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2013 Georgia General Assembly

April 2, 2013

The Georgia General Assembly completed its 40 day session last Thursday, March 28th at midnight.  The session was generally a positvie one for the Georgia AAP and our issues.

A major issue that emerged for pediatrics in this Medicaid budget was the proposed elimination of Consultation Codes in Medicaid. The new E/M codes that they are replaced with pay an average of 24% less than the consultation codes paid. These codes are used mainly by pediatric subspecialists and so could result in a serious access to care problem. Pediatric subspecialties are already in relatiively short supply in our state and children often have to travel several hours for speciality care. Such a deep cut in reimbursement will likely force some practices to curtail their Medicaid volume or stop seeing these patients altogether. The is the Chapter's number one priority in the budget. In the end, we won a partial victory, which we may even be able to improve upon. The Budget Conference Committee voted to put back the $4.6M in state funds and "pay the E/M codes at increased rates."  We hated to lose the Consultation Codes but we're glad that the budget writers appreciated the concept of "holding doctors harmless" by this move.  However, all doctors use the E/M codes of course, so the fix is not targeted to those we intended--pediatric subspecialists. We will work with DCH and see if this solution can be perfected to achieve that goal. Also, a bill to license lactation consultants was heard in House Health Committee and a favorable letter will be generated to the Licensing Board in support of this.

After mostly a quite session on gun bills, two major gun bills emerged late in the session. The Chapter rallied members to talk to their legislators on this issue and we're thankful that the major gun bill, SB 101, failed to pass in the final hours.

Also passing: , the "Return to Play" bill, HB 284. The 2 main elements of the bill are: education for parents and athletes about concussion; and a requirement that players be held out until clear for a return to play after they have been concussed; a bill, SB 212, to require HS students to complete a CPR co;urse prior to graduation; the renewal of the hospital tax, SB 24, which stabilized the Medicaid budget.  Bills failing to pass included SB 85, which would have allowed pharmacists to give vaccines to those 18 and over; and SB 94, which would have allowed nurse practitioners to order imaging studies.

A few weeks ago legislation was introduced that would liberaize Georgia's fireworks law to allow almost all types of fireworks. SB 229 did not pass but will certainly be considered next year, as all bills that don't pass in this session return the next year to be considered.

Legislative Priorities & Bills We Followed in the 2013 Session:

Legislative Priorities:

• Budget Issue: |Maintain stability in Medicaid reimbursement rates.

      Talking Points:-

• Nearly 60% of Medicaid patients are children so this impacts pediatrics acutely. There has not been a Medicaid increase in 12 and practices with high Medicaid volumes often struggle to maintain their viability.
• The elimination of consultation codes will result in a 24% payment cut to pediatricians practicing in a pediatric subspeciality.
• Access to care for Medicaid children is already diminished as many pediatricians have stopped seeing these patients or are limiting them.

       Talking Points:

• Vaccines are part of the basic preventive care given by pediatricians for children in the “medical home” that is, their regular source of physician care. Having vaccines available in drug stores would fragment that care; and disincent parents to maintain regular preventive visits.
• Pediatricians use immunization visits to discuss other issues with adolescents including, pregnancy prevention, tobacco or drug use, mental health issues, etc. 
• Concussions & Return to Play: Sponsors will likely re-introduce a bill that would require schools to inform parents and athletes re risk of concussion and require removal of concussed athletes and clearance for return to play by an “appropriate licensed health care provider” trained in concussion management. 
• Licensure of Certified Lactation Consultants: This bill would enable them to be reimbursed in the Medicaid program. Support.

        Talking Points:

• Breastfeeding is the optimal infant nutrition and data shows the many benefits it confers on infant and even the mother including less illnesses, allergies, decreased obesity, decreased ovarian and breast cancer.
• Currently inGeorgia, Medicaid cannot reimburse LC’s for breastfeeding services due the fact that they are unlicensed.
• Licensure would therefore provide greater access to these services for mothers and infants and help boostGeorgia’s breastfeeding rates and thereby improve overall infant health.

Bills Introduced in 2013 Session & Final Status

Senate Bill 1: By Sen. Ligon, Would prevent insurers from denying information about a child’s health condition to either parent, regardless of custody status. Passed Senate.

