Legislation aimed at protecting Georgians with health insurance from surprise outof-pocket medical expenses passed the Senate Tuesday, 52 to 0, to beat the Crossover Day deadline.
Thursday is the deadline for bills to cross over from one chamber to the other in order to remain alive for consideration.
Sen. Chuck Hufstetler, R-Rome, said his SB 56 is designed to keep the consumer out of the mix when there is a price dispute between an insurance company and an out-of-network medical service provider. Currently, the balance is charged to the patient, who could end up thousands of dollars in debt.
"What this bill does is, it gives transparency to consumers," he said Tuesday in presenting the legislation on the Senate floor.
Hufstetler said 90 percent of surprise bills stem from emergency care — for a trauma or sudden onset of a medical condition that appears to require immediate treatment. A formula in the bill would determine what the insurer must pay the provider, with the patient's share limited to the in-network cost.
"For those (instances) that aren't part of emergency situations, it sets up a dispute resolution process," he explained.
A secondary consideration was to overcome so-called "narrow networks," where the number of service providers in a patient's coverage network is limited.
In many cases, it's due to an underserved location. In others, it's because physicians opt out. During the committee hearing, physicians said insurance companies don't want to pay what a service is worth and insurers contended medical providers want to charge as much as they can.
"A University of Pennsylvania study says Georgia is No. 1 in the country for narrow networks," Hufstetler said. "What we're trying to do is provide a pathway where both providers and insurers have incentives to get those providers in network and keep the consumer out of the situations, even when it's not an emergency."
During the pre-vote question period, Sen. Renee Unterman, R-Buford, noted that lawmakers have been trying to address the issue for several years. House and Senate bills moved last year but neither passed both chambers.
SB 56 still has a rocky road ahead.
Hufstetler said he amended his bill after it passed out of committee last month at the urging of lawmakers who wanted to see more of a compromise between insurers and providers. He worked with the opposing sides for several days, he said, to resolve as many disparities as possible.
There's a full page of amended language in the version that passed the Senate but he's still expecting pushback in the House, where it's been assigned to the Insurance Committee for review.
"We made a lot of compromises to the insurance providers," Hufstetler said. "I believe this bill will pass overwhelmingly if it gets to the House floor. But to get past the insurance chairman, I think there still has to be some compromise made on payment methodology."
The committee chairman, Rep. Richard H. Smith, R-Columbus, was the sponsor of the House bill that stalled last year.
The main elements would have required healthcare facilities to disclose out-of-network providers and their fees if a patient asks in advance of a scheduled procedure. It also would have required balance bills to be submitted within 90 days and contained a dispute resolution process.
Some of Rome's future entrepreneurs put their talent to the test at Darlington School on Tuesday. Fourth-graders participated in an Invention Convention, complete with a Shark Tank like pitch to teachers and staff to generate interest in their project.
Teacher Elisabeth Lawson said teachers realized how talented some of the kids were and wanted to give them an opportunity to come up with their own business solutions to real world problems.
"That helped them to be a lot more invested in going through a scientific process and trying to test out different versions of what they wanted to see happen," Lawson said.
Sara Jo Pierce developed the "Command Pet Door," using smartphone technology and an app that allows dog owners to open and close a doggie door remotely. Sara Jo said she got the idea because her mom didn't seem to have the time to walk her dog. Her creation has a rain gauge and a thermometer that would override the command to open the door in the event it was too cold or raining.
William Holmes developed "Mr. Clean 2.0," a robotic cleaner that can be controlled remotely to clean up around the house.
"It works really well on hardwood floors and carpets both," Holmes said
Sara Shropshire, a competition cheerleader, created a cheerleading trainer called "I Fly." Young girls can stand on the device and perfect their acrobatic techniques without the need for a base cheerleader.
Molly Ledbetter developed a "Powerless Pan" to help out in the kitchen. The device uses radiant heat to aid in the cooking process.
The whole exercise crossed curriculum in science, language arts and design thinking.
"They did persuasive speeches, because we were all Sharks this morning and we had to choose who were going to invest in," Lawson said.
