This Week’s Legislative Action
This year’s session of the General Assembly is in the home stretch with scheduled adjournment Sine Die quickly approaching. The House and Senate took up legislation ready for final passage while committees met to “perfect” legislation that leaders would like to see completed before their business concludes on March 29th. Five legislative days remain, and next week’s schedule will likely be even faster paced and dominated by controversial issues that have emerged this year. This includes whether to legalize online sports betting in Georgia, issues related to gender reassignment of minors, Certificate of Need (CON) changes, changes to voting laws, and even a thorough debate over whether the state should statutorily increase the maximum weight of tractor trailer payloads allowed on Georgia roads. The next five legislative days will be fast and furious, and NGHS Government Affairs will keep you informed of key developments throughout the process.
BILLS HEADED TO THE GOVERNOR’S DESK
As we approach the end of the 2023 session, the following bills received final passage this week and are headed to the desk of Governor Brian Kemp. The Governor has three options he may exercise on measures sent to him: Sign the bill into law; veto the bill; or take no action. In the rare event the Governor takes no action on a bill, it will become law on the effective date enumerated in the bill following the 41st day after General Assembly adjournment Sine Die. If a bill does not contain a specific effective date, the automatic effective date is July 1, 2023.
HB 85, introduced by Representative Sharon Cooper (R–Marietta), carried in the Senate by Senator Kay Kirkpatrick (R-Marietta), would amend Georgia Code to require insurance coverage for biomarker testing. As amended, HB 85 requires prior authorizations seven business days before a non-emergency service and 72 hours before an emergency service. This passed by a vote of 47-5.
HB 155, introduced by Representative Chuck Martin (R–Alpharetta), carried in the Senate by Senator John Albers (R-Alpharetta), would provide for the issuance of licenses by endorsement for certain licenses to spouses of firefighters, healthcare providers, and law enforcement officers who relocate to the State of Georgia. “Healthcare provider”, as defined in this bill, would include any physician or other person licensed or otherwise authorized in this state to furnish healthcare services, including the following: any dentist, podiatrist, optometrist, pharmacist, psychologist, licensed professional counselor, clinical social worker, registered professional nurse, advanced practice registered nurse, licensed practical nurse, registered optician, physical therapist, chiropractor, physician assistant, cardiac technician, emergency medical technician, or paramedic. This bill passed by a vote of 54-0. This bill now moves to the desk of Governor Kemp.
HB 440, introduced by Representative Doug Stoner (D–Smyrna), carried in the Senate by Senator Matt Brass (R-Newnan), 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. This passed by a vote of 56-0.
HB 482, introduced by Representative Steven Sainz (R-St. Marys), carried in the Senate by Senator John Albers (R-Alpharetta), prohibits tax-exempt organizations, including hospitals, from utilizing the state’s Quality Jobs Tax Credit unless the jobs created are solely associated with the organization’s unrelated business income. A substitute was introduced in the House that would change the preamble language of the bill to exclude language referencing previous legislative intent. This passed by a vote of 52-0.
SB 46, introduced by Senator Chuck Hufstetler (R-Rome), 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. Patients may refuse this testing requirement. 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 patient refuses testing, during the third trimester only, regardless of whether such testing was performed during the first two trimesters. This bill passed by a vote of 169-2.
COMMITTEE ACTIVITY
The House Public Health Committee:
SB 1, introduced by Senator Greg Dolezal (R-Cumming), would remove the sunset date on existing statute that prohibits state and local governments from requiring proof of COVID vaccination for government services. Entities that are regulated by the Centers for Medicare and Medicaid Services (CMS) are exempt from this legislation and may still require COVID vaccination as a condition of employment. This bill passed out of committee.
The House Health Committee:
SB 76, introduced by Senator 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 not to exceed $35 per 30-day supply or $105 per 90-day supply. No vote was taken, as this was a hearing only.
SB 99, introduced by Senator Greg Dolezal (R-Cumming), would provide a Certificate of Need (CON) exemption for acute care hospitals in rural areas established on or after July 1, 2023. No action was taken, as this was a hearing only. The committee is expected to vote on potential amendments and/or the underlying bill next week.
