recess
Tuesday, March 27th 30th legislative day
Wednesday, March 28th 31st legislative day
Thursday, March 29th 32nd legislative day
Friday March 30th 33rd legislative day
Saturday, March 31st-Monday, April 9th Recess
*subject to change

GAFP Board Action on Current Legislative Initiatives

The Board met in Macon on Sunday, March 4th and voted to oppose the following bills currently being debated at the State Capitol:

Senate Bill 103 – Chiropractors Scope of Practice
Background: This bill will expand chiropractors’ scope of practice and allow them to refer patients for diagnostic imaging, neurodiagnostic studies and laboratory tests, as well as, to sign health certificates. It was noted that the Senate Chairman of the Rules Committee, Don Balfour, had introduced the bill and therefore it could move through the Senate. This bill has been opposed by the GAFP in the past.

House Bill 367 – Therapeutic Substitution
Background: The bill would allow pharmacists to substitute a physician’s prescription across classes.

The pharmacists would have 72 hours to inform the physician of the change. Dr. Wherry, Co-Chair, has met with the bill sponsor Representative Buddy Carter (a pharmacist). The Georgia Academy has asked the Georgia Pharmacy Association for different language that might relieve the hassle factor but not at the expense of patient safety.

House Bill 342 – Direct Billing for Pathologists
Background: House Bill 342 which would disallow direct billing by non pathologists (including family physicians) for lab related services. This is an initiative from the national association (College of American Pathology) to carve out niche billing. It was noted that this would be confusing to the patients. It would also disallow the current practice of negotiating a fee with a lab or pathology group and discounting the savings on to the patient.

House Bill 528 Cosmetic Laser Practitioner
Background: This bill would require a cosmetic laser practitioner to have a Georgia license under the Board of Cosmetology. The bill’s wording is vague and there is no physician oversight on any of laser procedures. It was noted that many cosmetic procedures are benign. However, some procedures that utilize laser technology should have physician oversight. Staff has been directed to work with our members who do these procedures for continuing review of this bill.

Major Senate Action Related to Health Care

SB 86- Pick Up Truck Seatbelts
Sponsored by Sen. Don Thomas, MD (R-Dalton), SB 86 requires the use of seatbelts in pickup trucks, just as they are now required in automobiles and SUVs. The Senate approved the measure on March 1 by a vote of 45 to 10. It will now go to the House and be assigned to a committee for review. The Georgia Academy supports this legislation.

SB 88- Care of a Grandchild Act
Sponsored by Sen. Renee Unterman (R-Buford), SB 88 would allow grandparents to care for their minor grandchildren without court approval. Instead, the child's parents could give the grandparents authority by simply signing a legal document. The bill also would establish a subsidy program, managed by the state Department of Human Resources, to help low-income grandparents who have legal custody or guardianship of their grandchildren and participate in programs designed for grandparents raising grandchildren. This bill passed the Senate on March 1.

SB 155- HPV Vaccine
Sponsored by Sen. Don Balfour (R-Snellville), SB 155 would require girls in Georgia who are entering the sixth grade to be vaccinated against human papillomavirus, or HPV. Despite concerns raised by various groups, a Senate committee approved the bill and, if it becomes law, it would go into effect in 2008. The GAFP does not currently have a position on this bill. However, the AAFP has come out with a policy (February 2007) stating that the following: The AAFP feels it is premature to consider school entry mandates for the HPV vaccine until such time as the long term safety with widespread use, stability of supply, and economic issues have been clarified.

Major House Action Related to Health Care

HB 330- Georgia State Board of Pharmacy
Sponsored by Rep. Ron Stephens (R-Savannah), HB 330 requires the Georgia State Board of Pharmacy to establish a process of maintaining a registry of pharmacy technicians. This updated information on the pharmacy technicians will be provided to the board by the pharmacist in charge of the pharmacy. The board will be allowed to collect fees from pharmacy technicians for maintaining the registry. The House adopted the measure February 28 and it has moved to the Senate for consideration.

HB 581- CON (Certificate of Need) Legislation
Sponsored by Rep. Mickey Channell (R-Greensboro), HB 581 would require hospitals and physicians alike to apply for certificates of need before they could open new surgical facilities. HB 581, like Gov. Perdue’s bill (HB 568) and other CON measures introduced this session, would implement many of the non-controversial recommendations made by a CON study commission for revising some of the current licensing procedures.

