This Week’s Legislative Action
Twenty of 40 legislative days having been completed, the General Assembly is at the halfway point of the 2023 session. “Crossover Day,” the deadline by which House and Senate bills must be passed by their originating chambers to continue movement this year, is merely two weeks away. We expect a flurry of activity to begin on Tuesday when the legislature reconvenes and will continue to pick up pace through the March 6th crossover deadline. When the legislature reconvenes on Tuesday, we expect two Certificate of Need (CON) bills, SB99 and SB162, to be heard in the Senate Regulated Industries Committee. This will be the second committee hearing on SB99, so a committee vote is expected. It remains unclear whether SB162 will receive a vote or will only be heard. NGHS Government Affairs, GHA, and GACH are working closely with the Senate regarding these proposals. The committee is scheduled to meet at 4:00 p.m. on Tuesday, February 21st. You can watch via livestream here.
Below you will find a list of new legislation introduced in the House and Senate this week that we are following, a summary of numerous committee meetings that were held to consider legislation, and floor passage of bills of interest to NGHS.
NEW BILLS INTRODUCED THIS WEEK
HB 337, introduced by Rep. Marin, was assigned to House Judiciary Non-Civil Committee. HB 337 would amend the law relative to the Department of Public Health, and general provisions relative to torts, to authorize the use, production, manufacturing, and dispensing of medical marijuana in this state. This bill would also provide the medical conditions for which medical marijuana may be prescribed and used.
HB 339, introduced by Rep. Hutchinson, was assigned to House Public Health Committee. HB 339 would amend the law relating to the governing and regulation of mental health to provide that the Department of Behavioral Health and Developmental Disabilities conduct or coordinate all audits of behavioral health providers to prevent duplicative audits from being conducted by DCH.
HB 343, introduced by Rep. Newton, was assigned to House Health Committee. HB 343, known as the “Low Prescription Drug Costs for Patients Act”, would amend the law relating to regulation and licensure of pharmacy benefits managers (PBMs). This bill would require PBMs to calculate defined cost sharing for insureds at the point of sale and report those annual amounts to the department.
HB 361, introduced by Rep. Mack Jackson (D-Sandersville), was assigned to House Public Safety & Homeland Committee. HB 361, known as the “Eurie Lee Martin Act”, would establish the creation of a state-wide data base by the Criminal Justice Coordinating Council to be known as the “ELM Data Base”.; The ELM Data Base will include identifying information from arrest records of individuals who suffer from addictive disease, developmental disabilities, or mental illness so that law enforcement officers can use the ELM Data Base whenever practicable while responding to a call. This bill would provide for additional training on how to identify and respond to individuals who suffer from addictive disease, developmental disabilities, or mental illness.
HB 362, introduced by Rep. Karen Mathiak (R-Griffin), was assigned to House Insurance. HB 362 would amend the law to require benefit providers to disclose certain payments, within 30 days of the written request, to a treating healthcare provider for personal injury cases. This bill defines “healthcare provider” as a person duly licensed or legally authorized to provide healthcare services and that has provided such services to an injured party.
HB 363, introduced by Rep. John LaHood (R-Valdosta), was assigned to House Ways & Means Committee. HB 363 would amend the law relating to tax credits for contributions to rural hospital organizations. This bill would increase the Rural Hospital Tax Credit (RHTC) cap from $75 million to $100 million beginning January 1, 2023, and would extend the sunset for this program from December 31, 2024 to December 31, 2029. Last Session, HB 1041 increased the RHTC from $60 million to $75 million. HB 363 would allow hospitals designated as a rural emergency hospital to be added to the definition of a “rural hospital organization” and would move the contribution deadline from December 31 to October 31. NGHS supports this legislation and the potential benefit it may provide to NGMC Lumpkin.
HB 378, introduced by Rep. Shelly Hutchinson (D-Snellville), was assigned to House Insurance Committee. HB 378 updates the definition of “Autism Spectrum Disorder” to be defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as of January 1, 2023.
HB 129, introduced by Rep. Soo Hong (R-Lawrenceville), would amend Georgia Code relating to public assistance to expand the temporary assistance for needy families (TANF) eligibility criteria to pregnant women. As currently written, this code section does not include pregnant women. This bill passed out of the House yesterday and was assigned to Senate Children and Families Committee.
