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Sine Die Legislative Update

The House and Senate adjourned minutes before 1:00 a.m. on Thursday, March 30, completing the 2017 Legislative Session. Below you will find some highlights from the long and eventful evening under the Gold Dome.

PASSED LEGISLATION

HB 127 – Sponsored by Rep. Richard Smith (R-Columbus), this bill repeals certain obsolete provisions relative to nonprofit medical service corporations and nonprofit hospital service corporations as they relate to insurance (Chapter 18 and 19 in Georgia Code).

HB 154 – Authored by Rep. Sharon Cooper (R-Marietta), this bill authorizes a licensed dental hygienist to perform certain functions under general supervision in certain settings. This bill was combined with SB 12, authored by Sen. Renee Unterman (R-Buford), which contained similar language.

HB 157 – Sponsored by Rep. Trey Kelley (R-Cedartown), this piece of legislation revises certain criteria for certain certifying organizations as they relate to advertising or publicizing of medical specialty certification.

HB 165 – Authored by Rep. Betty Price (R-Roswell), this bill provides that maintenance of certification shall not be required as a condition of licensure to practice medicine, staff privileges, employment in certain facilities, reimbursement, or malpractice insurance coverage.

HB 174 – Authored by Rep. Eddie Lumsden (R-Armuchee), this bill expands an insurer's medium of payment of policy to include any other method of payment approved by the Commissioner.

HB 192 – Sponsored by Rep. Beth Beskin (D-Atlanta), this piece of legislation changes provisions relating to the responsibilities and standard of care of directors and officers of banks, trust companies, and corporations. The bill would also clarify and expand the ability of directors and officers to rely on other individuals in the performance of their duties.

HB 196 – This bill was stripped of its original language in conference committee and multiple tax credit bills were added, such as HB 195. Authored by Rep. Brett Harrell (R-Snellville), this bill allows for certain for profit corporations to participate in the indirect ownership of a home for the mentally disabled for primarily financing purposes. The rural hospital tax credit language was also removed in conference committee.

HB 206 – Rep. Trey Kelley (R-Cedartown) authored this piece of legislation, which removes an exception relating to certain audits conducted by the Department of Community Health relating to Medicaid, by providing that any clerical or record-keeping error not constitute fraud or constitute a basis to recoup full payments made by providers. SB 202 was attached to the bill on Sine Die. Sponsored by Sen. Michael Rhett (D-Marietta), this bill provides for an increase, upon future appropriations, in the personal needs allowance to be deducted from a nursing home resident's income.

HB 210 – Authored by Rep. Jodi Lott (R-Evans), this bill alters the current definition of ‘clinical laboratory' so that it would exclude any specimen collection station that collects human blood for the manufacturing of biological products.

HB 213 – Sponsored by Rep. Rich Golick (R-Smyrna), this bill prohibits the sale or possession of four grams or more of fentanyl.

HB 231 – Authored by Rep. Bruce Broadrick (R-Dalton), this piece of legislation is the annual dangerous drug update bill, which includes fentanyl. The bill was amended in committee to add HB 30, authored by Rep. Kevin Tanner (R-Dawsonville). The language adds a synthetic opioid to Schedule I controlled substances.

HB 249 – Authored by Rep. Kevin Tanner (R-Dawsonville), this bill changes the frequency of reporting Schedule II controlled substances to the Prescription Drug Monitoring Program (PDMP). SB 241 was added to the bill. SB 241, authored by Sen. Renee Unterman (R-Buford), moves the PDMP from the Georgia Drugs and Narcotics Agency to the Department of Public Health. It also provides for the department's authority to continue the maintenance and development of the electronic data base of prescription information. Additionally, language from SB 81 was added to the bill. Also authored by Sen. Unterman, this language relates to narcotic treatment programs and requires an annual onsite inspection of each narcotic treatment program licensed in the state. The Department of Community Health and the Department of Behavioral Health and Developmental Disabilities will also publish an annual report using data from the departments central registry data base on the number of patients enrolled in treatment, the number of patients discharged from treatment, patients' state of residents, and other information determined by the departments. Such reports shall exclude patient identifying information.

HB 262 – Authored by Rep. Eddie Lumsden (R-Armuchee), this piece of legislation relates to provider directories and accuracy, and exempts standalone dental plans from the requirement of printed directories for certain entities.

HB 276 – Sponsored by Rep. David Knight (R-Griffin), this piece of legislation authorizes the Commissioner of Insurance to promulgate certain rules and regulations related to licensure of pharmacy benefits managers and would prohibit pharmacy benefits managers from requiring the use of mail-order pharmacies under certain conditions.