Report 5 – February 26, 2007
The GAFP sends weekly updates during the Georgia legislative session. If you need more information on a legislative issue; please contact the GAFP office by calling 404-321-7445.

Legislative Session Continues
As of February 23, the General Assembly had completed 26 out of 40 legislative days. They will recess Monday, February 26th and work Tuesday (27th), Wednesday (28th), and Thursday (1st). Hearings are being scheduled at a rapid pace as bills must pass out of one chamber prior to day 31, if they have a chance to pass during this session.

PeachCare for Kids – Enrollment Stops after March 11th
Due to the lack of reauthorization of PeachCare at the federal level, the Department of Community Health is moving forward to curtail additional enrollees even if the children are eligible for the program.

Any new applications received or postmarked after March 11, 2007 will not be processed for PeachCare eligibility.

Members whose participation in the program is suspended for failure to timely pay premiums or for failure to provide required income verification will also be affected by this change and will be precluded from re-enrollment. These members will receive additional notice by direct mail as required by governing regulations. Members enrolled and/or determined eligible prior to March 11, 2007 will not be impacted by this particular proposed change.

Congressional Election
Gov. Sonny Perdue issued a writ of election Thursday that sets June 19 as the date for the special election to replace the late Charlie Norwood as the congressman from northwest Georgia’s 10th District. A runoff, if necessary, would be held on July 17.

Major Senate Action Related to Health Care
SB 60- Georgia Trauma Commission
Sponsored by Sen. Cecil Staton (R-Macon), SB 60 provides that hospitals offering or seeking to offer emergency trauma services may add additional beds or operating rooms for emergency trauma purposes without the necessity of applying for a certificate of need. The bill would establish a nine-member commission to take in funds and distribute grants that would enable trauma care hospitals around the state to continue operating. The Senate adopted the bill February 21, it now moves to the House.

SB 84- Insurance related to U.S. Armed Forces
Sponsored by David Shafer (R-Duluth), SB 84 seeks to protect members of the U.S. armed forces from unscrupulous practices regarding the marketing and sale of insurance. The Senate adopted the bill February 21 and it now moves to the House.

Major House Action Related to Health Care

Fiscal Year 2008 Budget
Chairman Mickey Channell (R-Greensboro) held a public hearing on March 21 to hear testimony about the Fiscal Year 2008 budget. The Georgia Academy testified seeking increases in both Medicaid as well as the family medicine residency capitation rate. The following is some of that testimony:

The Georgia Academy is requesting two additions to the Department of Community Health’s Budget.

The first is a $3,000 increase in the Family Medicine resident capitation rate (currently at $19,000 per resident) which has been incrementally decreased over the last several years.
This increase would be an investment in keeping a strong primary care network throughout the state. Research has shown that graduates tend to establish their practice within a 50-mile radius of where they completed their training.

The Georgia family medicine residency programs are held accountable to the funding as they must have - at a minimum - a 50 percent retention rate of trained family physicians to stay in Georgia or must return the capitation funds.

The feds match the resident’s capitation funding through Medicaid and gives the state approximately $1.60 for every $1 in state capitation.

The request is a $3,000 increase for each of the 204 positions which would increase the capitation rate up to $21,000 per family medicine resident and would be a fiscal note of $612,000.

This funding would go through the Georgia Board for Physician Workforce which is an attached agency of the Department of Community Health.

Georgia currently has family medicine resident programs in the following areas around the state: Rome, Columbus, Macon, Atlanta (Emory and Morehouse), Morrow, Augusta, Waycross, Savannah and Albany.

Our second request is to increase the Medicaid and PeachCare payment to physicians. However, we would also like to add our support for an increase in the Medicaid, PeachCare physician payment structure for the evaluation and management codes.

There are ten codes that are routinely used for E&M for both a new patient and an established patient depending on the length and complexity of the visit. An increase in these codes would help family physicians, pediatricians – heck – all primary care physicians – as well as most physicians who meet routinely with their patients.