HB 383, introduced by Rep. Matt Reeves (R–Duluth), was assigned to House Judiciary Non-Civil Committee. HB 383, known as the “Safer Hospitals Act”, would provide for enhanced penalties for aggravated assault and aggravated battery committed upon emergency health workers and healthcare workers located on a hospital campus. This bill would add “Health care worker”, meaning any employee or independent contractor of a hospital or other healthcare facility”, to the existing list of professions protected. HB 383 would also authorize “hospital peace officers” who are POST certified to exercise the same law enforcement powers, including arrest, as local law enforcement officers while on hospital property.
HB 384, introduced by Rep. Sharon Henderson (D–Covington), was assigned to House Insurance Committee. HB 382 would amend Georgia Code relating to individual accident and sickness insurance coverage for mammograms, pap smears, and prostate-specific antigen tests to provide for annual notification by insurers to male insureds of coverage for prostate-specific antigen tests. Currently, insurers provide notifications to each insured female of her coverage for mammograms after the age of 40 for as long as mammogram screening is recommended based on her individual health status, as determined by her physician.
HB 405, introduced by Rep. Omari Crawford (D–Decatur), was assigned to House Public Health Committee. HB 405, known as the “Mapillar Dahn Act”, would require the Department of Community Health to conduct an annual review of medications and treatment for sickle cell disease for Medicaid recipients. The Department will be required to post their findings on their website annually for public accessibility.
HB 414, introduced by Rep. Shaw Blackmon (R–Bonaire), was assigned to House Health Committee. HB 414 would provide for a grant program within the Department of Behavioral Health and Developmental Disabilities to provide behavioral health services to military service members, veterans, and their families.
HB 416, introduced by Representative Sharon Cooper (R–Marietta), was assigned to House Health Committee. HB 416 would authorize qualified pharmacy technicians to administer certain vaccines (COVID-19 vaccines) at the discretion of a supervising pharmacist.
HB 417, introduced by Representative David Knight (R–Griffin), was assigned to House Insurance Committee. HB 417 would prohibit insurers from forcing the use of outsourced provider administered drugs (“white bagging”) on healthcare providers.
HB 428, introduced by Representative Carolyn Hugley (D–Columbus), was assigned to House Public Health Committee. HB 428 would direct the Department of Community Health to provide 12 months of continuous eligibility for Medicaid and the PeachCare for Kids Program to children from birth through age 18.
HB 434, introduced by Representative Lee Hawkins (R–Gainesville), was assigned to House Health Committee. HB 434 would amend Georgia Code to provide for the licensing of radiologist assistants by the Georgia Composite Medical Board. This bill would also provide that radiologists may use the services of licensed radiologist assistants under the supervision of said radiologists.
HB 440, introduced by Representative Doug Stoner (D–Smyrna), was assigned to House Public Health Committee. HB 440 would authorize public and private schools to stock a supply of undesignated ready-to-use glucagon for treatment of severe hypoglycemia. This bill would provide for requirements for the storage, maintenance, and distribution of undesignated ready-to-use glucagon and would provide for the authorized use in necessary situations. This bill would also amend Georgia Code relating to pharmacists and pharmacies to authorize certain healthcare practitioners to prescribe or dispense glucagon to an authorized entity for emergency purposes.
SB 135, introduced by Sen. Kirkpatrick, was assigned to Senate Children and Families Committee. SB 135 would amend the law relating to determination of paternity to align medical and genetic testing with the Uniform Parentage Act of 2017.
SB 140, introduced by Sen. Summers, was assigned to Senate Health and Human Services Committee. SB 140 would amend the laws relating to regulation of hospitals and related institutions to prohibit certain surgical procedures for the treatment of gender dysphoria in minors from being performed in hospitals and other licensed healthcare facilities. This bill would prohibit sex reassignment surgeries or any other surgical procedures for the purpose of altering primary or secondary sexual characteristics performed on a minor, except for those deemed medically necessary and individuals born with medically verifiable disorders of sex development.
SB 141, introduced by Sen. Dixon, was assigned to Senate Health and Human Services Committee. SB 141 would amend the law to prohibit health care providers from performing specified practices on minors relating to altering a person’s appearance relating to gender. This bill would prohibit school nurses and other employees and officials from engaging in certain conduct relating to a minor’s perception of his or her gender. This bill would prohibit the prescribing or administering of specific hormone related drugs such as testosterone, estrogen, or progesterone to a minor in an amount greater than would normally be produced in a healthy individual of that minor’s age and sex. This bill would prohibit health care providers from performing surgeries that sterilize or alter the appearance of the sex of a minor, including vasectomies, hysterectomies, metoidioplasty, and others.
