Updates on key 2017 bills

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The following is a rolling list of news and updates on some of the priority bills that the Medical Association of Georgia is focusing on during the 2017 state legislative session…

S.B. 8 (posted 3.23.17)

The Medical Association of Georgia (MAG) is encouraging you to put on your white coat and go to the State Capitol tomorrow to appeal to your state representative to urge them to vote no on the S.B. 8 substitute. Physicians who cannot make it to the Capitol are encouraged to contact their legislators by phone or email.

“Instead of protecting patients from the surprise health insurance coverage gap in a responsible and sustainable way, this insurer-friendly substitute would undermine Georgia’s health care system, especially in rural areas and in emergency care settings and at safety net hospitals,” says MAG President Steven M. Walsh, M.D. “A bill this complicated should have been vetted in full – and that simply hasn’t been the case with S.B. 8.” 

Dr. Walsh suggests that physicians let legislators know that… 

– The House Insurance Committee did not allow physicians testify to oppose the S.B. 8 substitute or to present the solution (S.B. 277) that MAG and other physician groups developed to address the surprise insurance coverage gap.  

– The health insurance industry has continually refused to share its payment methodology with physicians.  

– The study committee that the General Assembly approved to be formed in 2016 to address the surprise health insurance coverage gap failed to meet or produce any reports. 

– S.B. 8 is just as harmful as H.B. 71, a bill that would have required physicians to accept the same insurance plans as any hospital where they provide care as a condition of medical staff participation. 

The S.B. 8 substitute states that, “…the reimbursement allowed by the health care plan to the out-of-network physician is the greatest of: (1) The median network rate paid by the health care plan; (2) The rate of the health care plan in its standard formula for out-of-network reimbursement; or (3) The Medicare fee for service reimbursement; all as calculated for the same or similar services rendered in the general geographic region and provided by federal law and regulations.”

Dr. Walsh stresses that, "Leaving this unknown methodology in the purview of the health insurers will ultimately move health care away from transparency – where none exists today."

He concludes that, “It is imperative for physicians to oppose this bill in a powerful and unified way.”  

The House is expected to vote on the S.B. 8 substitute Friday, March 24.  

Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 404.274.4210 with questions.      

H.B. 249 (posted 3.17.17)

The Senate HHS passed an omnibus bill (H.B. 249) by Rep. Kevin Tanner (R-Dawsonville) that is designed to reduce opioid abuse in the state. This measure would 1) require health care providers and others to report instances of neonatal abstinence syndrome to the Georgia Department of Public Health and 2) codify Gov. Nathan Deal’s executive order to make naloxone available on an over-the-counter basis in the state and 3) require dispensers to update the state’s Prescription Drug Monitoring Program (PDMP) every 24 hours.

The committee considered an amendment that would have required physicians to provide their patients with written information about addiction and disposal (i.e., for unneeded drugs) every time they prescribe an opioid, but MAG was able to convince lawmakers to allow physicians to deliver the information to their patients on a verbal basis.

Under H.B. 249, physicians would have to check the PDMP every time they write a prescription for Schedule II (paragraph 1 and 2) drugs and for benzodiazepines, several exceptions notwithstanding (e.g., prescriptions for three days or for 26 pills or less or for prescriptions for 10 days or less after surgery). As for benzodiazepines, prescribers would only have to check the PDMP when they write the patient’s initial prescription and every 90 days thereafter. MAG has worked with Rep. Tanner and other lawmakers throughout session to ensure the best, most reasonable outcome for physicians and their patients. H.B. 249 will now move into the Senate Rules Committee. 

S.B. 153 (posted 3.16.17)

The Medical Association of Georgia (MAG) is encouraging every physician in the state to contact the members of the Georgia House of Representatives Regulated Industries Committee to urge them to VOTE NO ON S.B 153 – a bill that would allow optometrists to make injections in or near a patient’s eye. The committee is expected to hear the bill sometime soon.

During her recent appearance on MAG’s ‘Top Docs Radio’ show, House Health and Human Services Committee Chair Sharon Cooper (R-Marietta) said that this legislation would “place Georgians at risk of blindness and other serious eye complications.”

She also stressed that, “You only have two eyes. They are very delicate organs. They don't regenerate if you do something to them. That's why this bill is so wrong and so dangerous for patients.”  

MAG President Steven M. Walsh, M.D., shares Rep. Cooper’s concerns, emphasizing that, “MAG is opposing this legislation because it would inappropriately expand optometrists’ scope of practice and they would undermine patient care.”  