HB 322 – Authored by Rep. Bill Hitchens (R-Rincon), this bill changes the definition of the term “war veterans” by altering the discharge date from May 7, 1975 to August 1, 1990.

HB 486 – Authored by Rep. Tommy Benton (R-Jefferson), this piece of legislation provides for select providers to train proxy caregivers in accordance with selected curriculum. The curriculum is to be selected by the Department of Behavioral Health and Developmental Disabilities.

HR 170 – Authored by Rep. Sharon Cooper (R-Marietta), this resolution urges state agencies, medical service providers, health care agencies, research facilities, medical schools, and all interested parties to work towards increasing research, clinical care, and medical education for myalgic encephalomyelitis.

HR 354 – Rep. Dar'shun Kendrick (D-Lithonia) authored this resolution, which urges the Department of Education and the Department of Behavioral Health and Developmental Disabilities to develop and provide to local school systems a list of training materials that would serve to increase awareness of mental health issues and behavioral and learning disabilities.

HR 431 – Authored by Rep. Scot Turner (R-Holly Springs), the original resolution would have created the House Study Committee on the Ramifications of Changes in Federal Health Care Policy. Chairman Sharon Cooper (R-Marietta) amended the bill in committee to instead establish a Health and Human Services Subcommittee to study and discuss the potential changes in federal health care policy. Chairman Cooper stated that the group would meet in the Fall.

SB 14 – Sen. Dean Burke (R-Bainbridge) authored this bill, relating to grants to hospital authorities. The bill includes rural hospital organizations as an authorized recipient of these grants determined by the Department of Community Health. The original bill would have clarified the income tax credit amount a ‘S' corporation would receive for contributions made to rural hospitals. The tax credit would have been for $10,000 or 70 percent of the actual amount expended, whichever is less.

SB 16 – Sen. Ben Watson (R-Savannah) sponsored this piece of legislation, which increases the list of conditions that are eligible for treatment with medical cannabis, including autism. The original bill would have changed the definition of low THC oil by lowering the amount of cannabidiol from 5 to 3 percent. The bill is essentially HB 65, authored by Rep. Allen Peake (RMacon).SB 41 – Authored by Sen. Renee Unterman (R-Buford), this piece of legislation provides for the licensure of durable medical equipment suppliers. The following persons and entities shall be exempt from the requirements (unless any such person or entity has a separate company that is in the business of selling or renting durable medical equipment to consumers):

  • Pharmacies and pharmacists;
  • Hospitals;
  • Ambulatory surgical centers;
  •   Health care facilities owned or operated by the state or federal government;
  •   Skilled nursing facilities;
  • Assisted living facilities;
  •   Health care practitioners who:
    • Provide durable medical equipment within scope of practice of profession;
    • Are licensed in the state to practice health care practitioner's profession
  • Suppliers of insulin infusion pumps and related supplies or services;
  • Manufacturers or wholesale distributors that do not provide durable medical equipment directly to consumers;
  • Renal dialysis providers and persons or entities that distribute devices necessary to perform home renal dialysis to patients with chronic kidney disease;
  • Suppliers of osteogenesis stimulators, transcutaneous electrical nerve stimulators, pneumatic compression devices, and related supplies or services.

SB 52 – Sponsored by Sen. P.K. Martin (R-Lawrenceville), this bill removes the sunset provision in current law, which allows licensed professional counselors to sign a 1013.

SB 70 – Sponsored by Sen. Butch Miller (R-Gainesville), this piece of legislation renews the Hospital Provider Payment Program/Hospital Medicaid Financing Program and extends the program until June 30, 2020. Currently, the program would sunset on June 30, 2017. The bill has been signed by the Governor.

SB 96 – Sponsored by Sen. Ben Watson (R-Savannah), this piece of legislation allows registered professional nurses, nurse practitioners or physician assistants to pronounce the death of patients in nursing homes even if the patient is an organ donor.

SB 102 – Sponsored by Sen. Butch Miller (R-Gainesville), this bill allows for the designation of emergency cardiac care centers and establish an Office of Cardiac Care within the Department of Public Health.

SB 103 – Authored by Sen. Jeff Mullis (R-Chickamauga), this bill authorizes the Commissioner of Insurance to promulgate certain rules and regulations and to examine and investigate certain matters with regard to pharmacy benefits managers. It also prohibits pharmacy benefits managers from requiring the use of mail-order pharmacies under certain conditions.

SB 106 – Authored by Sen. Greg Kirk (R-Americus), this bill addresses the licensure requirements for pain management clinics and would remove the administration of anesthesia by a certified registered nurse anesthetist from current law.

