2017 Legislative Session Wrap Up

Author: HMHB Public Affairs Committee

Sine Die was March 31, 2017 – Here’s What Happened:

Please note that, while uncommon, all passed bills are subject to veto by the Governor. For the last legislative session, for example, there were 16 vetoes by the Governor. The Governor has 40 days to sign or veto legislation after the session ends. If he fails to sign or veto, the bill then becomes law on the effective date as established in the bill (which is typically July 1 of that year).

The following bills passed both the House and Senate and are on their way to the Governor for his consideration:

SB 81/HB 249 Prescription Drug Monitoring Program (PDMP) (Senator Renee Unterman/Rep. Kevin Tanner): This bill seeks to address the growing misuse of opioids and other medications. Specifically, this bill would 1) Extend the database of prescriptions written for schedule II, III, IV and V medications and require physicians to consult this registry prior to prescribing under certain conditions; 2) Codify the Governor’s emergency order on an overdose reversal drug (naloxone), making it available without a physician prescription; 3) Require the tracking and reporting of Neonatal Abstinence Syndrome (NAS); and 4) Establish penalties for certain violations. House Bill 249 passed by the House and Senate by a 164-9 and 50-0 vote respectively. It now goes to the Governor.

SB 70 Hospital “Bed Tax” (Senator Butch Miller): The Senate voted overwhelmingly to extend the sunset provision, on a tax on hospital revenues, for three years. The tax is designed to generate about $300 million per year in state revenues, which is then matched by another $600 million in federal match money. The additional dollars are in turn used disproportionately to support rural and safety net hospitals that are struggling to remain viable. SB 70 has been signed by the Governor and is now law.

SB 12/HB154 Dental Hygienists (Senator Renee Unterman/ Rep. Matt Hatchett ): SB 12 and HB 154 would allow dental hygienists to clean teeth and apply sealants and fluoride in schools, safety-net clinics, nursing homes, and in private dentists’ practices under “general supervision.” House Bill 154 passed the House 164-0 and the Senate 50-3. It now goes to the Governor.

HB 54/SB 14/SB 180 Tax Credit for Hospitals (Rep. Geoff Duncan/Senator Dean Burke): HB 54 and SB 14 were designed to build on last year’s bill that established a tax credit for those wishing to donate to eligible local hospitals. At issue is that the hospital tax credit limit was established in 2016 at 70%, though it was based on a similar education tax credit of 100%. As a result, tax credit donations to hospitals last year barely reached $1 million dollars (though the cap was set at $50 million). HB 54 seeks to increase the tax credit amount from 70% to 90% in an attempt to further motivate giving. Both HB 54 and SB 14 were overtaken by SB 180. SB 180 includes provisions of both the House and Senate previous versions, and includes a credit increase from 70% to 90% for certain corporations, and adjusts the deduction cap for S-corps. SB 180 passed the House 173-0 and the Senate 43-9. It now goes to the Governor.

“Repeal and Replace” Task Force: The Senate has established a task force to address the looming termination of the ACA. This task force met for its first public meeting on March 10 with presenters from ALEC and American Enterprise Institute rendering a cursory overview of the Republican plan to repeal and replace the ACA. Though there were few details discussed on the specific impact to Georgia, both presenters indicated that Georgia “should not wait” to act on our states health care needs. Early concerns for Georgia include adequate funding for block grants, cuts to public health and cuts to the CDC. Given the failure to pass a replacement for the ACA at the Federal level, the role of the task force has been elevated to assessing what options are now available and best for Georgia.

HB 198 Flu Vaccine and Education (Rep. Katie Dempsey): Requires local school systems to provide information to parents and guardians of students in grades 6-12 on influenza and its vaccine whenever other health information is provided. The House agreed to minor Senate amendments by a vote of 155-1 after a Senate vote of 46-1. It now goes to the Governor.

HB 241 Metabolic Screening (Rep. Lee Hawkins): Adds Krabbe disease to the list of metabolic and genetic conditions for which a newborn may be screened at the request of the parents. Parents would pay for the screening. There has been some debate as to the accuracy of this test. The Senate passed HB 241 unanimously; it now goes to the Governor.

SB 88 Addiction Rehab Senator Jeff Mullis): This bill sets standards for narcotics treatment programs, and prioritizes treatment of drug-dependent pregnant women. SB 88 was passed by the House 138-29 and now goes to the Governor.

SB 201 Family Care Act (Senator Butch Miller): Allows employees who work at least 30 hours per week the ability to use their earned paid leave to care for a sick child or immediate family member. The House and Senate passed a substitute to SB 201 by a vote 114-51 and 31-14 vote. The bill now goes to the Governor.

HB 427 The ‘Physicians and Health Care Practitioners for Rural Areas Assistance Act’ (Rep. Mark Newton): Would add dentists, physician assistants, and advanced practice registered nurses to the list of practitioners who are eligible for the service cancel-able loan program that is administered by the Georgia Board for Physician Workforce. These funds are already built into the budget for FY 2018. The bill passed both chambers and now goes the Governor.

SB 200 Prescription Coverage (Senator Chuck Hufstetler): Would require insurers to cover prescriptions that are for less than 30 days at a “prorated daily cost-sharing rate” when it is in the best interest of the patient or when it is for the purpose of synchronizing the insured patient’s medications for chronic conditions. The bill passed both chambers and now goes to the Governor.