Family docs have taken a beating the past several years with declining Medicaid payments and the issues with the implementation with the managed care program.

HB 568- Certificate of Need (CON)
Sponsored by Governor Perdue, Rep. Rich Golick (R-Smyrna) introduced HB 568, which would deregulate ambulatory surgical centers if they agree to devote 6 percent of their adjusted gross revenue to indigent care and treat patients on Medicaid and PeachCare. Am/surg centers that don’t participate in Medicaid and PeachCare would have to commit to 10 percent of gross revenues for indigent care. The bill would also allow specialty hospitals like Cancer Treatment Centers of America to avoid CON requirements if they take at least 75 percent of their patients from out of state, accept Medicaid patients, and spend 3 percent of their gross revenues on indigent care.

Report 4 – February 16, 2007
The GAFP sends weekly updates during the Georgia legislative session. If you need more information on a legislative issue; please contact the GAFP office by calling 404-321-7445.

Legislative Session Continues
As of February 16, the General Assembly had completed 21 out of 40 legislative days. They will recess Monday, February 19th and work Tuesday (20th), Wednesday (21st), and Thursday (22nd).

Major Senate Action Related to Health Care

SB 86- Pick up Truck Seatbelts
Legislation that would require the use of seatbelts in pickup trucks, just as they are now required in automobiles and SUVs, was given a “do pass” recommendation Tuesday on a 9-2 vote by the Senate Public Safety Committee. The committee action makes it likely that the bill will get a vote by the full Senate. The Georgia Academy strongly supports this legislation.

SB 148- Stem Cell Research: “Saving the Cure Act”
Sponsored by Sen. David Shafer (R-Buford), SB 148 creates a new state agency, the Commission for Saving the Cure, which would work with hospitals & medical schools to establish a network of facilities that collect, store placentas, umbilical cords, and amniotic fluids donated by women who have given birth. The stem cells would be used in medical research.

SB 17- Optometrist Prescribing Authority
Sponsored by Sen. Seth Harp (R-Midland) SB 17 would allow optometrists to prescribe a limited number of oral medications and antibiotic drugs for their patients. The bill passed February 9 by a vote of 52-0. It now moves to the House of Representatives, where its supporters include Rep. Earl Ehrhart (R-Powder Springs), chairman of the House Rules Committee. The Georgia Academy continues to oppose this legislation.

SB 28- Insuring Georgia’s families Act was separated into four bills, which address the following issues:
HB 404- Insurance Premium Tax
Introduced by Rep. Mickey Channell (D-Greensboro) the bill is intended to address amendments to the tax code. Per the constitution, all tax bills must originate in the House.

SB 150- Pharmacies/Pharmacists Cost Data
Sponsored by Sen. Judson Hill (R-Marietta), the bill addresses patient data reporting and the shift from employer-sponsored healthcare plans to individual healthcare plans.

SB 151- Georgia Health Security Underwriting Authority
Sponsored by Sen. Judson Hill (R-Marietta), and related to high risk pools, the bill provides alternative mechanism coverage for the availability of individual health insurance and provides for an assignment group underwriting board.

SB 154- Georgia Consumer Driven Health Insurance Plan
Sponsored by Sen. Judson Hill (R-Marietta), the bill provides for the development of consumer driven insurance plans by the Insurance Commissioner with incentives for health savings accounts.

Major House Action Related to Health Care

HB 236- State Funding for PeachCare
Sponsored by Rep. Nikki Randall (D-Macon), HB 236 would authorize the state to put its own money into PeachCare. Randall said several Republican lawmakers have indicated to her they will support HB 236, but Republican Gov. Sonny Perdue and the GOP’s legislative leaders are not, at this point, in favor of it. President Bush stated he will not provide emergency funding for children’s health insurance programs in Georgia & 16 other states. Georgia’s congressional delegation predict that Congress will not be able to pass a bill for funding until April, which is after the March shutdown that state officials have projected. If PeachCare does terminate in March, more than 270,000 Georgia children will lose their health insurance coverage.