SB 109 – Sen. Michael Williams (R-Cumming) authored this legislation, to enact the “Recognition of Emergency Medical Services Personnel Licensure Interstate Compact,” also known as REPLICA. The bill facilitates the day-to-day movement of EMS personnel across state boundaries. The compact recognizes that states have a vested interest in protecting the public's health and safety through shared licensing and regulation of EMS personnel. Georgia is the tenth member to sign REPLICA legislation, thereby enacting the compact. SB 166 was added to the bill. Sponsored by Sen. Renee Unterman (R-Buford), this bill creates a “Nurse Licensure Compact” and would provide for the establishment of the Interstate Commission of Nurse Licensure Compact Administrators.

SB 121 – Sponsored by Sen. Butch Miller (R-Gainesville), this piece of legislation allows pharmacists to dispense opioid antagonists to people pursuant to a statewide standing order. It also reschedules Naloxone from the list of dangerous drugs to a Schedule V Controlled
Substance.

SB 125 – Sponsored by Sen. Rick Jeffares (R-McDonough), this piece of legislation authorizes a physician to delegate to a physician assistant the authority to prescribe hydrocodone compound products.

SB 153 – Sponsored by Sen. Matt Brass (R-Newnan), this piece of legislation would have exempted certain activities of hearing aid dealers, hearing aid dispensers, and others related to the manufacture and sale of certain nonprescription hearing aids. The bill was stripped of its original language and the language from SB 221 and HB 36 were added to the bill. Both pieces of legislation changes and provides certain definitions to permit doctors of optometry to administer pharmaceutical agents by injection under certain circumstances.

SB 173 – Sponsored by Sen. Burt Jones (R-Jackson), this bill provides for scope of provisions and lines of businesses a captive insurance company may engage to add an agency captive insurance company with certain restrictions.

SB 180 – Authored by Sen. Dean Burke (R-Bainbridge), this piece of legislation relates to the Rural Hospital Tax Credit. HB 54, authored by Rep. Geoff Duncan (R-Cumming), was added to the bill during the committee process. The bill raises the donation credit percentage from 70% to 90% and increases the population threshold for rural areas from 35,000 (state definition) to 50,000 (federal definition) individuals in Georgia's Rural Hospital Tax Credit program. The legislation also limits companies from charging more than 3% of revenue when assisting hospitals with their Rural Hospital Tax Credit program. Additionally, it standardizes the aggregate amount of tax credits allowed from 2017 through 2019 to $60 million per year.

SB 200 – This bill, authored by Sen. Chuck Hufstetler (R-Rome), provides for synchronizing patients' chronic medications.

SB 201 – Authored by Sen. Butch Miller (R-Gainesville), this piece of legislation allows employees to use their sick leave for the care of immediate family members. It is known as the Family Care Act.

SB 242 – Sponsored by Sen. Renee Unterman (R-Buford), this piece of legislation provides for an exception to the number of advanced practice registered nurses with which a delegating physician can enter into a protocol agreement at any one time for nurses. Physicians may have no more than 10 protocol agreements at one time and may not supervise more than four APRNs at one time.

STUDY COMMITTEES

SR 130 – Authored by Sen. Chuck Hufstetler (R-Rome), this resolution creates a Joint Transparency and Open Access in Government Study Committee to look at ways the state can be more efficient in collecting and maintaining data. The committee will be composed of 15 members. The President of the Senate will appoint four members of the Senate and the Speaker of the House will appoint four members of the House of Representatives. They will also each appoint three people from private industry to include one member with expertise in health information technology; one member with expertise in data security or related technology field; one member from a stakeholder's group with expertise in the delivery of healthcare or other service provider utilizing public data in Georgia.

SR 188 – Sen. Renee Unterman (R-Buford) authored this resolution, which creates the Senate Study Committee on barriers to Georgians' Access to Adequate Healthcare. The committee will be composed of nine members to be appointed by the President of the Senate to include two members of the Senate, including the chairperson of the Senate Health and Human Services Committee; the commissioner of the Department of Public Health, or her designee; the commissioner of the Department of Community Health, or his designee; one member of the Board of Nursing; one advanced practice registered nurse who works full time in Georgia; one dean, director, or professor from a school of nursing in Georgia; one physician who works full time in Georgia; and the president of the Georgia Nurses Association, or her designee.

SR 222 – Sponsored by Sen. John Albers (R-Roswell), this resolution creates the Senate Special Tax Exemption Study Committee to conduct a comprehensive study of tax exemptions. The committee will consist of six members of the Senate to be appointed by the President of the Senate.

