State Legislative News
Legislative Update - February 5, 2014
The Georgia General Assembly will be meeting all five days this week and February 10-13th next week. By the end of this week they will have used 19 days out of total of the 40-day session.
Georgia Academy Opposes Expansion of Fireworks Sales
The Legislative Committee and State Legislative Session Working Group recommended to the Executive Committee to oppose Senate Bill 229 or any similar bill. This bill would, if passed, expand the sales of fireworks in Georgia. The Georgia Academy will be joining a coalition that includes Children's Healthcare of Atlanta and the Georgia Chapter - American Academy of Pediatrics to oppose firework expansion.
Georgia Enrollment Numbers for Insurance Exchanges
Based on the latest report, Georgia's enrollment in the exchange had 58,611 sign up by the end of December, according to federal statistics, up from 6,859 from the month before. Federal data shows that 78 percent of Georgia's enrollees will qualify for subsidies. Enrollment in the exchange will end on March 31.
Licensure of Certified Lactation Consultants - House Bill 363
The Georgia Academy testified last week in support of House Bill 363 (licensure of lactation consultants). By certifying lactation consultants, it will enable the Board Certified Lactation Consultants to be reimbursed by Medicaid and the State Health Benefit Plan. The GAFP supports this legislation and cosponsored a 2012 resolution to the Medical Association of Georgia's House of Delegates requesting that they support this bill as well.
Georgia Academy's Day at the Capitol - Thursday, February 13
With over 100 of our colleagues attending our Day at the Capitol next week - we look forward to conversations with key legislators and Department of Community Health Clyde Reese who will be our keynote speaker. For additional preparation and education on how to effectively meet with our legislators, we will have a session focusing on interacting with our legislators. Kim Ross, formerly the Vice President of Government Relations with the Texas Medical Academy, will present: Doctors as lobbyists: how hard could it be? How to make friends and influence legislators without the benefit of hallucinogenics.
If you would still like to attend, but have not registered, please contact Fay Fulton Brown directly at email@example.com
Recent Activity on Healthcare Legislation
HB 51 - Hospital Medicaid Financing Program Act; enact
House Committee: Governmental Affairs
Status: House Second Readers - Jan/16/2013
HB 73 - Insurance; coverage for physician prescribed special dietary food
House Committee: Insurance
Status: House Second Readers - Jan/28/2013
HB 74 - Hearing Aid Coverage for Children Act
House Committee: Insurance
Status: House Second Readers - Jan/28/2013
HB 230 - Hospitals; authorities created are acting pursuant to state policy; express and clarify
House Committee: Judiciary
Status: House Second Readers - Feb/8/2013
HB 279 - State health planning and development; physician owned ambulatory surgical centers; define and provide exemptions
House Committee: Health and Human Services
Status: House Second Readers - Feb/12/2013
HB 404 - Freestanding pediatric emergency facilities; certificate of need requirements
House Committee: Health and Human Services
Status: House Second Readers - Feb/22/13
HB 662 - Patient Injury Act; enact
House Committee: House Insurance Committee
Status: House Second Readers - Mar/26/2013
HB 695 - Public assistance; provide reimbursement for Medicaid providers; provisions
House Committee: Health & Human Services
Status: House Second Readers - Jan/14/2014
HB 697 - HOPE; revise amount of grants; equal student's cost of tuition
House Committee: Appropriations
Status: House Second Readers - Jan/15/2014
SB 38 - Insurance; provide individual accident and sickness insurance policies in Georgia
Senate Committee: Insurance and Labor
Status: Senate Read and Referred - Jan/15/13
SB 46 - Insurance; establish the Georgia Health Insurance Marketplace Authority
Senate Committee: Insurance and Labor
Status: Senate Read and Referred - Jan/15/2013
SB 141 - 'Patient Injury Act'; create an alternative medical malpractice litigation
Senate Committee: Health and Human Services
Status: Senate Read and Referred - Feb/11/2013
SB 171 - Health Planning; single ambulatory surgical centers/joint venture; acquired are exempt from certain requirements under Chapter 6 of Title 31
Senate Committee: Health and Human Services
Status: Senate Read and Referred - Feb/19/2013
Register now to attend the Day at the Capitol – Thursday, February 13, 2014
Free Registration Before January 30th
Whether an old political hack or your idea of being politically active is voting, plan now to attend the Georgia Academy of Family Physicians’ Day at the Capitol. The meeting is open to all family physicians, residents, medical students as well as your clinical and business staff. You will meet with your state legislators and top government officials to learn how the state government and legislature impacts your practice and Family Medicine in Georgia. Join us under the Gold Dome.