SB 223, introduced by Senator Ben Watson (R-Savannah), would authorize reimbursement of patient incurred expenses related to participation in a cancer clinical trial. This bill passed out of committee.
SB 164, introduced by Senator Chuck Hufstetler (R-Rome), 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. This bill passed out of committee.
SB 197, introduced by Senator Chuck Hufstetler (R–Rome), 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. This bill passed out of committee.
The Senate Health and Human Services Mental Health Parity Subcommittee:
HB 520, introduced by Representative Todd Jones (R–South Forsyth), is follow-up legislation to 2022’s HB 1013, the Georgia Mental Health Parity Act. The bill requires the state to develop a uniform definition of “serious mental illness”; establish a clearinghouse of best practices and resources to handle individuals with serious mental illness who have frequent contact with criminal justice, homelessness or behavioral health systems; conduct a comprehensive study of behavioral health workforce in the state; create a task force to study access to inpatient behavioral health beds; study and make recommendations on ways to modernize the process for obtaining a professional license; allow psychiatric hospitals to enroll in the Medicaid program and provide services to children in fee-for-service Medicaid; seek a waiver to allow Medicaid funds to be used for housing support, employment support, and case management; create a Georgia Health Care Professional Data System; and establish a loan repayment program for mental health and substance use professionals. This was a hearing only, so no vote was taken.
The House Special Committee on Healthcare:
HB 558, introduced by Representative Todd Jones (R-South Forsyth), would provide for the establishment of a pilot program to conduct a simulated exchange for hospitals to purchase and sell charity care credits to meet their charity care requirements (“floor and trade”). The concept has not been implemented in any other state and is based on European models developed for buying and selling of carbon emission offsets to combat global warming. This was a hearing only, so no vote was taken.
The Senate Regulated Industries Committee:
HB 455, introduced by Representative John LaHood (R–Valdosta), would provide that programs established to address career fatigue and wellness in healthcare professionals are not obligated to report to licensing boards except in certain circumstances. This bill passed out of committee.
The House Higher Education Committee:
SB 86, introduced by Senator Matt Brass (R-Newnan), would allow eligible students participating in the Dual Enrollment program to access HOPE grant funds for certain CTAE courses regardless of whether they have reached the maximum credit hour caps. An amendment was added on the floor that would establish participation and performance targets and provide for centralized data collection and reporting. A committee substitute was introduced that would clarify that the intent of the bill is to include general eligibility for the HOPE grant. This bill passed out of committee by substitute.
SB 246, introduced by Senator Mike Hodges (R-Brunswick), relating to the Georgia Board of Health Care Workforce, would provide for student loan repayment for a registered professional nurse duly licensed and authorized to practice in the state who holds a master’s or doctoral degree in nursing and is currently employed or has been employed for at least one year as a faculty member of a nursing program at a post-secondary institution in the state. A committee substitute was introduced that would clarify that this bill is applicable for University System of Georgia qualifying schools. This bill passed out of committee by substitute.
The House Regulated Industries Committee:
HB 557, introduced by Representative Ron Stephens (R-Savannah), would authorize physicians to delegate the authority to prescribe Schedule II controlled substances to advanced practice registered nurses (APRN) and physician assistants (PA). A substitute was introduced in committee that would limit the authorized Schedule II drugs to hydrocodone and oxycodone compounds. The substitute would allow APRNs and PAs to issue disability parking permits and also clarifies that prescriptions could only be written for patients 18 years of age and older. This bill passed out of committee by substitute.
The House Insurance Committee:
SB 20, introduced by Senator Kay Kirkpatrick (R–Marietta), the Consumer Access to Contracted Healthcare (CATCH) Act, creates network adequacy standards for commercial health plans regulated by the state. The Act requires health plans to maintain a network of providers, including hospitals, “in sufficient number and appropriate type…through such plan’s service area to ensure covered persons have access to the full scope of benefits and services covered under such plan,” and it gives the Commissioner of Insurance the authority to define appropriate network adequacy criteria and to determine whether a plan’s network meets such criteria. The Act also restricts health plans from implementing requirements for coverage of telehealth services. There was a committee substitute in the House introduced by the author that exempts HMOs from the legislation. As a result of this amendment, the effect of this bill is very limited. This bill passed out of committee.
