Week 5 Legislative Report
The General Assembly has picked up their pace! Committees have been working hard to passing out legislation this week. It is important to note that Crossover Day this year will be on March 3, which is Day 28, instead of Day 30 like it has been during previous sessions. This means that legislators have two fewer days to get their bills passed out of committees and to receive a vote on the House or Senate floors. Any legislation that does not make it to a vote by the end of Day 28 will not move forward this session. Lawmakers are also working hard on the FY 2018 Budget. It is anticipated that the House will have its version out of the Appropriations Committee sometime next week.
Passed Legislation
While most of the bills which passed this week are not relevant to your organization, I have included the ones that are of interest below:
- SB 4, by Sen. Renee Unterman (R-Buford) is the "Enhancing Mental Health Treatment in Georgia Act," that in part establishes a Mental Health Treatment Task Force and prohibits any submission of a mental health Medicaid waiver application without legislative approval. SB 4 passed by Committee Substitute with a vote of 40-0.
- SB 52, by Sen. P.K. Martin (R-Lawrenceville) removes a sunset provision for licensed professional counselorsto perform emergency exams and certification of individuals who require involuntary treatment. It passed by a vote of 51-3.
- HB 64, by Rep. Shaw Blackmon (R-Bonaire) requires a health benefit plan in the State to pay a commission to an agent who has sold a group health plan or an individual health plan. It passed 172-2.
- HB 75, by Chairman Wendell Willard (R-Sandy Springs) seeks to protect from disclosure certain records belonging to the Department of Human Services and DFCS that includes information provided by law enforcement or prosecution agencies in any pending investigation or prosecution of criminal activity contained within the child abuse, neglect, or dependency records.
- SB 40, by Sen. Renee Unterman (R-Buford) allows EMS to take individuals with mental illnesses who require involuntary treatment to emergency receiving facilities. Sen. Joshua McKoon (R-Columbus) proposed an amendment to replace the word "transporting" on line 39 with "making the decision to transport". The amendment also adds that Emergency Medical Personnel will not be liable for damages when making the decision to transport a person under this subsection "unless those damages are a result of such personnel's willful and wanton negligence." The amendment was adopted and the bill passed by a vote of 47-1.
Committees
House Health and Human Services Committee – 02/07
The House Health and Human Services Committee met and had two pieces of legislation on the agenda,HB 36andHB 165. There was no discussion on HB 165 and it was held.
HB 36 by Chairman Earl Ehrhart (R-Powder Springs) is a scope of practice bill to permit optometrists the ability to provide certain injections into the eyes. He argued that Georgia has 250 ophthalmologists and over 1000 optometrists. Chairman John Meadows (R-Calhoun) also appeared before the committee, working with Chairman Ehrhart to promote this legislation. He reminded his colleagues that optometrists are taught about how to do injections in school but they cannot actually perform such in practice. There were numerous questions raised on the training of optometrists versus the training of ophthalmologists. The Committee also asked questions about risk to the patient and access to care. Rep. Betty Price (R-Roswell) also asked about malpractice coverage required. The response was that optometrists are required to have the same amount as an ophthalmologist with malpractice limits. A Dalton ophthalmologist, Dr. Kim, who is also president of the Georgia Society of Ophthalmology, opposed the legislation noting that it was too far reaching and there is no simple innocuous procedure. A number of physicians spoke against the proposal. In the end, a motion was made 'do-pass'. A voice vote was taken and the Chairman ruled that the no's had it, meaning the proposal failed. A hand count was requested and Chairman Cooper said the no's still had it. Someone called the question on the vote 12-12 and Chairman Cooper broke the tie vote.
Senate Health and Human Services Committee – 02/07
Chairwoman Renee Unterman (R-Buford) conducted a two hour meeting Tuesday afternoon onSB 8relating to "surprise" or balanced billing practices,SB 16relating to use of cannabis oils for autism andSB 40relating to transport of consumers suffering from mental illness by emergency medical technicians.
