State Advocacy
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March 3, 2017 – State Legislative Update
The Georgia General Assembly has utilized 28 out of a potential 40 legislative days. Crossover day (technically the last day that bills can move from one chamber to the other is scheduled for today – Friday, March 3rd. A full update will be sent out to the membership next week.
If you have questions about any pending legislation, please contact our Executive Vice President Fay Fulton (ffulton@gafp.org).
FY 18 Budget Being Considered in the Senate
Continuing Steps Towards Physicians Medicaid–Medicare Rate Parity
Stabilizes Georgia’s Healthcare System & Increases Access to Care
The Issue:
HB 44 is the Governor’s proposed Budget for State Fiscal Year (SFY) 2018, which begins July 01, 2017. The Governor appropriated $18M in the Department of Community Health (DCH) budget to increase 81 select primary care and OB/GYN codes to 2014 Medicare levels.
However, Primary Care Providers Being Denied Medicaid Payment Increases
Authorized under HB 751 (FY 2017 budget) & Will Be in FY 2018 Also
Since increased physician payment rates (to match Medicare) for Medicaid were passed by the General Assembly for FY 2017, the DCH policy on “attestation” has denied some providers from receiving the increased rates. The legislature enacted these increases—the first since 2000–to stabilize Georgia’s primary care workforce, support rural healthcare system, and improve access.
DCH implemented the first rate increases in FY 2016 using the same criteria which the federal ACA had used to provide federal dollars to increase Medicaid rates to Medicare levels for 2 years, calendar 2013 and 2014. That is, eligible physicians had to be board-certified in pediatrics, family medicine or internal medicine. And they had to “attest” that they practiced in one of these 3 specialties. This was a reasonable approach which was broadly supported.
But new DCH policy, implemented on July 1, 2016 had these 2 effects: A. any provider who changed locations or works in another office other than where they worked and attested in 2013-14, would lose their rate increases. And B. If a provider did not attest during 2013 or 2014 for the federal increase, no matter what the reason, they would also be denied receiving the increases.
Governor Deal, in his FY 2018 DCH budget proposal, recommended funds for the 3rd phase of this effort to make Medicaid reimbursement for primary care practices for more services on par with Medicare. The payment for these services will also be denied to some providers unless this policy is changed.
We ask the Senate to take steps that mirror the House’s action in the FY 2018 budget by allocating funds or otherwise by language to ensure that DCH resolves this issue effective July 1, 2017. These providers have already been unreasonably denied the increases for too long and waiting until next January to fix this problem will only exacerbate the access to care issue the General Assembly had sought to address.
The following are real examples of providers have been denied or lost the rate increases:
Example 1: In 2013 an Athens internal medicine physician attests for the ACA increase. In 2016, he begins practicing at a new office they have opened in Bogart. Instantly, he loses the rate increases due to his location change.
Example 2: A family physician attested in 2013. In 2016 the practice renovated their
office space near the hospital campus where they were located. Her office was relocated 200 feet away on the other side of the street. She is now denied as ineligible to attest due to changing addresses.
Example 3: A pediatrician finishes her residency in 2012 and begins practicing in Conyers in 2013. She is not yet board-certified during that period so she cannot attest, since you must be board-certified to attest. She becomes board-certified in 2015. But she cannot attest then because Medicaid is no longer taking attestations. She then tries to attest in December 2016. And she is denied then and told she is not eligible.
The Georgia Academy recommends to the State Senate that effective July 1, 2017 the beginning of FY 2018, DCH simply follow the same criteria used in 2013 and 2014 to identify eligible providers: namely board-certification in family medicine, pediatrics or internal medicine. And therefore, that the ability to attest is always open and ongoing for those providers who meet that criteria.
House Bill 301 – Support Preceptor Tax Credits for Physicians Teaching Georgia’s Medical Students
The Georgia Academy supports House Bill 301 (sponsor Rep. Jodi Lott – Augusta) to change our current preceptor tax deduction to a tax credit.
For Georgia to provide the community based education demanded by these critical health disciplines (physician, APRN, and PA) they must be able to compete with the out of state / off shore programs who are willing to pay Georgia community based faculty to take their students. The current program was implemented in July 2014 and offers up to a $10,000 deduction for precepting medical/osteopathic, APRN, or PA students. Eligible recipients are licensed physicians in the state of Georgia.