Registration is free until January 30th. Travel stipends for family medicine residents and GAFP students are available (up to $75.00 to cover parking and mileage).
Report 1 - January 17, 2014
The 2014 Georgia General Assembly convened Monday, January 13 and met through the week expending five days of the 40 day session. The legislature is in recess through the MLK holiday but will reconvene on Tuesday, January 21.
Due to a recent lawsuit and an order by a federal court requiring Georgia to have at least 45 days for run-off elections to accommodate absentee voters in federal elections the Primary Date was moved from the traditional July date to May. In response to this change, the leadership in the Georgia General Assembly is committed to complete their 40 days by mid-March. Incumbents are not allowed to receive any campaign donations while the legislature is in session. This session is the second of a two year cycle, so bills that did not get voted down last year are still in play.
Patients for Fair Compensation (Senate Bill 141) - What's all the FussBy Brian K. Nadolne, MD, FAAFP - GAFP President
The Georgia Academy of Family Physicians Board of Directors has taken a position of support for Senate Bill 141 - Patients for Fair Compensation. While a complex issue, we will continue to send information in terms of why your leadership has taken this position.
The bill, if passed, would be groundbreaking, and Georgia could lead the nation in timely assisting patients who have been harmed, as well as, greatly reducing the burden of unnecessary and expensive defensive medicine.
Georgia Academy's Review of the Bill
Over a year ago, the 2012 Congress of Delegates charged the Board to evaluate the Patient Compensation System, (also known as the Patient Injury Act) as a potential replacement to the current tort system.
Over 150 of our leaders (which include the Congress of Delegates, the Legislative Committee, a working group of the Legislative Committee and our Board of Directors) have studied this issue. We agree that the current malpractice system is bad for doctors and bad for our patients - and the Georgia Academy is willing to look for solutions to ease the burden and strain of our current system.
As this bill is innovative and complicated, we also engaged an attorney to help us review the bill.
As we spent more time speaking to both proponents and opponents of the bill, we kept circling back to the same analysis - which is - this current system is not working for any of us - not for physicians, hospitals - or harmed patients. With no other malpractice reform looming - we decided this was an innovative way to get to the crux of the issue. The current system needs to be replaced.
It is important to note - that the current bill is not perfect - and we have met with those supporting the bill and working on new language to improve the bill which includes the following:
- Adding a safe harbor clause that would allow the dismissal of a claim if a bad outcome occurred although appropriate medical care was dispensed (utilizing nationally recognized medical guidelines).
- Mandating the medical review panel is comprised of the same specialty as the provider being reviewed.
- Reducing the annual contribution to include a cap and to reduce the contribution to be reflective of the specialty (i.e. surgeons would pay more than primary care).
All of these suggestions have been amicably received and Senator Beach is currently working on a committee substitute that will be submitted once the 2014 Legislative Session commences.
The Georgia Academy could have easily stood on the sidelines on this legislation but we believe taking a position of support is important. And we have a long time saying that is passed down from Georgia Academy President to President which is - "It's never wrong to do the right thing".
Senate Hearing on Patient's for Fair Compensation
The first day of the legislative session, there was a lengthy four hour hearing that wrapped up the work that the Senate Health and Human Services subcommittee did over the summer.
To hear the bill's sponsor Senator Brandon Beach summarize the bill:
Register Now for the Day at the Capitol - Free Until January 30
Legislative Day at the Capitol - Thursday, February 13, 2014
Floyd Veterans Building, Floyd Room, West Tower, 20th Floor
2 Martin Luther King Drive, Atlanta, GA 30334 and Georgia State Capitol
Plan to Attend the Georgia Academy of Family Physicians Legislative Day at the Capitol! Meet your state legislators and top government officials and learn how the state government and legislature impacts your practice and Family Medicine in Georgia. Join us under the Gold Dome!