HB 350 PeachCare Restoration Act
Sponsored by Rep. Chuck Sims (R-Ambrose), HB 350 would temporarily put sales taxes back on groceries to pay for PeachCare health insurance for children. Putting the sales tax back on groceries for two years, as the bill recommends, would cost Georgians about $850 million in additional taxes. If approved, Sims' bill would fund PeachCare.
HB 340- PeachCare Eligibility Standards
Sponsored by House Speaker Glenn Richardson, HB 340 would tighten the eligibility standards for PeachCare participants, which would save money for the program but would also remove several thousand children from the PeachCare rolls. The bill would lower the threshold rate for PeachCare eligibility from 235 percent of the federal poverty level to 200 percent of the federal poverty rate.

PeachCare Task Force
Lt. Gov. Casey Cagle has appointed a special committee of state senators to develop some options for shoring up the financially threatened PeachCare health insurance program for children. Cagle appointed Senate Majority Leader Tommie Williams (R-Lyons), Sen. Greg Goggans (R-Douglas), Sen. Mitch Seabaugh (R-Sharpsburg), and Sen. Horacena Tate (D-Atlanta) to the task force, which has a Feb. 22 deadline to come back with alternatives.

PeachCare Enrollment
DCH Commissioner Rhonda Medows, MD said the state will freeze the membership of the financially troubled PeachCare program, closing off enrollment to the children’s health insurance program on March 11. Children who are currently enrolled in the program will continue to receive medical care but no new members will be allowed to enroll until Congress decides whether the state will receive additional federal funds for PeachCare.

HB 147- “Woman’s Right to Know Act”
Sponsored by Rep. James Mills (R-Gainesville), HB 147 is the first abortion bill to be actively considered by the General Assembly this session. The bill would require all women seeking an abortion, even if they are victims of rape or incest, to have an ultrasound before the procedure is performed. The patient would not be required to view the ultrasound, but a doctor who performed an abortion without an ultrasound would be punished for a misdemeanor criminal offense.

Report 3 – February 5, 2007
The GAFP sends weekly updates during the Georgia legislative session. If you need more information on a legislative issue; please contact the GAFP office by calling 404-321-7445.

Legislative Session Continues
As of Friday, February 2, the General Assembly had completed 14 out of 40 legislative days. They will be in recess February 5-7th and work Thursday, Friday and Saturday of this week. Saturday will be Family Day where legislators encourage Georgians to come to the Capitol on a weekend to see the legislative session.

Budget News – Physical Education in Schools
According to the Georgia Physical Activity and Nutrition Coalition (of which the GAFP is a member), State Superintendent of Schools, Kathy Cox, spoke to legislators about the education budget. During her presentation Ms. Cox commented on the need for a health/physical education coordinator position at the central office to address student wellness. She indicated that this position would be funded in the FY 2008 proposed budget using existing resources. Currently, there is no staff in the State focused on physical education for public school children.

Major Senate Action Related to Health Care
Pickup Truck Seatbelts – GAFP Member Introduces Legislation
Sen. Don Thomas, MD (R-Dalton) has introduced legislation SB 86, which would require persons above the age of 18 to use a seatbelt when driving or riding in the front seat of a pickup truck. Similarly, Rep. Mary Margaret Oliver (D-Decatur) introduced HB 114, which has been assigned to the Agriculture Committee. Dr. Thomas is a long standing member of the Georgia Academy. The Georgia Academy has a long standing mandate from the Congress of Delegates to pass legislation concerning seatbelt use in pickup trucks.

SB 17- Optometrist Prescribing Authority – Passes Senate Health Committee
Sen. Seth Harp (R-Midland) has introduced SB 17, which in its original version would give optometrists much of the same authority as higher-paid ophthalmologists to prescribe drugs for treating eye diseases and conditions. This year's version of the bill, received a unanimous "do pass" recommendation on a substitute bill. The substitute would allow optometrists to prescribe the following oral antibiotics limited to tetracycline, doxycycline, cephalosporin, and dicloxacillin for use in treating ocular surface disease and lid disease only; provided, however, that a doctor of optometry shall not be authorized to treat systemic diseases."

SB 1- Registered Sex Offenders Photographing Minors
The bill, sponsored by Eric Johnson (R-Savannah), which prohibits registered sex offenders from photographing minors, unanimously passed the Senate Judiciary Committee.