The surprise billing discussion did not lead to a vote on SB 80 but the vote is expected on Thursday, February 9. Sen. Unterman brought a substitute to the hearing, but it is not yet available on line. She took testimony from the Georgia Association of Health Plans, AHIP, The Medical Association of Georgia, the Georgia Hospital Association, Georgia Association of Emergency Room Physicians and others. The primary issue at this point is what version of a default payment to non-network providers is contained in the legislation and whether it is based in part on the Fair Health data base which contains tabulations of billed physicians charges by region and specialty. Sen. Unterman's proposed substitute contains an arbitration process for reimbursement disputes betweeninsurers and physicians before the Department of Insurance which defaults to a payment derived from an average of Medicaid, Medicare and Fair Share pricing, using each system at 33 1/3% of the formula. The insurers are pushing to use a data base that is comprised of actual rates contracted for in network providers by specialty and region, and the physicians for 80% of the Fair Share data base price. Senators questioned the witnesses extensively. Other testimony by GHA concerned the types of disclosures that hospitals make to patients about which of its employed or contracted physicians are in the hospitals' networks.
SB 16, by Sen. Ben Watson (R-Savannah), passed on a 9-1 vote, but only after attempts by Sen. William Ligon, Jr. (R-Brunswick) to lower the maximum percent of THC that is permitted for medical treatment from 3% to .5%. The proposed bill added autism to the medical conditions that qualify for cannabis oil medical use, but had lowered the THC from 5% in current law for all diseases to 3% and limited the use of cannabis oil for autism to adults over the age of 18, rather than children.Ligon's amendment failed on a vote of 5-7 after the Committee also defeated an effort by Sen. Steve Henson (D-Tucker) to restore the THC level from 3% to 5%.
SB 40, by Sen. Renee Unterman (R-Buford, also passed out of the Committee with an amendment to tighten when an EMS may transport a patient eligible for civil commitment to an emergency room. The bill remains under active discussion as to whether and how the EMS can evaluate the condition of the patient as qualifying for possible detention by an ER, a crisis stabilization or emergency receiving unit. The goal of the bill is to minimize police or law enforcement transports to emergency receiving facilities and to secure faster responses to patients in crisis by the more numerous EMTs.
House Appropriations Committee – 02/08
The full House Appropriations Committee, under the leadership of Chairman Terry England (R-Auburn), met to take up the Governor's bill regarding the hospital provider fee. Rep. Chuck Efstration (R-Dacula) presentedSB 70to his colleagues. SB 70, originally authored by Sen. Butch Miller (R-Gainesville), is the renewal of the hospital provider fee which will expire on June 30, 2017. This legislation seeks to extend that fee by three years, or until June 30, 2020. The fee generates $311 million in State funds which is then matched with $600 million in federal money for a total of $911 million. This money is placed in a segregated account and used for the State's Medicaid program. The Department of Community Health Board is allowed to set the rate imposed and it is also allowed to discontinue the fee if it no longer is eligible for federal matching funds. 49 of 50 states use a similar financing scheme. SB 70 received a do pass recommendation and passed easily from the Committee and now heads to the House Rules Committee.
Medical Cannabis Work Group – 02/08
This House Work Group on Medical Cannabis met in the afternoon, discussing various recommendations that have been proposed. Rep. Allen Peake (R-Macon) chairs this Work Group, which is not an official Subcommittee or Committee of the House. However, the Work Group agreed to a set of four recommendations which it had developed which will be submitted to the House Judiciary Non-Civil Committee forHB 65. The Work Group did not take up the constitutional amendment proposal which would address cultivation of cannabis,HR 36. The recommendations essentially address: providing reciprocal agreements with other states if an individual has a card permitting him or her to have medical cannabis; addressing intractable pain in an effort to eliminate use of opioids; requiring card holders to provide information to the Department of Public Health on their experiences/side effects (rather than physicians making such reports); and allowing a card for medical cannabis when a patient is admitted to a hospice program. HB 65 amends O.C.G.A. § 31-2A-16 regarding the Low THC Oil Patient Registry and the conditions and eligibility for such.
House Ways and Means Committee – 02/09
Chairman Jay Powell (R-Camilla) and his Committee passed out a couple relevant proposals which now move to the House Rules Committee for further review:
- HB 54 – This legislation is by Rep. Geoff Duncan (R-Cumming) and addresses the law passed in 2016 establishing a rural hospital tax program. In this proposal, it moves the 70 percent cap for the amount expended to 90 percent so as to attract more corporate donors. It also addresses the third-party fundraising concerns as well as advertising of those. It also raises the individual tax credits so that those are increased, and that such will be retroactive to January 1, 2017. It also makes the amount of the cap to be approved by the Department of Revenue at $60 million for years 2017, 2018 and 2019 rather than having varying amounts. Rep. Trey Kelley (R-Cedartown) moved the proposal forward with a do pass recommendation.