Georgia Prescription Drug Monitoring Program Begins Allowing Access to RX Data
On July 26th, the switch was finally flipped to turn on access for practitioners to register and have access to the Georgia Prescription Drug Marketing Program (PDMP). This means that all practitioners licensed by the Georgia Composite Medical Board who have authority to prescribe or order controlled substances can now register to access the GA PDMP.
Georgia prescribers will be able to use the GA PDMP to determine where (which pharmacies) their patients are having their controlled substance prescriptions filled, and if their patients have been obtaining controlled substance prescriptions from other physicians and where those prescriptions have been filled. Two other PDMP functions will allow prescribers to see a listing of how many controlled substance prescriptions have been filled as having been written in the name of that prescriber. A similar function will allow a prescriber to see how many controlled substance prescriptions have been filled using their DEA permit number.
Even though prescribers have just gained access to the GA PDMP, community pharmacies have been reporting prescription data to the PDMP since mid-May. Even then they were required to report their controlled substance prescription data starting with prescriptions filled on September 1, 2012. The number has steadily climbed after the bugs were worked out to close to 15 million prescriptions from January through June 2013. In June alone, 3 million controlled substance prescriptions were reported as being filled.
Since pharmacists were able to register first, we have already had quite a number of pharmacists register and begin accessing the PDMP, almost 1,000. One pharmacist checked the database for several of his patients who he thought were only using his pharmacy to get their hydrocodone and alprazolam prescriptions filled. To his surprise, he found that all of the patients he checked had been going to multiple other pharmacies, getting the same type prescriptions filled and going to multiple physicians. He decided to stop filling prescriptions for those customers. Another pharmacist checked the database for patients she suspected were doctor shopping. But to her relief, none of those patients were getting prescriptions filled at any other pharmacy than hers.
As soon as you read this article, take the time to register for your access to the PDMP, don't wait any longer. Some of you have been waiting for almost nine years for access to a PDMP, so now's the time. To register, just follow these directions:
- Access the GA PDMP website at: www.hidinc.com/gapdmp.
- On the main PDMP website page, click on the Practitioner/Pharmacist link located on the Left side Menu.
- On the next page, click on "Registration Site" and a log-in menu will appear.
- On the log-in menu, type "newacct" in the User Name field, then type "welcome" in the Password field, and click on "OK".
The GA PDMP Account Registration Form page will appear. Complete this form. Make sure you type in your name exactly as it appears on the board of pharmacy website, otherwise your application will be flagged for further review. When you type in your pharmacist license number, be sure to include the 'RPH0' in front of your license number. For those of you with two zeros in front of your license number, include both zeros.
After you finish your registration, you are asked to print out the form for your records.
As soon as your application is approved, you will receive an email with further instructions on completing your registration - and in this email you will be asked to decide on a PDMP User Name and Password. Once you complete your registration, then you can begin accessing the GA PDMP database for information on your controlled substance prescriptions.
And despite the restrictions the law has placed on the use of PDMP database information, the GA PDMP is an excellent tool for prescribers who will take the time to use it in order to weed out drug abuse, drug misuse and identify patients that are being under treated by not having their prescriptions filled.
If you have any questions, please either contact HID (the database company operating the GA PDMP) using their contact information at www.hidinc.com/gapdmp. Or send your questions to the GA PDMP managers at GAPDMP@gdna.ga.gov.
GA Composite Medical Board Releases New Pain Clinic Management Application and Guidelines
The Georgia Composite Medical Board approved and released the application and guidelines for the state's new pain management clinic license on Friday, June 21, 2013. The Board's publication of the application represents the final step in implementing House Bill 178, the Georgia Pain Management Clinic Act.
Passed with overwhelming support in both the House and Senate, HB 178 creates a licensure process for pain management clinics operating in Georgia, and charges the Georgia Composite Medical Board with the responsibility of licensing and regulating pain management clinics. The Wall Street Journal reported that the number of pain clinics in Georgia rose by 1,300% from 2010 to 2012, following a crackdown on illicit pain clinics in Florida. ("New Georgia Law Aims to Control Pill Mills", May 2, 2013)
The application process includes payment of a $500 application fee, a criminal background check of each person with an ownership interest in the clinic, affidavits, and other documentation. The application and checklist can be downloaded at www.medicalboard.georgia.gov/pain-management-clinic-license-forms.