SB 10- Georgia Special Needs Scholarship Act
Introduced by Sen. Eric Johnson (R-Savannah) SB 10 proposes giving scholarships to special needs children to attend the public or private school of their choice. Senators adopted the legislation Wednesday by a vote of 31 to 23.

Major House Action Related to Health Care

Certificate of Need (CON) Regulations
SB 53, introduced by Sen. Tommie Williams (R-Lyons) and HB 249, sponsored by Rep. Ron Stephens (R-Savannah) and Rep. Mickey Channell (R-Greensboro) would provide an exemption from CON requirements for "acute cancer hospitals with 50 or fewer beds that specialize in advanced cancer treatment and that have a majority of their patients originating from outside the State of Georgia." The bill would specifically benefit Cancer Treatment Centers of America, a national network of cancer hospitals and facilities.

HB 263 (CON) sponsored by Rep. Jill Chambers (R-Atlanta) and Rep. Earl Ehrhart (R-Powder Springs) would repeal entirely the state's CON laws on the grounds that "the Georgia Constitution prohibits the General Assembly from authorizing agreements which defeat or lessen competition or encourage monopolies."

HB 6- Firearms during Emergency Conditions
Introduced by Rep. Bobby Franklin (R-Marietta), HB 6 would ban police officers, National Guardsmen and others from confiscating guns or requiring people to register them after the governor has declared an official state of emergency in Georgia. The bill would also strip the governor of his emergency powers to suspend the sale and transportation of firearms. And it would give gun owners the option to go to court and seek the return of their seized weapons along with "reasonable attorneys' fees."

HB 89- Transporting Firearms
Sponsored by Rep. Timothy Beard (R-Villa Rica), HB 89 allows anyone licensed to carry a pistol or revolver to transport that pistol or revolver in any private passenger vehicle. The measure passed the Judiciary Non-Civil Committee Monday.

Report 2 � January 29, 2007

As of January 29th, the General Assembly has worked 10 out of 40 legislative days. The current schedule is to remain in session through Friday, February 2 (14th legislative day).

Major House Action Related to Health Care

Firearms
HB 143- introduced by Rep. Tom Graves (R-Ranger), and SB 43 sponsored by Sen. Chip Rogers (R-Woodstock) would prohibit certain employers from prohibiting employees from lawfully carrying and possessing firearms in locked motor vehicles.

Wireless Communication Devices in Motor Vehicles
Rep. Mary Oliver (D-Decatur) introduced HB 5, which would add a points penalty for Georgians involved in traffic accidents while using cellular, hands-free, or mobile telephones or other wireless communication devices.

Sale of Prescription Drugs
Rep. Carl Rogers (R-Gainesville) sponsored HB 180, which provides that certain prescription drugs and other health care products sold by Georgia biotechnology, biopharmaceutical, or pharmaceutical companies shall not be subject to certain access restrictions or supplemental rebates for purposes of coverage under the state health benefit plan, medical assistance program, PeachCare for Kids, or any other health benefit plan administered by or on behalf of the state.

Major Senate Action Related to Health Care

Georgia Special Needs Scholarship Act
Introduced by Sen. Eric Johnson (R-Savannah) SB 10 proposes giving scholarships to special needs children to attend the public or private school of their choice. Students would need to have an Individualized Education Program (IEP). The maximum scholarship awarded would be the lesser of a sum equal to the state and federal money spent on the child in public school or the cost of the private school.

Penalties for Unlicensed Drivers
Sen. John Wiles (R-Marietta) introduced SB 15, which proposes tougher penalties and lengthy prison sentences for persons who drive without a valid driver�s license. The bill provides that the first two convictions for driving without a license will be considered misdemeanors, with at least a two-day jail sentence for a first conviction and a 10-day jail sentence for the second conviction. A third conviction would be treated as a felony offense with a sentence of one to five years in prison. The Senate Judiciary Committee voted 7-3 in favor of the measure.