- HB 195 – Rep. Brett Harrell (R-Snellville) brought this legislation, addressing a property tax exemption issue for a Fulton County entity providing housing services to the mentally ill. It allows a for profit corporation or person in the indirect ownership of a home for the mentally disabled as a member of the limited liability company or limited partner of the partnership that is the direct owner of such home for the purpose of providing financing for the construction or renovation of such home in return for a share of the tax credits and which relinquishes all ownership of such home upon the completion of its obligation under the financing agreement so that such will not disqualify this home for the mentally ill to forego its property tax exemption. The Fulton County home had to pay $40,000 property taxes.
Legislation Tracking
Bill / Committees / Status / AnalysisHB030 / HC: Judiciary Non-Civil / Jan/11/2017 - House Second Readers / Rep. Kevin Tanner (R-) proposes to amend O.C.G.A. § 16-13-25 by adding a synthetic opioid to the list of Schedule 1 substances. The synthetic opioid added to the list is"(RR) 3,4-dichloro-N-(2-(dimethylamino)cyclohexyl)-N-methylbenzamide (U-47700)".
HB035 / HC: Insurance / Jan/23/2017 - House Second Readers / Rep. Bruce Broadrick (R-Dalton), would create a new Code Section relating to the licensure of pharmacy benefit managers at O.C.G.A § 33-64-10. The new language requires pharmacy benefit managers to provide notification of receipt of a request for prior approval for a prescription drug to a pharmacy or contracting representative within 48 hours of receipt of such request. Such notification must also include a claim reference number and return contact phone number for follow up. This new code section shall only apply to health insurance plans established under Article 1 or Chapter 18 of Title 45 or under Article 7 of Chapter 4 of Title 49.
HB055 / HC: Regulated Industries / Jan/23/2017 - House Second Readers / Rep. Rick Williams (R-Milledgeville), would add a new code section at O.C.G.A § 43-1-14.1 which provides that any members of a professional licensing board who are appointed to a term beginning on or after July 1, 2017, shall serve no more than eight consecutive years on such licensing board.
HB071 / HC: Insurance / Jan/25/2017 - House Second Readers / Rep. Richard Smith (R-Columbus), would add a new chapter (Chapter 20E) to Title 33 of the Official Code of Georgia Annotated relating to insurance. This bill requires health care providers, group practices, diagnostic and treatment centers and health centers to inform patients of the various health benefit plans and hospitals that it contracts with. If the provider is out of network for a patient and the patient is receiving nonemergency services, the provider must, upon the patient's request, provide the patient with the estimated cost of such services in writing. The bill also requires physicians to make certain disclosures to patients regarding referrals, such as the name and address of the referred physician or provider. Hospitals would be required to post information about its health benefit plans, physician groups contracted by the hospital, and a statement regarding the physician's services that are not included in the hospital's charges. Further, this legislation requires hospitals to enter into credentialing agreements with health benefit plans insurers. Finally, O.C.G.A. § 33-20E-3 and O.C.G.A. § 33-20E-5 of this bill create disclosure requirements for insurers.
HB075 / HC: Judiciary / Feb/09/2017 - House Passed/Adopted / Rep. Dar'Shun Kendrick (D-Lithonia) would create a new Code Section at O.C.G.A. § 20-2-779.2 to require the Department of Education, in consultation with the Department of Behavioral Health and Developmental Disabilities, to develop a list of training materials for awareness in mental health, behavioral disabilities, and learning disabilities. Such materials may include training materials currently being used by school systems.
HB077 / HC: Education / Jan/25/2017 - House Second Readers / Rep. Dar'shun Kendrick (D-Lithonia) would add a new code section at 20-2-779.2 to provide that no later than July 1, 2018, theDepartment of Education shall, in consultation with the Department of Behavioral Health and Developmental Disabilities and mental health experts, develop and provide to all local school systems a list of training materials for awareness in mental health, behavioral disabilities, and learning disabilities which mayinclude training materials currently being used by a local school system. It further states that no person shall have cause of action for any loss or damage caused by any act or omission resulting from any training, or lack thereof. Any training, or lack thereof, shall not be construed to impose any specific duty of care.