SB 150, introduced by Sen. Halpern, was assigned to Senate Regulated Industries Committee. SB 150 would require certain public schools, health clubs, and public sports facilities to have at least one functional automated external defibrillator on site. This bill would also require extensive physical examinations of students and athletes prior to participation in a sport at a public school or public sports facility.
SB 157, introduced by Sen. Brian Strickland (R-McDonough), was assigned to Senate Judiciary Committee. SB 157 would create a pre-clearance process in the licensing of individuals with criminal records who make an application to or are investigated by certain licensing boards and commissions.
SB 162, introduced by Sen. Ben Watson (R-Savannah), was assigned to Senate Regulated Industries and Utilities Committee. SB 162 eliminates certificate of need (CON) requirements for all types of health care facilities and services except long-term care facilities and home health agencies. Effective Jan. 1, 2024, new or expanded hospitals and other health care facilities and services currently subject to CON requirements will need a special health care services license (“Special License”) to operate. This new license is in addition to any existing permit, license or certificate issued by the Healthcare Facilities Regulation Division of the Department of Community Health (DCH). Health care providers that obtain a special health care services license would be subject to indigent and charity care requirements. The required amount of indigent and charity care to be provided by non-profit providers is higher than investor-owned providers. Most of the current CON exemptions would also apply to special health care services licenses, with new or expanded exemptions for single-specialty surgery centers, freestanding imaging centers, and behavioral health services. NGHS opposes SB 162 on the basis that it would weaken the CON program by creating unfair competition and unnecessary duplication of services. NGHS Government Affairs, GHA, and GACH are working closely on this critical legislation.
SB 164, introduced by Sen. Chuck Hufstetler (R-Rome), was assigned to Senate Health and Human Services Committee. SB 164 would revise definitions for licensure of advanced practice registered nurses. This bill also adds “advanced practice registered nurse” to the list of those who would receive a misdemeanor charge if caught practicing without a license.
SB 168, introduced by Sen. Rick Williams (R- Milledgeville), was assigned to Senate Health and Human Services Committee. SB 168 would amend the law to allow a chiropractic practice to have a lien on a cause of action accruing to an injured person for the costs of care and treatment of injuries arising out of the cause of action. This bill additionally included that in the case of any chiropractic lien, said lien can also be subject to any hospital lien.
SB 173, introduced by Sen. Ben Watson (R – Savannah), was assigned to Senate Health and Human Services Committee. SB 173 would provide that hospital authorities may transfer its ambulance service license to its local governing body directly if the governing body is eligible for such a license.
SB 187, introduced by Senator Ed Setzler (R–Acworth), was assigned to Senate Children and Families Committee. SB 187 would amend the existing “Safe Place for Newborns Act of 2002” to replace “medical facility” throughout the code with “safe haven facility”. In this bill, a “safe have facility” is defined as a child-placing agency, church, fire station, medical facility or police station.
SB 195, introduced by Senator Larry Walker (R-Perry), was assigned to Veterans, Military and Homeland Security Committee. SB 195, the “Freedom to Work Act”, would facilitate expedited licensure of transitioning service members, military spouses, and other qualified individuals who have the necessary certifications, pass any examinations that might be required by the state, and have no outstanding complaints, allegations or pending investigation in another state.
SB 196, introduced by Senator Ben Watson (R–Savannah), was assigned to Senate Transportation Committee. SB 196 would amend the Georgia Code to stipulate that failure to wear a safety belt or safety restraints for children would be admissible as evidence in civil actions. This bill would also prohibit the failure to wear a safety belt or safety restraints for children as a basis for cancellation of insurance coverage.
SB 197, introduced by Senator Chuck Hufstetler (R–Rome), was assigned to Senate Health and Human Services Committee. SB 197, known as the “Health Care Practitioners Truth and Transparency Act”, would prohibit misleading terms or false representations by health care practitioners in advertisements and representations. This bill would also prohibit the misappropriation of medical or medical specialty titles by health care practitioners in advertisements and representations.
