February 21, 2001

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Stanley S. Jones, Jr.

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           Today was a very busy day at the Capitol.  Bills are flying around, and amendments and deals are being made.  Budget efforts are also ongoing – advocates for various interest groups are working both House and Senate members trying to ensure monies in the Budgets (Supplemental FY 2001 and FY 2002). 

Floor Activity 

          Some of the biggest news and excitement dealt with the ongoing war between the optometrists and ophthalmologists.  The optometrists have been pushing HB 195 in an effort to expand their scope of practice in order to be granted prescriptive authority.  Needless to say, the members of the Medical Association of Georgia have been lobbying hard against the bill.  Today, the Senate took up HB 195 and the bill was defeated by a vote of 28 yeas to 26 nays with two Senators out today on excused absences.  A notice to reconsider was filed; the Senate will vote on that motion tomorrow.  As the bill was lost, it will go back to the Senate Rules Committee if the Senate agrees to reconsider its action and then have to make its way out of the Rules Committee again before being placed back on the Calendar. 

Committee Activity

Industry Committee 

          The House Industry Committee met this afternoon and passed out HB 652, authored by Rep. Ron Dodson, which would track the numbers, specialties, locations and ages of nurses in Georgia.  This is an effort to compile data which will help in evaluating and addressing shortages.  The bill came out of the House Industry Committee by Committee Substitute without any discussion.  It now proceeds to the Rules Committee. 

Health and Ecology Committee 

          The House Health and Ecology Subcommittee on Healthcare Facilities met this morning to take up HB 632 concerning the regulation of office-based surgeries performed by physicians.  Rep. Larry Walker introduced this bill on behalf of the Medical Association of Georgia.  The bill was engrossed; thus, no changes may be made to the legislation.  Today, in the hearing, there was testimony by Rep. Pinholster in favor of the bill as last year he proposed similar legislation and is a signer of this bill.  There were concerns raised by the Georgia Alliance of Community Hospitals' lobbyist and its counsel regarding the certificate of need issues surrounding ambulatory surgery centers and limited purpose, physician-owned surgery centers.  Mr. Monty Veazy, on behalf of the Alliance, expressed that his hospitals would like the Subcommittee to hold the bill in order that new legislation could be reintroduced to address some of his group’s concerns.  There were also concerns raised by Mr. Veazy about the liability that a hospital would be under when that physician had been credentialed to perform certain procedures in a hospital setting and was conducting those same procedures in an office setting.   After a good bit of discussion, the bill passed out of the Subcommittee with a tie‑breaking vote being cast by the Subcommittee Chair, Rep. Tom Bordeaux. 

          Late this afternoon, the Health and Ecology Committee addressed HB 632 in the full Committee with the bill being held in order that concerns could be addressed. 

          The Health and Ecology Committee also passed out HB 585, authored by Reps. Parham and Graves, which would require that a pharmacy benefit manager operating in Georgia be licensed as a pharmacy.  The bill came out of the Committee by Committee Substitute without any discussion.  It now proceeds to the House Rules Committee. 

          The Committee also took up HR 275 concerning the urging the Department of Community Health to adopt certain reimbursement methodologies for nursing facilities.  This bill also proceeds to the House Rules Committee. 

Senate Insurance and Labor Committee 

          The Insurance and Labor Committee met late this afternoon as well.  HB 355, authored by Rep. Nan Orrock, was one of the bills on the Committee’s agenda.  HB 355, requiring that health plans make direct reimbursement to Registered Nurse First Assistants who provide surgical assistance to physicians, was passed out by the Committee.  The Senate version of this bill authored by Sen. Nadine Thomas will no longer travel through the process by agreement of the two authors.  

          SB 98, which would require health plans to cover the costs of ovarian cancer surveillance testing (such as the CA 125 test), also passed out of the Committee.  There was emotional testimony in a packed room on Sen. Steve Thompson’s bill.  His mother-in-law from Augusta is a victim of ovarian cancer and she spoke at length to the Committee about the disease and the need for tests.   Sen. Thompson argued that these surveillance tests should be conducted on women who were at higher risk for ovarian cancer – such as those who had BRCA 1 and 2, breast cancer, or other members in their family with ovarian cancer.  The Governor also extended his support to the bill.  While available tests are not perfect, it was argued that insurance companies should cover these tests for women at high risk.  St. Joseph’s Hospital, Emory University Hospital, and the Ovarian Cancer Institute were in support of the bill as well.  It was stated that approximately 5,000 to 6,000 women are at risk per St. Joseph’s numbers.  The tests would cost about $2.4 million in one year; last year, treatment for ovarian cancer cost $65 million.  The American Cancer Society also rose in support of this legislation.  Last year, there were 780 women in Georgia diagnosed with the disease; of these, approximately 400 have died.  Sen. Don Balfour raised some pointed questions about the reliability of the testing available and the expenditures for the tests.  Sen. Seabaugh also raised concerns about why an insurance company would not pay for a $400 test when it could save more money.  Sen. Walker stressed that many times that the General Assembly placed too much emphasis on costs rather than the actual lives of the persons involved.  The lone dissent on the bill was Blue Cross Blue Shield of Georgia – their argument was that this bill might give false hope to women due to the inaccuracies of the tests.  Also, this test would screen women of high risk who knew their risks – it would not address those women who might not know their risks (such as women who were adopted and know nothing of their birth parents).  After all the discussion, the bill passed out. 

Appropriations Committee 

          The Department of Community Health Subcommittee, under the leadership of Rep. Mickey Channell, of the House Appropriations Committee on its recommendations for the FY 2002 Budget also met today.  New money was given for folic acid in an effort to prevent birth defects.  A sum of $200,000 was placed in the budget.  Also, the Subcommittee agreed to support the hospitals' request that reimbursement rates be calculated on the use of the most recent cost reports.  It is believed that this will allow the hospitals some leverage in making adjustments in the Budget.  Also, the Subcommittee agreed to help home health agencies serving the needs of pediatric patients.  The Subcommittee placed $125,000 in its recommendations with available federal funds totaling $307,730. 

          As the afternoon wore on, the Senate was beginning to address HB 179 concerning the Governor’s request for $468,000,000 for school construction.