When Governor Nathan Deal signed HB 178 on May 2, 2013, Georgia became the ninth state in the nation to require pain clinics to be licensed or registered, and to be owned by physicians, according to the National Alliance for Model State Drug Laws and the National Safety Council. Under the new law, which takes effect July 1, 2013, all pain management clinics must be licensed by the Board, and must renew their licenses biennially. The Board can deny, suspend and revoke licenses if the board finds that the licensee or a physician practicing at a licensed pain management clinic has furnished false information on the application, has been convicted of a crime relating to controlled substances, has had their DEA registration suspended or revoked, or who has violated any provision of the Pain Management Clinic Act.
The new law includes other notable provisions, including:
Physician Ownership: Clinics that were not operating in Georgia before July 1, 2013 must be owned wholly by physicians. (Clinics that were already operating may be licensed under certain "grandfather" provisions.)
Definition of Pain Management Clinic:
- A clinic or practice that advertises pain treatment services
- A clinic or practice that uses the word "pain" in the clinic or practice name
- A clinic or practice that treats more than 50 percent of its annual patient population with Schedule II or III substances for chronic, non-terminal pain conditions.
Exemptions: Clinics or practices owned or operated by hospitals are exempt from licensing, but must file annual notifications with the Board.
Registration as Dispensing Clinic: All pain management clinics that dispense controlled substances or dangerous drugs must be registered with the Georgia State Board of Pharmacy.
Criminal Penalties: Any person who operates a pain management clinic without a license shall be guilty of a felony.
Governor Appoints Georgia Academy Leader to Commission on Mandated Health Insurance Benefits
Gov. Nathan Deal, Lt. Gov. Casey Cagle and House Speaker David Ralston announced in mid-March the appointments to the Special Advisory Commission on Mandated Health Insurance Benefits. Dr. Harry Strothers, immediate past GAFP Board Chair, is the Georgia Academy's representative.
Under state law, signed by the governor, the commission is charged with evaluating the social and financial impact of current and proposed mandated benefits. Members will assess the impact of mandated benefits on employers and insurers, the impact of treatment, potential costs or cost savings and other appropriate information and from there they will advise the governor and the General Assembly.
Commission members are as follows:
William A. Bornstein, MD
Bornstein is the chief quality and medical officer of Emory Healthcare. He is board certified in Internal Medicine and in Endocrinology and Metabolism.
Harry S. Strothers, MD
Strothers is a chairman and a professor in the department of Family Medicine at Morehouse School of Medicine. He is board certified in family medicine, has a certificate of added qualifications in geriatrics and a certificate in medical management from the American College of Physician Executives and Tulane University. Strothers is also a past president of the Georgia Academy of Family Physicians.
James D. Fortenberry, MD
Fortenberry is pediatrician in chief at Children's Healthcare of Atlanta and professor of Pediatric Critical Care in the Department of Pediatrics at Emory University School of Medicine.
R. Charles "Randy" Daniel, DDS
Daniel has been a private practice dentist in Stockbridge since 1984. He is a member of the medical staff of Henry Medical Center.
Gray is executive vice president of logistics, research and development for Fieldale Farms. In his role, he leads the transportation, supply chain management and research functions, and provides functional leadership for operations and marketing.
Albert C. Ertel
Ertel is the chief operating officer at Alliant Health Plans. He served on the governor's committee for Health Insurance Exchanges and currently serves on the Healthcare Policy and Small Business committees with the Georgia Chamber of Commerce.
J. Myron Faircloth
Faircloth is a faculty member at the School of Nursing at Valdosta State University and practices rural family medicine at G&G Family Medicine in Valdosta. He earned a bachelor's degree in Nursing from Valdosta State University, a master's degree in Nursing with a family nurse practitioner concentration from Brenau University, and in 2011, he earned his doctor of Nursing Practice from Georgia Southern.
Frederick Lambert Hooper, III
Hooper is chief counsel for Shaw Industries Group, Inc., where he directs the legal and corporate compliance departments.
Steven M. Wilson, O.D.
Wilson currently practices optometry in Valdosta. Prior to opening the practice, he worked in Cambodian refugee camps in Thailand.