SB 198, introduced by Senator Sally Harrell (D–Atlanta), was assigned to Senate Health and Human Services Committee. SB 198 would create the Georgians with Intellectual and Developmental Disabilities Innovation Commission. This bill is a result of the findings from the 2022 Senate Study Committee on People with Intellectual and Developmental Disabilities and Waiver Plan Access, chaired by Senator Sally Harrell (D-Atlanta) and Senator John Albers (R-Roswell). The study committee found the need to establish an IDD innovation commission for long-term strategic planning purposes around complex issues such as managed care, workforce wages and incentives, direct service provider career paths, transportation, housing, employment and others.
COMMITTEE ACTIVITY
The House Human Relations and Aging Committee: The committee met Monday to hear presentations from multiple groups including GHA, the Department of Human Services, Georgia Health Care Association, Georgia Alliance of Community Hospitals and the Georgia Senior Living Association. GHA and GACH presented to the committee about the current state of hospital workforce, economic challenges for hospitals, and behavioral health patient placement challenges.
The House Health Committee: The committee heard HB 203, HB 215, and HB 278. HB 203 would amend the law to adjust restrictions on the sale and dispensing of contact lenses with respect to physicians. This bill outlines the requirements for writing an initial prescription for contact lenses, including completing all measurements, tests and examinations necessary to satisfy his or her professional judgement. This bill also changes language in the law from allowing only optometrists or ophthalmologists to be “prescribers”. This bill would allow for a telehealth visit for contact lenses renewal if a patient has had an in person visit in the last 24 months. This legislation was brought by 1-800-Contacts and contains compromise language negotiated by the online contact retailer and the optometry association. The bill passed out of committee unanimously.
HB 215, would amend Georgia law relating to nurses to provide for licensure of advanced practice registered nurses. This bill would make it a misdemeanor to practice advanced nursing practice without a license. It would also amend Georgia Code relating to prestige license plates, respectively, to authorize advanced practice registered nurses and physician assistants to execute affidavits certifying an individual is disabled for purposes of obtaining special vehicle decals for persons with disabilities. This bill passed out of committee unanimously.
HB 278, introduced by Rep. LaHood, would amend the law relating to athletic trainers to require athletic training students to be under the direct supervision of a physician or licensed athletic trainer. The bill would also change the definition of “athletic injury” to “athletic condition.” Concerns were raised by opponents that this definition change would expand scope of practice for athletic trainers. There was no vote on this bill, as it was hearing only.
Senate Insurance and Labor Committee: The committee met Wednesday. SB 76, introduced by Sen. Nikki Merritt (D–Grayson), would amend Georgia law relating to the state employees’ health insurance plan and post-employment health benefit fund to require state health benefit plans to cover insulin medication at a reduced rate. No vote was taken on this bill, as it was hearing only.
Senate Health and Human Services Committee: met Wednesday to consider SB 111, introduced by Sen. Chuck Hufstetler (R-Rome). This bill would amend Georgia Code to allow for an anesthesiologist assistant to be appointed in an advisory capacity to the Georgia Composite Medical Board. SB 111 passed out of committee unanimously.
SB 46, also introduced by Sen. Chuck Hufstetler, would amend Georgia Code relating to control of sexually transmitted disease by requiring physicians and healthcare providers to test all pregnant women for HIV and syphilis at the first prenatal visit, at 28–32 weeks gestation, and at delivery. Currently, the “Georgia HIV/Syphilis Pregnancy Screening Act of 2015” requires physicians and healthcare providers to test pregnant women for HIV and syphilis, except in cases where the woman refuses testing, during the third trimester only, regardless of whether such testing was performed during the first two trimesters. SB 46 passed out of committee unanimously.
SB 109, introduced by Sen. Shelly Echols (R-Alto), would amend Georgia Code relating to medical assistance to require the Department of Community Health to include continuous glucose monitors as a pharmacy benefit for Medicaid recipients and to provide for certain consultations by treating practitioners. SB 109 passed out of committee unanimously.
SB 106, introduced by Sen. Larry Walker (R–Perry), the “Healthy Babies Act”, would provide for a three-year pilot program to provide coverage for remote maternal health clinical services under the Medicaid program. SB 106 passed out of committee unanimously.
