The dust has settled on a major legislative deadline. Yet much uncertainty surrounds the many health care bills that still have a shot at passage in the Georgia General Assembly this year.
Which proposals end up passing both Houses, or falling by the wayside, will be revealed as the state’s legislative version of March Madness plays out.
Last Wednesday was Crossover Day. That’s the deadline for a bill to be passed by at least one chamber of the General Assembly to have a chance of final passage during the session. Though bills are occasionally revived after the deadline by having their language attached to other legislation, the vast majority that fail to make the cut at Crossover are dead, at least until another session rolls around.
Several health bills made it just under the wire. Others, involving the state health care regulatory licensing program, and a “modified risk” tobacco product, didn’t make it.
No major proposal to expand health insurance for Georgians who are currently uninsured has received any traction this session.
Among the bills successfully crossing over was an expansion of Georgia’s medical marijuana program to include patients suffering from post-traumatic stress disorder or from chronic pain.
The House bill did not address the issue of in-state cultivation of medical cannabis. Many patients permitted to have low-THC cannabis oil in Georgia have noted that it’s difficult for them to get the product, because it cannot be produced in the state, the Associated Press reported. And interstate transport of cannabis products is restricted by federal law.
And the House approved a “step-therapy” bill, which allows patients to qualify for exceptions to insurers’ prescribing protocols.
House Bill 519, introduced by Rep. Sharon Cooper, R-Marietta, limits step therapy, in which patients are required by insurers to “fail” on a series of treatments before they can obtain the medication prescribed by their physician.
The bill creates a basic framework for when it’s medically appropriate to exempt patients from drug protocols and establishes a transparent process for health care providers to request exceptions.
“Physicians know which medicines will work for their patients, and they must be afforded the tools and transparency to ensure they can make the best health care decisions,” said Cooper in a statement
The House defeated a measure that would allow a “modified risk” tobacco product to have a tax that’s half of what exists now for cigarettes sold in the state.
The FDA has yet to approve such a product to be sold in the United States — or to be marketed as less harmful than other tobacco products. Anti-smoking advocates opposed the measure, which was backed by the tobacco industry.
A bill that would provide a regulatory exemption for a projected $100 million sports medicine facility in Alpharetta never approached a Senate floor vote. Neither did a proposal to erase Georgia’s capacity and patient restrictions on Cancer Treatment Centers of America, a national chain that has its Southeastern regional hospital in Newnan.
Tax credits and surprise billing
The Senate passed legislation earlier in the session that would create a Health Coordination and Innovation Council and a position of director of health care policy and strategic planning. The Senate also approved a bill that would establish a Georgia director of substance abuse, addiction and related disorders and create a commission to address the crisis of addiction and substance abuse.
Meanwhile, the House put together a proposal to boost health care in rural areas. House Bill 769 would take several steps, including easing the creation of “micro-hospitals,” with 24/7 care and a small number of beds, to replace full-scale hospitals that close.
It also would allow grants to help rural physicians afford medical malpractice insurance, as an incentive to practice in rural areas; permit remote pharmacy prescription orders from outside Georgia; and require training of rural hospital board and authority members.
The legislation, sponsored by state Rep. Rick Jasperse, a Jasper Republican, would also raise the rural tax credit for donations to rural hospitals from 90 percent to 100 percent. (A separate bill would do the same.)
The Senate council and the House rural health proposal wouldn’t appear to clash, but may be intertwined in the political sparring in the last days of the session.
The Legislature is also again tackling surprise medical bills, which can involve hundreds and even thousands of dollars in out-of-pocket patient costs.
This billing occurs when people have procedures or visit ERs at hospitals in their insurance network, then are hit with separate, unexpected charges from non-network doctors who were involved in their care.
Senate Bill 359 by Sen. Chuck Hufstetler, R-Rome, is similar to but broader than a proposal that passed the House. The Senate version has provisions on payment for non-network medical services that the insurance industry opposes.
A needle exchange kit
Needle exchange programs would be facilitated under a bill that the House approved. It’s sponsored by state Rep. Betty Price, a Roswell Republican, and wife of Dr. Tom Price, the former U.S. Health and Human Services secretary who resigned that post last year. She has pushed similar legislation in previous General Assembly sessions.
The Georgia Board of Nursing would move from the Secretary of State’s Office to the Department of Community Health under a bill approved by the Senate.
And the Senate passed legislation that would allow a physician to supervise eight advanced practice RNs at one time, up from a current limit of four. The bill would also allow a doctor to delegate the ordering of radiographic images. The proposal that passed did not contain the original provisions to allow the nurses to practice more independently in rural areas.
There’s a name-change proposal in the works as well. The Georgia Board for Physician Workforce would be renamed the Georgia Board of Health Care Workforce under a Senate bill. That may get as smooth a ride as any of the health bills now on the agenda.
The final day of the 2018 session is March 29. That day is usually filled with a flurry of last-minute compromises and deals.
We may see many of these health care bills caught up in the frenzy of the final hours.