Insuring Georgia�s Family Act
Sen. Judson Hill (R-Marietta) introduced SB 28, which aims to move the responsibility for health insurance away from employers and encourage individuals to set up health savings accounts. These savings accounts are tax sheltered where the money is set aside to pay for medical expenses. The proposal is meant to reduce the number of Georgians without health insurance and reduce the cost of medical care with market-based competition. The bill would establish a Web site, www.georgiahealthcare.com, that would allow consumers to shop online for the cheapest medical services and prescriptions in their areas; set up a Georgia Health Insurance Exchange, allowing consumers to shop for coverage; and beginning Jan. 1, make health insurance premiums for individuals who buy "qualified policies" fully deductible from gross income on Georgia state tax returns.

Georgia Trauma Commission
Sen. Cecil Staton (R-Macon) introduced SB 60, which provides that hospitals offering or seeking to offer emergency trauma services may add additional beds or operating rooms for emergency trauma purposes without the necessity of applying for a certificate of need. The bill would establish a nine-member commission to take in funds and distribute grants that would enable trauma care hospitals around the state to continue operating. All 56 Senators have signed the bill.

Report 1 – January 19, 2007
The First Session of the 149th Georgia General Assembly convened Monday, January 8, 2007 for the 40-day legislative session. The House and Senate agreed to meet for four days through January 11, 2007. The legislature then recessed January 15-19 to conduct budget hearings on the FY07 Amended Budget and the FY 08 Budget proposed by Governor Sonny Perdue. The legislature will reconvene on Monday, January 22, 2006 for the fifth legislative day.

State of the State Address
During his State of the State address Wednesday, Gov. Perdue announced his Amended FY07 and $20.2 billion proposed FY08 budget. The Governor’s plan focuses on Education, Land Conservation, Economic Development, Healthcare, and Law Enforcement. There are neither cuts nor increases to physician Medicaid reimbursement in the Governor’s proposed budget.

State of the State: Budget as it relates to Healthcare

Rural Health Access Project to promote health care as a strategic industry in rural Georgia;
$176 million to fund health insurance costs for state employees;
$100 million to begin to meet the costs of Other Post Employment Benefits (OPEB);
Continuing to partner federal government on Medicaid and PeachCare;
$1 million to implement the Health Information Technology pilot program;
$1.5 million to increase access to primary health care facilities throughout the state;
$4.8 million to develop a real time information system to improve cancer screening, diagnosis and treatment to make Georgia a national leader in cancer information technology;
$16 million to fully fund the purchase of antiviral medications to treat a pandemic flu;
$9 million to provide additional funds for the operating expenses of state hospitals.

Budget as outlined by DCH Commissioner Rhonda Medows, MD
On Tuesday, January 16, Commissioner Medows testified about the Department of Community Health’s budget. Some of her comments included the following:

State Health Benefits Plan

Commissioner Medows indicated that retired teachers and state employees will not see their healthcare benefits cut in the proposed state budget for fiscal year 2008. Possible reductions in healthcare benefits have become a major concern among state employees and teachers because of a funding liability estimated at $20 billion. New federal accounting standards require Georgia to account for that shortfall over the next 30 years, and the alternatives reviewed by Gov. Sonny Perdue’s staff have included healthcare benefit reductions that would whittle away at that deficit.
The DCH budget also proposes a 10 percent increase in the premiums that active state employees and teachers will pay in 2008 for their medical coverage under the State Health Benefits Plan.

House Healthcare Legislation Introduced

HR 13- PeachCare for Kids Program
The House voted 166-0 Thursday to pass HR 13 introduced by Rep. Mickey Channell (R-Greensboro), which urges Congress to reauthorize federal funding for the PeachCare health insurance program for children. The Department of Community Health has not received $131 million in federal funds it has been expecting, which means the program may have to shut down.

HB 6- Possession of Firearms
Rep. Bobby Franklin (R-Marietta) introduced HB 6, which prohibits certain confiscation or registration of legally owned and carried firearms during certain emergency conditions.

HB 1- Abortion
Sponsored by Rep. Bobby Franklin (R-Marietta), HB 1 would make any abortion against the law.

HB 37- Prisoners with Mental Health Issues
Rep. Bobby Parham (D-Milledgeville) sponsored HB 37, which states that persons confined in jail, who are under the care and supervision of the Department of Human Resources for mental health reasons, will be transferred from the jail to a mental health facility until trial.