The Senate Children and Families Committee: The committee met Thursday to consider SB 135 introduced by Senator Kay Kirkpatrick (R–Marietta). This bill would amend the law relating to determination of paternity to align medical and genetic testing with the Uniform Parentage Act of 2017. An amendment was offered in committee to line 56 by Senator Matt Brass (R – Newnan) to delete the words “a report” and replace them with “the results” for clarity purposes. This amendment passed. The bill passed unanimously out of committee as amended.
HB 295, introduced by Representative Lee Hawkins (R–Gainesville), known as the “Surprise Billing Consumer Protection Act”, would amend the law to revise certain procedures, timelines, and other matters concerning consumer protections against surprise billing. This bill requires that insurers cover out of network emergency services in facilities at the greater of 1) the verifiable contracted amount paid by all eligible insurers, 2) the most recent verifiable contracted amount agreed to by the insurer and the facility or, 3) another higher amount agreed upon by the insurer and the facility. These provisions are already in effect for providers, but do not currently apply to facilities. This bill also changes the request for arbitration from 30 days to 60 days, and gives the Commissioner of Insurance and Safety Fire the authority to dismiss certain requests for arbitration. This legislation is designed to address insurers’ practices that seek to minimize amounts paid to providers in these instances. NGHS Government Affairs and GHA are working closely with Chairman Hawkins on this legislation and appreciate his leadership on this issue.
PASSED BY THE HOUSE
HB 129 would amend Georgia Code relating to public assistance to expand the temporary assistance for needy families (TANF) eligibility criteria to pregnant women. As currently written, this code section does not include pregnant women. HB 129 passed the House by a vote of 173-1.
HB 76, introduced by Rep. Alan Powell (R-Hartwell), would amend Georgia law regarding professional counselors, social workers, and marriage and family therapists to revise provisions relating to education, experience, and training requirements for licensure in marriage and family therapy. This passed with a vote of 173-0.
HB 85, introduced by Rep. Sharon Cooper (R–Marietta), would amend Georgia Code to require insurance coverage for biomarker testing. HB 85 was amended in subcommittee, and now also requires prior authorizations seven business days before a non-emergency service and 72 hours before an emergency service. This bill passed by a vote of 172-2.
HB 143, introduced by Representative Danny Mathis (R–Cochran), would amend Georgia Code relating to medical assistance to require the Department of Community Health to include continuous glucose monitors as a pharmacy benefit for Medicaid recipients and to provide for certain consultations by treating practitioners. This bill would allow for a general practitioner to monitor glucose levels and make care more accessible for patients who require glucose monitoring. HB 143 passed by a vote of 167-1.
HB 215, introduced by Representative Alan Powell (R–Hartwell), would amend Georgia law relating to nurses to provide for licensure of advanced practice registered nurses. This bill would make it a misdemeanor to practice advanced nursing without a license. It would also amend Georgia Code relating to prestige license plates, respectively, to authorize advanced practice registered nurses and physician assistants to execute affidavits certifying an individual is disabled for purposes of obtaining special vehicle decals. HB 215 passed by a vote of 165-0.
PASSED BY THE SENATE
SB 27, introduced by Sen. Matt Brass (R-Newnan) would add an addition to Georgia Code to prohibit a health care insurer from requiring an ophthalmologist or optometrist to extend any discount on services that are not covered eye care services in order to received increased payments, better reimbursements, or preferential treatment. This passed with a vote of 51-0.
SB 42, introduced by Sen. Mike Hodges (R-Brunswick) would amend the law relating to required posting of notices with human trafficking hotline information in businesses and on the internet. The bill would also increase the fine for failure to comply with model notice requirements. This passed with a vote of 51-1.
SB 65, authored by Sen. Ben Watson (R-Savannah), would allow the Commissioner of Insurance and Fire Safety to establish an advisory committee for the purpose of creating a state-based insurance exchange to take the place of the current federal-based insurance exchange that Georgia citizens utilize to purchase health insurance plans. This passed with a vote of 31-19.
SB 47, introduced by Sen. Chuck Hufstetler (R–Rome), would amend Georgia Code to address vaping in restricted areas and adds that non-compliance with posted non-smoking areas would be considered a misdemeanor punishable by fine. A bill substitute was introduced during committee. The substitute would add “vaping” to the definition of “smoking” to the Smoke Free Act of 2005. It clarifies that vaping is also prohibited anywhere smoking is prohibited. This bill passed by a vote of 51-3.