Ashley Evans opted to invest in Avery Klawon's Cheer Life, Thad Mathis chose Ella Peer's Handy Helper and Lawson made an offer for Pierce's Command Pet Door.
"They did persuasive speeches, because we were all sharks this morning and we had to choose who were going to invest in.
Darlington teacher Elizabeth Lawson
A Rome woman died from injuries sustained in a wreck on Mathis Road around 8:45 a.m. Tuesday.
Floyd County Coroner Gene Proctor identified the victim as Cami DePaz, 31, of a Nichols Road address in Silver Creek.
Sgt. Chris Fincher, Floyd County Police Department spokesman, said DePaz was northbound in the 100 block of Mathis Road, just south of the U.S. 411 intersection.
She hit a patch of ice and lost control of her 1997 Toyota 4Runner. The SUV spun into a utility pole on the west side of the narrow two-lane road, snapping the pole in two and spinning the vehicle around onto the west shoulder of the road.
Fire rescue personnel had to pry the driver's side door off the vehicle to extricate DePaz.
"It was a violent wreck," Coroner Gene Proctor said. "She caught the pole right in her door."
He said DePaz suffered multiple head and upper body injuries at impact and was pronounced dead at Floyd Medical Center approximately an hour late
A passenger in the SUV, identified as Benjamin Hash, 31, also of a Nichols Road address, was able to walk around at the scene but Proctor said he did go to the hospital later for an examination of what appeared to be relatively minor injuries.
It is a new day at the United Way of Rome and Floyd County and the new executive director says the organization is poised to make an impact.
Some from an older generation might conjure up terms like "accountability" or "bang for your buck," Executive Director Allison Mitchell told Seven Hills Rotary Club members Tuesday. But now the keywords for the future will be "engaged" and "collaborative."
Mitchell, who has returned to Rome from a two-year stint with the American Red Cross in Asheville, North Carolina, said that the United Way, not just in Rome, has not been engaging the next generation of philanthropists.
"We've got to change, we have to grow and we have to adapt," she said.
Donors are the primary customers and clients of the United Way and it is critical to be able to show modern donors how their money is making a difference.
"The United Way is in the impact business," Mitchell said. "Relationship management is my top priority."
A key goal of the United Way Board of Directors is to connect the philanthropic dollar to the most urgent needs of the community.
"The United Way exists to serve the interests of the donor," Mitchell said.
The United Way will target education, income and health issues and seek to create collaborative efforts because she said those issues are far too big for any one agency to try to tackle alone.
"The United Way of Rome and Floyd County, which is your United Way, excitedly announces our intent to transform into a community impact leader," Mitchell said. "Over the next month, we will engage with diverse community stakeholders, partners and contributors to identify significant community issues. We will hold community forums, interview community leaders and review available research. We will identify community concerns that resonate with residents and are supported by data as significant and far reaching problems and we'll establish those areas to direct our future work."
One of the ideas Mitchell and the United Way board have embraced is the creation of an Executive Director Round Table to bring CEOs of various nonprofits across the community together to allow them to share expertise with each other.
She said there are so many leaders of the numerous agencies with great ideas that need to be shared, and put away the notion that everyone is competing for the donor dollar.
The United Way of Rome serves agencies including Cave Spring Day Care, Rebecca Blaylock Child Development Center, Mercy Senior Care, Senior Adult Recreation Center, American Red Cross, STAR House, Boys & Girls Clubs of Northwest Georgia, Exchange Club Family Resource Center, House of the Children Academy, Boy Scouts Northwest Georgia Council, Girls Scouts, YMCA, Salvation Army, Hospitality House, Open Door Homes, Network Day Service Center, Rome-Floyd County Commission on Children and Youth, and Summit Quest.
We've got to change, we have to grow and we have to adapt.
The United Way is in the impact business. Relationship management is my top priority."
United Way of Rome and Floyd County Executive Director Allison Mitchell
Today's artwork is by Macie Hutchins, a fifth-grader at East Central Elementary School.