HB081 / HC: Ways & Means / Jan/25/2017 - House Second Readers / Rep. Tom McCall (R-Elberton) would amend O.C.G.A. § 48-7-161 to include under the definition of 'Claimant Agency' any health care facility that is formed, created, or operated by a hospital authority established pursuant to Article 4 of Chapter 7 or Title 31.
HB173 / HC: Health & Human Services / Feb/01/2017 - House Second Readers / Rep. Joyce Chandler (R-Grayson), proposes to authorize licensed marriage and family therapists to perform certain acts which physicians, psychologists, licensed clinical social workers, clinical nurse specialist in psychiatric/mental health, and licensed professional counselors can do in O.C.G.A. § 37-3-41(d). It further expands current law on acts they may perform regarding emergency involuntary treatment of an alcoholic, drug abuser, or a drug dependent individual in O.C.G.A. § 37-7-41(d) and those individuals' emergency involuntary treatment in O.C.G.A. § 37-3-41(d), and permits them to also perform necessary functions for the emergency admission of a person for involuntary evaluation of mental illness in O.C.G.A. § 37-3-41(d).
HB188 / HC: Appropriations / Feb/02/2017 - House Second Readers / Rep. Stacey Abrams (D-Atlanta), seeks to create a new Code Section at O.C.G.A. § 49-4-159 that would authorize appropriations for the purpose of obtaining federal financial participation for medical assistance payments to providers on behalf of Medicaid recipients and funding the State's portion of the cost to expand Medicaid under the Affordable Care Act. Such appropriations would provide up to a maximum of 138 percent of the federal poverty level.
HB195 / HC: Ways & Means / Feb/09/2017 - House Committee Favorably Reported By Substitute / Rep. Brett Harrell (R-Snellville) proposes to amend O.C.G.A. § 48-5-41 to provide that indirect ownership of a home for the mentally disabled through a limited liability company that is fully owned by a tax exempt organization shall be considered direct ownership.
HB206 / HC: Health & Human Services / Feb/07/2017 - House Second Readers / Rep. Trey Kelley (R-Cedartown), proposes to amend O.C.G.A. § 26-4-118, removing an exception relating to certain audits conducted by the Department of Community Health relating to Medicaid, by providing that any clerical or record-keeping error shall not in and of itself constitute fraud or constitute a basis to recoup full payments made by providers. No such claim would be subject to criminal penalties without proof of intent to commit fraud. The recoupment amount shall be limited to the amount paid. It would give a provider of medical assistance 30 days to correct any errors or omissions, following receipt of notice. Such provider would also be afforded the right to a hearing for any attempted withholding of reimbursement or recoupment.
HB213 / HC: Judiciary Non-Civil / Feb/07/2017 - House Second Readers / Rep. Golick (R- Smryna), proposes to amend O.C.G.A. § 16-13-31 to prohibit the sale, manufacture, delivery, or possession of four grams or more of 'fentanyl.'
HB213 / HC: Judiciary Non-Civil / Feb/07/2017 - House Second Readers / Rep. Golick (R- Smryna), proposes to amend O.C.G.A. § 16-13-31 to prohibit the sale, manufacture, delivery, or possession of four grams or more of 'fentanyl.'
HB231 / HC: Judiciary Non-Civil / Feb/07/2017 - House Second Readers / Rep. Bruce Broadrick (R-Dalton), is Georgia's proposed annual dangerous drug update legislation. It adds new controlled substances in Chapter 13 of Title 16 which are Schedule I, II, IV and V controlled substances to this list. It includes a new "fentanyl analog structural class" of drugs and derivatives, salts, isomers or salts of isomers.
HB231 / HC: Judiciary Non-Civil / Feb/07/2017 - House Second Readers / Rep. Bruce Broadrick (R-Dalton), is Georgia's proposed annual dangerous drug update legislation. It adds new controlled substances in Chapter 13 of Title 16 which are Schedule I, II, IV and V controlled substances to this list. It includes a new "fentanyl analog structural class" of drugs and derivatives, salts, isomers or salts of isomers.