SR 352 – Authored by Sen. Renee Unterman (R-Buford), this resolution creates the Senate Study Committee on Homelessness to find a long-term solution to the problem of homelessness. The committee will be composed of 15 members. The President of the Senate will appoint two members, including the chairperson of the Senate Health and Human Services Committee. The Governor will also appoint to members. The commissioner of community health will appoint two members representing Medicaid and home community based service programs. The commissioner of community affairs will appoint one member representing community development and housing and one representative from the Georgia Association of Regional Commissions. The commissioner of human services shall appoint two members representing adult protective services, aging services, and public guardianship. The commissioner of behavioral health and developmental disabilities will appoint two members representing addictive disorders and behavioral health. The commissioner of public health will appoint one member and the commissioner of veterans services shall also appoint one member.

SR 392 – Sen. David Lucas (D-Macon) authored this resolution, which creates the Senate Rural Georgia Study Committee to study the existing issues in Georgia's rural areas and create policies to enhance the delivery of service to individuals and businesses in these areas. The committee shall be composed of seven members of the Senate to be appointed by the President of the Senate.

SR 412 – Authored by Sen. John F. Kennedy (R-Macon), this resolution creates the Senate Stroke Trauma Center Study Committee to examine the need for a stroke trauma center in the state. The committee shall be composed of four members of the Senate to be appointed by the President of the Senate. The President shall also appoint an additional four non-legislative members of the committee.

FAILED LEGISLATION

SURPRISE BILLING
The House and Senate failed to pass any surprise billing legislation this legislative session despite the two chambers dropping bills to address the issue.

The Senate offered SB 8 this year. Authored by Sen. Renee Unterman (R-Buford), this piece of legislation is known as the Surprise Billing and Consumer Protection Act and would provide consumer protections against surprise medical bills that patients' insurers do not cover. The bill contained disclosure requirements and reimbursement guidelines for out-of-network emergency situations. The bill made it through the House Insurance Committee, but failed to be heard on the House Floor.

HB 71, authored by Rep. Richard Smith (R-Columbus), is the House's version of the bill. This piece of legislation would also provide consumer protections against surprise medical bills that patients' insurers do not cover. The bill was amended in the House Rules Committee to narrow

the language relating to credentialing. The new language would only apply the credentialing requirements to physicians with an exclusive contract to provide services at the hospitals. This legislation did not make it to the House Floor for a vote.

CERTIFICATE OF NEED

The Certificate of Need issue also failed to move through the legislative process. Rep. Wendell Willard (R-Sandy Springs) offered the following two bills, which were heard in the House Governmental Affairs Government Administration Subcommittee midway through the session:

HB 464 would alter CON restrictions and provide for a five-year phase-in decrease in the percentage of out-of-state patients required to compose the patient base of the Cancer Treatment Center of America. The legislation would also eliminate the licensed bed capacity, and would raise the charity care requirements from 3 percent to 4 percent.

HB 299 would repeal certain aspects of the certificate of need law, such as eliminating the CON requirement for medical equipment and capital expenditures. It would also exempt freestanding emergency departments and facilities that provide alcohol, drug abuse, and mental health services from the law.

MENTAL HEALTH TREATMENT TASK FORCE

The Mental Health Treatment Task Force legislation failed to pass this session. SB 4, sponsored by Sen. Unterman (R-Buford), would create the Georgia Mental Health Treatment Task Force and the Georgia Mental Health Treatment Advisory Council. Both would examine the insurance coverage status of patients affected by serious mental illness and substance abuse disorders. The bill would also allow these entities to develop an application for a Section 1115 Medicaid waiver targeted at mental illness and substance abuse disorders. The bill was amended in the House Committee to have the council consist of 21 nonvoting members to be appointed by the Governor. Appointees include the commissioner of public safety or his or her designee; a board licensed psychiatrist practicing in an acute care hospital that maintains in-patient psychiatric beds; a licensed professional counselor; a licensed emergency medical technician or paramedic; among others.

INSURANCE COPAY LEGISLATION

SB 164, authored by Sen. Fran Millar (R-Atlanta), also failed to pass this session. This piece of legislation would prohibit certain insurers from imposing a copayment, coinsurance, or office visit deductible amount greater than such charges imposed on a physician or an osteopath to an insured for services rendered by a physical therapist, an occupational therapist, or chiropractor.

ADDITIONAL FAILED LEGISLATION

HB 124 – Authored by Rep. David Clark (R-Buford), this piece of legislation would re-designate Code Section 49-4-15, relating to fraud in obtaining public assistance, food stamps, or Medicaid, penalties, and recovery of overpayments, as new Code Section 16-9-64. It would also clarify ‘department' as the Department of Human Services.