SB 109 EMS Licensure Compact (Senator Michael Williams): This bill would establish an interstate licensure compact to allow EMS personnel to travel from one participating state to another without having to obtain a license in the other states under certain circumstances (e.g., transporting a patient). The measure was also amended to include the provisions of the ‘Nurse Licensure Compact’ (SB 166 by Senator Unterman) – which would allow registered nurses and licensed practical nurses to be licensed in more than one state, though the scope of the care they are allowed to provide would be determined by the state where the patient receives the care. The bill passed both chambers and now goes to the Governor.

SB 125 Hydrocodone Prescriptive Authority to PAs (Senator Rick Jeffares): SB 125 would give Physician Assistants the ability to write prescriptions for hydrocodone – an addictive narcotic pain medicine. The bill passed the Senate by a vote of 48-3 and went to a subcommittee of the House Judiciary Committee. In that Committee, the bill was amended to allow Nurse Practitioners to also have such prescriptive authority. Amendments were also added to limit the quantity and total dosages. Subsequently, the nurse practitioners requested that they be removed from the bill. The bill (allowing only PAs to prescribe), passed both chambers and now goes to the Governor.

HB 391 Safe Havens for Newborns (Rep. David Clark-98th): This bill amends the current law by adding locations where a newborn infant can be left to include fire stations and police stations along with the current permissible medical facilities. The bill also adds language to allow the mother to decline to provide her name and address when an infant is left. This bill has unanimously passed both the House and the Senate. It now goes to the Governor.

The following items were passed in the budget:

Medicare/Medicaid Parity: The final installment of a range of Medicaid codes being increased to Medicare rates was added to the Governor’s budget this year. These were the prioritized primary care, pediatric and OB codes. Their inclusion in the Governor’s budget reflects the improving budget climate and awareness of the underfunding of many codes. It also positions supporters to further expand parity for additional codes.

Maternal Mortality Review Committee: Funding to evaluate and recommend a program to reduce maternal mortality using outcomes-based research due December 1st, 2017, recognizing that Georgia currently ranks toward the bottom in maternal deaths in the United States ($100K).

Rural Newborn Delivery: Adds $500 more dollars per newborn deliver at rural hospitals to add to the additional $250 approved last year. So rural hospitals (population less than 35,000) will get $750 in additional funds compared to urban hospitals. Total funds proposed – $1.9M; State Funds – $600K. This will require CMS approval for the full funding amount.

OB/Gyn Residency Programs: The five current longstanding OB/Gyn residency programs in Georgia (Emory University, Augusta University Health, Morehouse School of Medicine, Memorial University Health and Medical Center, and Navicent Health) received current residency slot enhancement funding (called cap funding) for 4 slots each (5 x 4 =20). This provides a small stipend of approximately $15,000 for each of 4 slots (total $60,000) per program to allow the current resident to engage in additional activities such as rural rotations or high tech training opportunities such as simulation or telemedicine.

The following bills failed to pass this legislative session:

SB 50: Direct Physician Contracting (Senator Hunter Hill): SB 50 would allow for direct physician-patient contracts for health care services without being subject to laws governing conventional insurance policies. SB 50 passed the Senate 49-0 and was regarded favorably in the House, but it never came up for a final vote in the House. Therefore, this bill will remain in the House Insurance committee, and it is eligible to be picked up there next year.

HB 71/SB 8: Surprise Medical Billing (Rep. Richard Smith/Senator Renee Unterman): Like HB 71, SB 8 struggled to get support needed for a House floor vote. Both versions of these bills were met with opposition from multiple areas and neither made their way to the House floor for a final vote. According to the House sponsor, there will be a robust study committee addressing the issue of balance billing, gaps in insurance coverage and network adequacy during this off-session in hopes that an agreement can be reached for a bill next legislative session.

HB 301 Tax Credit for Mentoring Medical, PA and NP students (Rep. Jodi Lott): This bill would allow physicians, PAs, and nurse practitioners a nominal tax credit for volunteering their time as a preceptor for students in training. This bill failed to get a final vote in the Senate and will remain in place in the Senate Finance Committee next session.

SB 61 Family Planning (Rep. Tate): Would have created a Georgia Family Planning Initiative program within the Department of Public Health with service for low income women and infants prioritized. Services may have included long-term birth control and related counseling, breast and cervical cancer screening, pregnancy testing and counseling, screening and treatment for sexually transmitted diseases, HIV testing, and other patient education and referrals. The bill did not get a hearing in the Senate, thus it did not crossover.

HB 8/HB 151 (Rep. Keisha Waites): This bill sought to prohibit the routine shackling or handcuffing of female inmates during labor, delivery and recovery. The bill did not get a committee hearing, thus it did not crossover.

Georgia Pregnant Workers Fairness Act (Rep. Boddie): Would have required employers to provide for reasonable accommodations to job applicants and employees for circumstances related to pregnancy, childbirth, or related conditions. The bill also required the Department of Labor to develop courses and educate the public on such accommodations. The bill had been assigned to House Industry and Labor Committee, but was not scheduled for a hearing.

Tobacco Tax: We were awaiting the introduction of two potential bills that would address the tobacco tax. One would have reduced the cigar tax, increased the cigarette tax, and placed a commensurate tax on vaping tobacco products, which are entirely un-taxed despite being the fastest growing segment of tobacco/nicotine consumption. The main thrust of this bill would have been to equalize tax rates across tobacco products and modestly raise revenues (by about $120 million). The second bill was a broader tax reform bill that sought a revenue neutral position with the cigarettes tax being increased between 25 and 40 cents, with a commensurate vaping tax as well. In the end, neither bills were introduced prior to Crossover Day.