Senate Bill 24: By Sen. Bethel, Would renew the hospital provider fee which expires 6-30-13. The funds raised by this fee and the matching federal dollars it brings in, provides $400M to the already strained Medicaid program. Passed.

Senate Bill 85: By Sen. Bethel, would permit pharmacists to give all vaccines to thoseat our request, 19 and over. Passed Senate Committee where age was lowered to 18. Failed.

Senate Bill 94: By Sen. Millar, would lift the current restriction on NPs to order "radiographic imaging" which is now permitted only in "life-threatening situations." Failed.

Senate Bill 191: By Sen. Albars, would require insurance plans to cover services for autism. Referred to Mandated Benefits Commission.

Senate Bill 201: Would expand places where a gun could be legally carried in Georgia. Failed in conference committee.

Senate Bill 217: By Sen. B. Carter, would require DCH to offer Assignment of Benefits option in administration of synagis for RSV. Failed.

Senate Bill 229: By Sen. Mullis, would expand Georgia's fireworks law to include all types legally sold in US. Failed.

Senate Resolution 378: By Sen. Mullis, would ask voters to designate funds to fire safety and trauma care. The bill intends to use fireworks tax revenue for this purpose but the word "fireworks" is not in the resolution question. Passed Senate.

House Bill 284: By Rep. Pruett, Concussion & return to play. Would require schools to provide information to parents about the same. Passed.

House Bill 73: By Rep. Lindsey, would require insurance companies to cover “medical foods” used in diagnosis and treatment of inherited metabolic and genetic disorders and food tolerance & absorption disorders. This would include elemental formulas. Referred to Mandated Benefits

House Bill 74: By Rep. Lindsey, would require insurance companies to cover hearing aids for children, aged 22 years and younger. Referred to mandated benefits commission.

House Bill 309: By Rep. Harbin, would mandate coverage for autism spectrum disorders in health insurance policies. Referred to mandated benefits commission.

House Bill 365: By Rep. Hutchens, would require seat belts in passenger vans carrying 12 or more passengers. Passed.

House Bill 363: By Rep. Cooper, would establish licensure for certified lactation consultants. In House Health Committee, with favorable report. Did not pass.

2013 Key State Legislative Committees & Members

HOUSE APPROPRIATIONS SUB-COMMITTEE ON HEALTH

HOUSE HEALTH COMMITTEE

    
Cooper, Sharon                                                                                                       Chairman

SENATE APPROPRIATIONS, SUB-COMMITTEE ON HEALTH

(This committee makes recommends on Medicaid and Peachcare payment levels.)

Sen. Tim Golden, Chair, Valdosta, 404-656-7580, This email address is being protected from spambots. You need JavaScript enabled to view it.

Sen. Valencia Seay, Riverdale, 404-656-5095, This email address is being protected from spambots. You need JavaScript enabled to view it.

Sen. Cecil Staton, Macon, 404-656-5039, This email address is being protected from spambots. You need JavaScript enabled to view it.

Sen. Renee Unterman, Buford, 404-463-1368, This email address is being protected from spambots. You need JavaScript enabled to view it.

Sen. Tommie Williams, Lyons, 404-656-0089, This email address is being protected from spambots. You need JavaScript enabled to view it.

SENATE HEALTH & HUMAN SERVICES COMMITTEE

Sen. Rene Unterman, Chair
Senator Don Balfour, 121-F CAP
Senator Fran Millar, 319-B CLOB
Senator Judson Hill, 421-D CAP
Senator Gloria S. Bulter, 420-C CAP
Senator Buddy Carter, 421-B CAP
Senator Steve Henson, 121-B CAP
Senator Chuck Hufstetler, 320-A CLOB
Senator Lester Jackson, 432 CAP
Senator William Ligon, 324-B CLOB
Senator Nan Orrock, 121-C CAP
Senator David Shafer, 321 CAP

For a complete text of any these bills you can visit the Georgia General Assembly website:  www.legis.state.ga.us.   For more information on these or other bills, contact Rick Ward, at the Chapter office, at This email address is being protected from spambots. You need JavaScript enabled to view it. .  Thanks to the members of the Legislative Committee for their efforts during the session and to all our members who contacted their legislators about our issues.  Your support and participation in the legislative process is vitally important to our advocacy.