HB 300 – Authored by Rep. Geoff Duncan (R-Cumming), this bill would require incentives for public employees to utilize federally qualified health centers and would provide for the identification of up to 100 potential new sites for federally qualified health centers. It would also transfer the state health care benefit plan from the Department of Community Health to the Department of Administrative Services.

HB 301 – Authored by Rep. Jodi Lott (R-Evans), this piece of legislation would create a new income tax credit for taxpayers who are licensed physicians, advanced practice registered nurses, or physician assistants who provide uncompensated preceptorship training to medical students, advanced practice registered nurse students, or physician assistant students for certain periods of time.

HR 240 – Sponsored by Rep. Sharon Cooper (R-Marietta), this piece of legislation would create the Joint Study Committee on Reforming HIV Related Criminal Law.

HR 388 – Authored by Rep. Tom Kirby (R-Loganville), this resolution would create the House Study Committee on Meeting the Demand for Nursing Care in Georgia.

HR 446 – Sponsored by Rep. William Boddie (D-East Point), this resolution would create the Johnny Tolbert III House Study Committee on Heatstroke.

HR 464 – Authored by Rep. Betty Price (R-Roswell), this resolution would create the House Study Committee on Infectious Disease Preparedness.

HR 468 – Authored by Rep. Karen Bennett (D-Stone Mountain), this resolution would create the House Study Committee on Health in Georgia.

HR 627 – Authored by Rep. Paulette Rakestraw (R-Powder Springs), this resolution would create the House Study Committee on Mental Health and Addiction Treatment Funding Mechanisms. The bill was amended in committee to remove the word “addiction” and replace it with “substance abuse.”

SB 2 – Authored by Sen. Dugan (R-Carrollton), this piece of legislation would enhance accountability and notice requirements for agency rule making so as to reduce regulatory burdens on businesses.

SB 50 – Authored by Sen. Hunter Hill (R-Atlanta), this piece of legislation would allow for direct primary care agreements between physicians and patients. These agreements would not be considered insurance.

SB 81 – Authored by Senator Renee Unterman (R-Buford), this bill would allow the state health officer to issue a standing order to allow a licensed pharmacist to distribute Naloxone over the counter. Additionally, the legislation would mandate that every pharmacy in Georgia keep a record of every opioid antagonist dispensed and would require reporting to the PDMP by July 1, 2018. Children with ADHD (and others) would be exempt from the regulations of this bill.

SB 99 – Sponsored by Sen. Elena Parent (D-Atlanta), this piece of legislation would provide for a judicial procedure for purging a person's involuntary hospitalization information received by the center.

SB 118 – Authored by Sen. Renee Unterman (R-Buford), this bill would allow for autism coverage for children up until the age of 21.

SB 157 – Authored by Sen. Ben Watson (R-Savannah), this piece of legislation would allow certain multi-specialty physician practices to operate up to two operating rooms in an ambulatory surgical environment. It would also require that these operations provide care to Medicaid beneficiaries and children enrolled in the PeachCare for Kids program.

SB 158 – Sponsored by Sen. Ben Watson (R-Savannah), this bill would allow a single freestanding emergency department to operate in any county without a hospital. It would also allow certain multi-specialty physician practices to operate up to two operating rooms in an ambulatory surgical environment.

SR 73 – Sen. Horacena Tate (D-Atlanta) authored this resolution, which would amend the Constitution to create the Family Medical Leave Fund.

SR 238 – Sponsored by Sen. Donzella James (D-Atlanta), this resolution would create the Senate Electroshock Therapy Study Committee.

SR 465 – Authored by Sen. Vincent Fort (D-Atlanta), this resolution would create the Senate Study Committee on Reforming HIV Related Criminal Laws.

SR 474 – Authored by Sen. Valencia Seay (D-Riverdale), this resolution would create the Senate Study Committee on Adult Changing Stations in Commercial Public Facilities.

SR 484 – Authored by Sen. Ed Harbison (D-Columbus), this resolution would create the Senate Study Committee on Creating a Lottery Game to Benefit Veterans.

SR 489 – Authored by Sen. William Ligon (R-Brunswick), this resolution would create the Senate Study Committee on Prescribing Patterns for Antidepressants and Other Psychotropic Medications.

SR 502 – Authored by Sen. Steve Gooch (R-Dahlonega), this resolution would encourage the Congress of the United States and Federal Agencies to do all within their powers to develop policies and funding sources to help bring high-speed broadband access to Rural America.

SR 506 – Authored by Sen. Mike Dugan (R-Carrolton), this resolution would create the Senate Study Committee on the Excessive and Duplicative Regulatory Oversight of Community Based and Developmental Disability Services.

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