James J. Rush, Jr.
Rush is the chief integrity officer for the Georgia Regents enterprise. Prior to that, he was the director of risk management for the Georgia Regents Medical Center.
Strickland is president of Georgia Metals, Inc., a managing partner of Madison County Ace Hardware and the Hampton House Assisted Living Facility.
Roy "Reg" Gilbreath, MD
Gilbreath is vice president and chief medical officer for the DeKalb Regional Health System. He was formerly chief medical officer at Gwinnett Hospital System, chief quality officer at Texas Health Presbyterian Dallas, and vice president of medical affairs at Georgetown Hospital System.
Fitzgerald is president of Robert Fitzgerald Insurance Agency. He is an independent agent serving the health insurance marketplace.
Addison is currently the deputy director of the Governor's Office of Planning and Budget. Before joining OPB, he served as Gov. Deal's policy adviser for economic development.
Lt. Gov.'s Appointments
Sen. Tim Golden (R-Valdosta)
Golden, of the 8th Senate District, was first elected to the Georgia State Senate in 1999. He is now serving in his seventh term. He is the chairman of the Senate Insurance & Labor Committee and serves on the Administrative Affairs, Appropriations, Finance and Higher Education committees.
Sen. Renee Unterman (R-Buford)
Unterman, of the 45th Senate District, was first elected to the Georgia State Senate in 2003. She is now serving in her fifth term. She is the chairwoman of the Senate Health & Human Services Committee and serves on the Administrative Affairs, Appropriations, Assignments, Insurance & Labor and Rules committees.
Rep. Richard H. Smith (R-Columbus)
Smith, of the 134th House District, was first elected in 2004 to the Georgia House of Representatives. He is currently serving in his fifth term. He is the chairman of the House Insurance Committee and serves on the Appropriations, Natural Resources and Environment, Legislative and Congressional Reapportionment and Rules committees.
Rep. Ben Watson, MD (R-Savannah)
Watson, of the 166th House District, was elected in 2011 to the Georgia House of Representatives and is now serving in his second term. He is the vice chairman of the House Health and Human Services Committee and serves on the Appropriations, Higher Education and Science & Technology committees.
Commissioner David Cook, Georgia Department of Community Health
Commissioner Ralph Hudgens, Georgia Department of Insurance
Commissioner Mark Butler, Georgia Department of Labor
March 22, 2013 Report
Waning Days of the Session
The Georgia General Assembly is currently scheduled to complete their 40 days of service on Thursday, March 28th (Sine Die). Next week they will meet Monday (March 25th), Tuesday (March 26th), and Thursday (March 28th). If you have any questions about legislation, please do not hesitate to contact our Executive Vice President Fay Brown at firstname.lastname@example.org or via phone at 800.392.3841.
Budget for Fiscal Year 2014
Last week, the House approved a budget for FY 2014 that would begin July 1, 2014 and they voted to restore the Medicaid cut to physicians as recommended by the Governor. They also restored by half the issue of reducing the payment related to CPT consult codes. The budget was then transmitted to the State Senate and they passed out their version of the budget late on Friday afternoon, March 22. In their proposal they went back to the initial recommendation of the Governor to cut physician Medicaid rates by .74 percent and eliminated the restoration of the funding for the CPT Consultation codes.
The budget will now go to conference where a small committee of both House and Senate leaders will work on a compromise. The GAFP Legislative Committee has deployed your registered lobbyists (Fay Brown and Chuck McMullen) to aggressively engage on this issue. The leaders of both Chambers as well as senior staff with the Lieutenant Governor and the Governor are aware of the importance of restoring these funds.
Updates on Board Approved Legislative Priorities
- Oppose physician cuts to the Medicaid budget. See above.
- Support funding for expansion of family medicine residency programs. Ongoing - part of budget negotiations.
- Seek venues to educate key policymakers and legislators on the medical home. Ongoing.
- Stand vigilant and ready to review any proposed legislative initiative to expand a medical providers' scope of practice. Continue to insure the safety of patients. Legislative Committee meets weekly to review bills of note.
- Support House Bill 178 - Pain Management Clinics. This bill passed the House on February 20th and the Senate on March 21.
