The most favorable development was probably the passage of increases in reimbursement in the Medicaid program.  The new rate schedule, effective July 1 which must also be observed by the Medicaid CMOs, goes to 80% of the 2007 Medicare fee schedule. This will result in increases for most, though, not all codes, used by pediatricians.  However, the most commonly used codes, e.g. 99213 and 99214, will increase 22% and 20% respectively.

Also in the positive column: we passed a bill that would create House and Senate Study Committees on Children's Mental Health, which we hope will produce needed solutions to that vexing problem.

One noteworthy disappointment was the failure of the legislature to address the child obesity problem. A modest Senate bill, SB 506, which only would have required schools to assess students' fitness levels and observe PE requirements for elementary school students, was defeated soundly on the House floor Friday.

Thank you to members who talked to their legislators during the session and helped us push our issues. I appreciated all the members especially, who are on the Legislative Committee, and made an extra effort to follow the issues and make their voices heard.

William Sexson, MD, Chair

Chapter Legislative Affairs Committee

2008 Summary of Bills

Below is a summary of bills we followed during the session and what happened to them:

House Bills

HB 109:

HB 127. Would prohibit pharmacists from substituting drugs used in treatment of epilepsy. Passed House; died in Senate Rules.

HB 367: Would permit a pharmacists to substitute a drug (brand for brand) of drugs that are "therapeutically equivalent". (Pharmacists already have the right to substitute generic versions if they're available unless the physician specifies the brand.) Died in House Insurance Committee.

HB 492: State Composite Medical Board, change composition.  This would add 2 non-physicians to the board. Passed House but died in Senate.

HB 526: Would require parental approval for PH clinics to dispense birth control to minors. Died in House committee.

HB 549: Would require Medicaid CMO's to cover 16 units of OT, PT & Speech Tax for children on Medicaid before prior approval is needed for additional units. (Peachcare children are exempt from this law, though).

HB 901: Patient Protection Act:  would require employers to permit employees 24 hours of unpaid leave per year to attend things like parent-teacher conferences, medical appointments etc. Died in House Health Committee.

HB 977: A combination bill that would permit the issuance of High Deductible High Plans tied to Health Savings Accounts. Passed.

HB 1043:  Would change the level for determining what constitutes a blood lead level risk from 20 to 15 micrograms.  Passed.

HB 1177:  Newborn Hearing Screening: Would require all newborns to be screened and establish a followup program.  While current practice is nearly universal in the state, it's not technically required, but rather "voluntary."  Died in House Children & Youth Committee due to concerns about fiscal impact note. The sponsors, March of Dimes, vowed to return with the bill next year.

HB 1197:  Would increase the tax on a pack of cigarettes by $1 and use part of these funds for healthcare. Died in House Ways & Means; but kudos to Rep. Ron Stephens, Savannah, for advancing this idea.

HB 1234: Would require several reforms in the Medicaid CMO program, including provision to stop practice of CMO recouping funds after service has been rendered and later the CMO claims the child wasn't eligible. Passed.

HR 1746: Would create House study committee on Children's Mental Health. Passed. (Senate also passed a version which has effect of creating a "joint" committee for more impact.)

Senate Bills

SB 86:  Would require use of seat belts by adults in pick-up trucks, require use: by Sen. Don Thomas. Passed Senate last year; but died in House.

SB 109: Would require Third party administrators to adhere to the state's prompt pay laws. (15 days on a "clean" claim.).  TPA's handle many of the self-funded plans by large employers such as Delta, Coca-Cola, et al. Passed Senate; but died in House.

SB 383:  High Deductible, Health Savings Account Plan:  would permit plans with high deductibles linked to HSAs.  This is touted as way to get more people insured, as they tend to cost far less. Problem for children: many such plans don't provide first-dollar coverage for preventative care. Rolled into HB 977, which passed.

SB 433: CON reform. Amends the state's CON laws in a compromise bill, which MAG achieved after working many years and finally getting version hospitals could accept.

SB 461: Anti-bullying. Requires schools to develop policies on bullying, prevention programs procedures to investigate bullying incidents, and reporting mechanisms. Passed Senate; died in House.

SB 506: Would require schools to conduct fitness testing on students annually, and then report aggregate scores to the state. Would also encourage schools to observe the state requirement of 150 minutes a week of PE for K-6 schools. Passed Senate, died on House floor last night of session, 103-61.

SR 1187: Would create a Study Committee on Children's Mental Health. Introduced by Sen. Thomas at the request of the Ga. Chapter. Passed.

FY 09 Budget

The FY 09 Dept. of Community Health budget included an increase for physician reimbursement for the first time since 2003. New rate will be  80% of 2007 Medicare rates, effective July 1, 2008. CMOs must also observe this.

2008 Georgia Chapter Legislative Agenda

1)      Improved Medicaid Payment for pediatricians and pediatric subspecialists. Support DCH recommendation to increase physician payment in Medicaid to 88.5% of current Medicare rates with assurance that CMOs be required to pass this rate thru to providers.

2)      Establish appropriate ongoing oversight of Medicaid HMO program by legislature; review & specify measures to ensure their solvency and compliance with applicable Georgia and federal laws; and support appropriate needed legislation to rectify the most grievous problems with the current system.

3)      Childhood Obesity:  Support legislation that will begin to address the problem of Childhood Obesity in Georgia. A Senate Study Committee on the topic may advance a bill on this topic which a coalition of child health advocates could support and pass.

4)      Mental Health:  Support initiatives to improve access to mental health care for children, and to improve resources to PCPs

5)      Support legislation to reduce administrative barriers to enrollment of eligible children in Medicaid and PeachCare; and assure prompt enrollment of eligible newborns.

6)      Support adequate funding for the state perinatal system.

7)      Driving Safety:  Make improvements to Georgia’s Teen Driving law, including banning cell phone use by teens while driving.*

8)      Preservation of Peachcare eligibility standards and benefits at current levels*

9)      Mandatory use of seat belts in pickup trucks*

10)  Oppose inappropriate therapeutic substitution by pharmacists*

11)  Oppose unreasonable changes to mechanism for newborn screening & pt notification. *

* Bills were introduced on these topics in 07 session and hence can be reconsidered in 08.

List of Key Committees & Members

Mickey Channell, Greensboro
mickey.channell@house.ga.gov
404-656-7856

 

Donna Sheldon, Dacula
404-656-8086
donna.sheldon@house.ga.gov

Mark Burkhalter, Alpharetta
404- 656-0213
mburkhalter@legis.state.ga.us

Carolyn Hugley, Columbus
404-656-5058
carolynl.hugley@house.ga.gov
 

Pat Gardner, Atlanta
404-656-0305
pat@patgardner.org 
 

Chuck Sims, Ambrose
404-656-0287
chuck.sims@house.ga.gov

Larry O’Neal, Warner Robins
404-651-7737
larry.oneal@house.ga.gov
 

Richard Royal, Camilla
richard.royal@house.ga.gov
 404-656-5105

Penny Houston, Nashville
penny.houston@house.ga.gov
404-656-0202

 

Ron Stephens, Savannah
404.656.0202
quickrxdrg@aol.com

Butch Parrish, Statesboro
404.656.0298
butch.parrish@house.ga.gov