The House Public Health Committee:
SB 47, introduced by Senator Chuck Hufstetler (R–Rome), would add “vaping” to the definition of “smoking” to the Smoke Free Act of 2005. This change codifies that vaping is also prohibited anywhere smoking is prohibited. This bill passed out of committee.
The House Human Relations and Aging Committee:
HR 141, introduced by Representative Lee Hawkins (R-Gainesville), would create a House Study Committee on Expanding Long-Term Care options. A substitute was introduced in committee to include all types of long-term care services. Amendments were added in committee that add the study of any models of care that may lower the costs of long-term care for patients and public and private payers. This bill passed as amended by committee substitute.
The Senate Insurance and Labor Committee:
HB 384, introduced by Representative Sharon Henderson (D–Covington), would amend Georgia Code relating to individual accident and sickness insurance coverage for mammograms, pap smears, and prostate-specific antigen tests to require 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. No action was taken on this bill, as it was hearing only.
HB 383, introduced by Representative Matt Reeves (R–Duluth), 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. This bill passed out of committee.
HB 416, introduced by Representative Deborah Silcox (R–Sandy Springs), would authorize qualified pharmacy technicians to administer certain vaccines (COVID-19 vaccines) at the discretion of a supervising pharmacist. This bill passed out of committee.
HB 453, introduced by Representative Scott Hilton (R-Peachtree Corners), would repeal a requirement that every ambulance service pay an annual license fee and that ambulance service annual license fees be deposited into the Indigent Care Trust Fund. This bill passed out of committee.
The House Governmental Affairs Committee:
SB 26, introduced by Senator Greg Dolezal (R-Cumming), would permit meetings and public hearings of development authorities, including hospital authorities, and community improvement districts to be held by teleconference. This bill passed out of committee by substitute.
SB 62, introduced by Senator Carden Summers (R-Cordele), would prohibit certain local ordinances or policies relating to public camping or sleeping. A House substitute has been introduced that would prohibit hospitals from transporting homeless persons to other counties for drop off. This bill passed out of committee by substitute.
The Senate Finance Committee:
HB 308, by Representative Mark Newton (R–Augusta), would change the credit for physicians and licensed dentists to $1,000 per preceptorship and $750 per preceptorship for an advanced practice registered nurse or physician assistant. An amendment was added in committee to change the program sunset from 2028 to 2026. Another amendment was added to cap the program at $3 million per calendar year and would require eligible recipients to apply for such tax credit. This bill passed out of committee as amended.
HB 82, introduced by Representative Mack Jackson (D-Sandersville), would amend Georgia Code relating to imposition, rate, computation, exemptions, and credits relative to state income taxes to limit eligibility for the rural physician tax credit to persons qualifying as a rural physician on or before December 31, 2023. This bill would expand the current $5,000 income tax credit for rural physicians to also include dentists, nurse practitioners, and physician assistants. This bill, as written, would sunset the existing program at the end of 2028. There was a substitute introduced that would exclude military bases from the population count for rural counties. The substitute would require a “pre-approval” at the request of the Department of Revenue for administration purposes. An amendment was added in committee that would sunset the program on December 31, 2026. This bill passed out of committee as amended by committee substitute.
CROSSED-OVER BILLS PASSED BY THE SENATE
HB 129, introduced by Representative Soo Hong (R-Lawrenceville), carried in the Senate by Senator Mike Hodges (R-Brunswick), 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 with a vote of 50-1. This bill now moves to the desk of Governor Kemp for final approval before becoming law.
CROSSED-OVER BILLS PASSED BY THE HOUSE
SB 140, introduced by Senator Carden Summers (R-Cordele), carried in the House by Representative Josh Bonner (R-Fayetteville), 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. There was an amendment added in committee that would add a period after the word “violation” on line 72 and would strike lines 73-75. This amendment would now hold physicians and healthcare practitioners civilly or criminally liable for damages, injury, death, or loss. This bill passed by a vote of 96-75. The bill now returns to the Senate for reconsideration of the House-amended legislation. A vote in the Senate is expected early next week.