- Support House Bill 125 - Allow immigration status to only be confirmed once when applying for state license (including all physician and nurse state licenses). This bill passed the House on February 20th and also passed out of the Senate Judiciary Non-Civil Committee and now resides in the Senate Rules Committee.
- Support Senate Bill 85 - Allow pharmacists, under physician protocol, to administer adult vaccines. Passed out of the Senate on March 7th and now resides in the House Health and Human Services Committee.
Physician Order for Life Sustaining Treatment - Bill Passes!
The Georgia Academy has had a long standing priority of supporting passage of the POLST language (2011 and 2012) and also worked to get a technical fix of the language approved by both Houses this year (Senate Bill 158). This bill passed in the House on March 7th and today in the Senate (162-0)!!
Additional Health Care Bills - Of Note
HB 179 - Pharmacies; The Pharmacy Audit Bill of Rights; change certain provisions
House Committee: Insurance - passed
Senate Committee: Insurance and Labor - passed
House Passed/Adopted By Substitute 2/22/13; Senate Read Second Time 3/21/13
HB 499 - Torts; payor guidelines and criteria under federal law shall not establish legal basis for negligence or standard of care for medical malpractice; provide
House Committee: Judiciary - passed
Senate Committee: Judiciary
House Passed/Adopted By Substitute 3/7/13; Senate Read and Referred 3/11/13
HB 240 (Carson-46th) Requires Medicaid and PeachCare for Kids reimbursement for certain speech-language pathology services provided by those who are clinical fellows licensed by the State Board of Examiners for Speech-Language Pathology and Audiology in the same amount as would be paid for such services if provided by fully licensed speech-language pathologists. Passed House. Assigned to Senate Insurance and Labor Committee.
HB 284 (Pruett-149th) "Return to Play Act of 2013" requires public and private schools which provide youth athletic activities to provide information to parents on the nature and risk of concussion and head injury and to establish concussion management and return to play policies. The bill also requires public recreation leagues to provide information to parents on the nature and risk of concussion and head injury. Passed House. Recommended Do Pass by the Senate Education and Youth Committee.
HB 337 (Fleming-121st) A public or private school in this state may acquire and stock a supply of auto-injectable epinephrine and designate an employee or agent who is appropriately trained to be responsible for the storage, maintenance, and distribution of the auto-injectable epinephrine stocked by the school. Any employee that is appropriately trained may administer auto-injectable epinephrine to any student such employee believes is experiencing an anaphylactic adverse reaction. Passed House. Recommended Do Pass by the Senate Education and Youth Committee.
HR 502 (Tanner-9th) Creates the Joint Study Committee on Mental Health and School Violence. Passed House. Recommended Do Pass by the Senate Rules Committee.
SB 1 (Ligon-3rd) No insurer shall have a policy of denying, or which effectively prevents, a parent of a child the right to inspect, review, or attain copies of health insurance records relating to his or her own child, in all types of custody arrangements, unless a court order has specifically removed the right of the noncustodial parent to such information or unless parental rights have been terminated. Passed Senate. Recommended Do Pass by the House Judiciary Committee.
Note: The following issues were addressed by the Special Advisory Commission on Mandated Health Insurance Benefits at its first meeting on March 12. So far these were the only three issues the commission is considering. They will be reviewed by three subcommittees of the commission which will consider the economic impact, the social impact and the medical appropriateness of the bills.
HB 73 (Linsdsey-54th) Each insurer providing a prescription drug benefit or reimbursement for health care costs shall provide coverage and reimbursement for medical foods used in the diagnosis and treatment of inherited metabolic and genetic disorders and food tolerance and absorption disorders where the attending physician has issued a written order stating that the medical food is medically necessary.
HB 74 (Lindsey-54th) Every health benefit policy shall provide coverage for the full cost of one hearing aid per hearing impaired ear subject to a $2,500.00 minimum and up to $3,000.00 per hearing aid for covered individuals 22 years of age or under and for the replacement for one hearing aid per hearing impaired ear every 36 months.
HB 309 (Harbin-122nd), SB 47 (Fort-39th), SB 191 (Albers-56th), HB 559 (Sims-169th) - An insurer shall not deny, terminate or restrict coverage solely because an individual is diagnosed with or received treatment for an autism spectrum disorder.