HB 45- Prescription Drugs
Sponsored by Ron Stephens (R-Savannah), HB 45 seeks to prohibit prior authorization for a prescription drug which a drug manufacturer provides to a community pharmacy at the lowest price of a pricing structure.

HB 28- Georgia Assignment Pool Underwriting Authority
Sponsored by Rep. Tom Knox (R-Cumming), HB 28 would repeal the Georgia High Risk Health Insurance Plan and institute the Georgia Assignment Pool Underwriting Authority, which provides alternative mechanism coverage for the availability of individual health insurance.

Senate Healthcare Legislation Introduced

SB 26 – Regulations of Sunday Alcohol Sales
Sen. Seth Harp (R-Midland) introduced SB 26, which will allow local communities to hold referendums to decide if they want to allow Sunday sales of beer and wine in grocery and package stores.

SR 6- PeachCare for Kids Program
Similar to the House resolution, Senators unanimously voted in favor of SR 6, which urges the U.S. Congress to full fund and ensure the reauthorization of the State Children’s Health Insurance Plan (S-CHIP).

SB 17- Optometrist Prescription Authority
Introduced by Sen. Seth Harp (R-Midland), SB 17 authorizes certain optometrists to prescribe and administer oral and topical pharmaceutical agents related to the diagnosis or treatment of diseases and conditions of the eye and adnexa oculi except Schedule I and Schedule II controlled substances.

SB 28- Insuring Georgia’s Families Act
Sponsored by Sen. Judson Hill (R-Marietta) provides for the development of consumer driven health insurance plans by the Commissioner of Insurance and requires pharmacies to submit certain performance and cost data to the Department of Community Health.

SB 10- Georgia Special Needs Scholarship Act
Sen. Eric Johnson (R-Savannah) sponsored SB 10, which seeks to provide disabled public school students with scholarships to attend eligible private schools.

Update on Nurse Practitioner Prescribing
As you know, the state legislature passed a nurse practitioner prescribing bill (SB 480) that the Georgia Academy supported. The law went into effect on July 1. However, the regulations to support the law are still under review. The Composite State Board of Medical Examiners have posted two draft regulations and received multiple feedback from the public over the past three months. The latest hearing was September 21 and included over 18 people testifying on the regulations. The Board did take a vote on the regulations and the vote was to table for further review. It is our understanding that the Medical Board is still working on revisions and will post another draft set of regulations within the next 90 days. The Georgia Academy's Legislative Committee is continuing to review the draft versions of the regulations.

What does this mean for you and your nurse practitioner?
It's important to note that the Board has not yet adopted rules. Any nurse protocol agreements filed with the Board prior to the Board's adoption of rules regarding the agreements may need to be re-filed by the licensed physician in order to comply with rules subsequently adopted by the Board.

An Advanced Practice Registered Nurse has no authority to issue written prescriptions for controlled substances without possession of a valid DEA registration in his or her name and is not authorized, under any circumstances, pursuant to SB 480 to issue prescription drug orders for Schedule I and II controlled substances.

October 9, 2006

Good News and Great Tidings - Priceless
During the 2006 legislative session that just recently came to a close you received 9 legislative updates, the Legislative Committee met 10 times, the Executive Committee met 4 times and over 50 of you participated in the Primary Care Physicians' Day at the Capitol. It was a struggle and during the middle of the session it looked bleak, but by the end family physicians can say that legislation passed will help our patients and not harm them.

We did not win these hard felt battles alone. A multitude of legislators worked tirelessly on our behalf to insure that our patients and our professions are protected. We have depleted our Political Action Campaign coffers and are looking to replenish, so we can appropriately thank the legislators who helped us and are now campaigning for re-election.

Please note that the Congress of Delegates have passed policy seeking to raise our annual giving to the PAC up to $30,000 annually. We are seeking a minimum contribution of $100 per family physician, $25 per resident, and $15 per medical student. Those contributors will receive special opportunities to deliver PAC checks and receive special election related mailings.

Please respond to the special GAFP PAC mailing being sent to you this month. You may also hear from some of our GAFP leaders who will be doing outreach by phone. For questions, or more information, please contact our Executive Director, Fay Brown at fbrown@gafp.org or by phone at 404-321-7445.

Remember, the cost of having a successful legislative session.......priceless

May 9, 2006