This bill has passed out of the House and is slated to be heard in the Senate Finance Committee on Tuesday, March 7th.
House Bill 360 – Expedited Partner Therapy (sponsor Rep. Sharon Cooper)
Georgia Academy also supports the Expedited Partner Therapy Bill (House Bill 360). This bill is a public health issue and will assist physicians to treat patients and their partners with sexual transmitted diseases. This bill has passed out of the House and will now crossover to the Senate Health and Human Services Committee.
February 17, 2017 – State Legislative Update
The Georgia General Assembly has utilized 20 out of a potential 40 legislative days. Crossover day (technically the last day that bills can move from one chamber to the other is scheduled for Day 28 – Friday, March 3rd.
If you have questions about any pending legislation, please contact our Executive Vice President Fay Fulton (ffulton@gafp.org).
House Passes Budget Today with Medicaid Increases for Family Physicians!
Continuing Steps Towards Physicians Medicaid–Medicare Rate Parity
Stabilizes Georgia’s Healthcare System & Increases Access to Care
The Issue:
- HB 44 is the Governor’s proposed Budget for State Fiscal Year (SFY) 2018, which begins July 01, 2017. The Governor appropriated $18M in the Department of Community Health (DCH) budget to increase 81 select primary care and OB/GYN codes to 2014 Medicare levels.
- HB 44 passed the House and is pending Senate review and mark-up before both chambers vote on the compromise budget.
- This significant increase is the culmination of a three-year effort by the Patient-Centered Physicians Coalition of Georgia to raise primary care and OB/GYN codes to Medicare levels, and represents a restoration of the two-year primary care increase the federal government provided in 2013 and 2014. Prior to that, Medicaid payment rates in Georgia had not been increased by the state in 15 years.
- In SFY 2016, the General Assembly added $23M in new state funds in the DCH budget to increase Medicaid reimbursement rates for 12 services provided by primary care and OB/GYN physicians. Last year, the General Assembly added an additional $26.5M in the SFY 2017 DCH budget to increase payment levels for an additional 28 codes.
We are appreciative of the support the Governor and the General Assembly have shown in recognizing that past low Medicaid reimbursement rates had a detrimental impact on primary care physician practices and the citizens they serve. These rate increases to Medicare parity will:
- Improve access to care for patients: Medicaid payment directly impacts physician participation in the Medicaid program and is a key factor in ensuring access to care for Medicaid patients.
- Help to stabilize rural health in Georgia: Physicians practicing in rural Georgia are disproportionately impacted by low Medicaid reimbursement rates because they generally serve a larger percentage of Medicaid patients in their practices – children, pregnant women, and other fragile adults.
- Strengthen Georgia’s ability to retain an adequate physician workforce: Strong physician practices are fundamental for the health systems in our communities, especially in non-metro areas. Georgia already has a shortage of primary care physicians in 75% of its counties (119 out of 159).
- Support physician practices as vital contributors to the state’s economy in addition to being critical to community healthcare systems. The AMA has reported that primary care physicians’ practices are significant economic engines in Georgia.
The Patient-Centered Physicians Coalition of Georgia is comprised of the Georgia Academy of Family Physicians; Georgia Chapter-American Academy of Pediatrics; Georgia Chapter-American College of Physicians (Internal Medicine); Georgia Osteopathic Medical Association; and Georgia OBGyn Society. With membership of more than 9,000 physicians, the Coalition represents the primary care and OBGyn specialties that provide the overwhelming majority of medical care to Medicaid patients in Georgia.
New Legislative Priority – House Bill 301 – Support Preceptor Tax Credits for Physicians Teaching Georgia’s Medical Students
The leadership approved supporting House Bill 301 (sponsor Rep. Jodi Lott – Augusta) to change our current preceptor tax deduction to a tax credit.
For Georgia to provide the community based education demanded by these critical health disciplines (physician, APRN, and PA) they must be able to compete with the out of state / off shore programs who are willing to pay Georgia community based faculty to take their students. The current program was implemented in July 2014 and offers up to a $10,000 deduction for precepting medical/osteopathic, APRN, or PA students. Eligible recipients are licensed physicians in the state of Georgia.