Under the Gold Dome This Week
Certificate of Need
CON Legislation is expected in the next few legislative days, ranging from a full repeal, to amendments to the existing law and/or other significant changes to the CON statute. The law has remained intact since 2008, the last significant reform package.
We understand the main House proposal will include a repeal of CON for Health Planning Service Region 3, which is all of metro Atlanta. It appears, nursing home services will remain under CON statewide. We understand that existing for-profit facilities will be grandfathered relative to changes to the indigent care tax, but significant changes will be proposed for not-for-profit entities along with sweeping transparency requirements. See the headline below from the Newnan Times-Herald.
Work continuing on CON legislation
By SARAH FAY CAMPBELL
Jan. 30, 2019 - 9:09 PM
Bills that would make changes to the state’s “Certificate of Need” process for hospitals and medical facilities have been going through several different drafts under the Gold Dome.
“We’re probably on the fourth or fifth version now,” said State Sen. Matt Brass, R-Newnan. “I think the original bill was about 30 pages, now we’re up to about 80. There’s just a lot to it.”
You can read the full article
here.
Out of Network Billing
Out of Network Billing legislation is expected to be dropped early next week by Sen. Chuck Hufstetler (R-Rome). This bill is nearly identical to last years OON legislation. Legislation within the bill will result in greater transparency for elective procedures, establish a patient/physician arbitration process for “unexpected events” that take place during elective medical procedures, and establish a standard physician payment model for out-of-network emergency care.
Step Therapy
Rep. Sharon Cooper (R-Marietta) this week introduced
HB 63
– legislation to reform the insurance practice known as step therapy, which forces patients to try and fail on medications other than what their health care provider prescribes – and in some cases, happens even when patients have already tried the insurer-preferred medications or when those medications could cause their health to deteriorate.
House Bill 63 only limits step therapy and fail first protocols in certain critical situations, while still allowing insurers to use step therapy when it is appropriate for a patient’s health. The legislation also creates a basic framework for when it is medically appropriate to exempt patients from step therapy protocols and establishes a transparent process for health care providers to request exceptions.
Currently, the bill sits in House Insurance and is expecting a hearing next week.
Andrews Sports Medicine CON Reform Bill
The Andrews CON Reform Bill was introduced this week, the bill allows for a multi-specialty ASC LNR exemption to the CON process.
HB 89
, sponsored by Rep. Chuck Martin, has several key members of House leadership listed as co-sponsors. The bill was assigned to the Special Committee on Access to Quality Health Care. (All CON bills are expected to be assigned to the special committee)
DXM & Minors
HB 112
, sponsored by Rep. John LaHood, requires identification by minors for drug products containing dextromethorphan. The bill will likely be assigned to the House Health Committee. This piece of legislation passed the HHS committee last session.
Interstate Licensure Compacts
SB 16
- Physician Interstate Compact
HB 39
- Physical Therapy Interstate Compact
HB 26
- Psychology Interstate Compact
For our complete legislative tracking sheet
click here.