He concludes that, “Optometrists who receive just 30 hours of additional training simply do not have the necessary training or skill set to perform these kinds of delicate procedures in or near a patient’s eye.”  

Dr. Walsh also points out that optometrists are prohibited from performing these procedures in 42 states.  

Click for members of the House Regulated Industries Committee

Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 404.274.4210 with any questions.

Click for op-ed by Dr. Walsh

Click here for recording of Rep. Cooper’s recent ‘Top Docs Radio’ show

H.B. 71

The Medical Association of Georgia (MAG) is encouraging physicians to contact their state representative to thank them for tabling H.B. 71, a bill that would have required physicians to accept the same insurance plans as any hospital where they provide care as a condition of medical staff participation. This means the bill is no longer viable for this year’s legislative session.

“My sincere thanks to every physician who supported MAG’s grassroots efforts to oppose this legislation,” says MAG President Steven M. Walsh, M.D. “And I would like to applaud the members of the House of Representatives, especially Representative Richard Smith, who introduced H.B. 71, for being open-minded and for genuinely listening to our perspectives.”  

Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 404.274.4210 with questions.   

Click for list of the members of Georgia’s House of Representatives

S.B. 81

The Georgia Senate passed a measure (S.B. 81) by Sen. Renee Unterman (R-Buford) that is designed to reduce prescription drug abuse.

MAG supports parts of this “omnibus bill,” including Section 1 – the ‘Jeffrey Dallas Gay Jr. Act’ – which codifies the emergency order that Georgia Gov. Nathan Deal recently issued to allow a standing order so naloxone is available on an over-the-counter basis in the state.

S.B. 81 also includes a provision that would require physicians to register with the PDMP and to check it every time they write a prescription for benzodiazepines, opiates, opioids, opioid derivatives, and opioid analgesics – and every 90 days thereafter – beginning on July 1, 2018. Exemptions would include prescriptions for three days or less, prescriptions for terminally ill patients, and any time the PDMP isn’t operational. First-time prescriptions for benzodiazepines, opiates, opioids, opioid derivatives, and opioid analgesics would be capped at five days unless the prescription is for an acute condition, chronic pain, or pain associated with a cancer diagnosis. The criminal penalties that were originally included in this legislation have been removed.  

Finally, S.B. 81 would 1) create reporting requirements for cases of neonatal abstinence syndrome and 2) require an annual onsite inspection of every narcotic treatment program that is licensed in the state and 3) require the Georgia Department of Community Health (DCH) and the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) to publish an annual report that is based on the DCH/DBHDD’s central registry data base on the number of patients who enroll for treatment, the number of patients who are discharged from treatment, patients’ states of residence, and other information as determined by the two departments.

MAG will continue to work with legislators to improve this legislation, which has been assigned to the House Judiciary Non-Civil Committee.

H.B. 36

H.B. 36 by Rep. Earl Earhardt (R-Powder Springs) would allow optometrists to make injections and perform other delicate procedures in and around a patient’s eye or eyelid. The Medical Association of Georgia (MAG) is opposing this measure because it would inappropriately expand optometrists’ scope of practice and it would undermine patient care.

“We had a great grassroots response to oppose a really bad scope of practice bill (H.B. 36) that would have allowed optometrists to make injections in or near the patient’s eye,” Palmisano says. “The bill isn’t necessarily dead, but this was a big win for organized medicine – and I want to thank the physicians who testified, including Drs. Baker Hubbard, Brian Kim, Sid Moore, Steve Walsh, and John Harvey.”

Palmisano also thanked Dr. Hubbard and Julian Nussbaum, M.D., for writing letters on behalf of the Emory Eye Center and Augusta University.

And Palmisano applauded the Georgia Society of Ophthalmology for the key role it played in opposing H.B. 36, which failed to pass the House HHS Committee. 

H.B. 416

A bill by Rep. Earl Ehrhart (H.B. 416) that would have allowed optometrists to administer pharmaceutical agents that are related to the diagnosis or treatment of diseases and conditions of the eye and adnexa oculi by injection (except for sub-tenon, retrobulbar, peribulbar, intraorbital nerve block, intraocular, or botulinum toxin injections) if they meet certain requirements did not pass the House Health and Human Services (HHS) Committee. The bill had been amended to add facial nerve block, injected local anesthetics, dermal filler, intravenous injections, and intramuscular injections to the list of pharmaceutical agents that an optometrist is not allowed to administer. This legislation would have also expanded the list of pharmaceutical agents an optometrist could administer. MAG opposed this legislation because it would have undermined patient safety in significant ways.