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March 1, 2001 For more information contact: 404-817-6133 404-817-6247 404-817-6170 |
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Spring is around the corner and today marked the twenty-ninth day of the
2001 Session. Legislators and
lobbyists alike are losing that fresh-faced look as the Session wears on and day
forty looms ahead. Work is at a
frenzy as Legislators know that in order to make the ‘cut’ a bill must make
the cross-over by day thirty-three. Moreover,
no new bill which is introduced can now make it across the finish line.
Thus, the bills that are outstanding must either get moved or attached to
some other piece of legislation in order to be passed into law. In other news, the Budget is still
making headway. The House Green
Door Committee has been meeting to ‘hash’ out the final details of its
Budget recommendations for FY 2002. Needless
to say, the advocates and various State Departments and Agencies are nervous as
to whether their monies may be in or out of the Budget. Newly Introduced
Bills
SB 269 – Sen. Kemp and others have authored this bill
amending O.C.G.A. § 5-3-30 regarding the calendaring of appeals in the superior
or state courts and jury trials therein in an effort to eliminate the magistrate
court monetary jurisdictional limit. This bill has now been forwarded to the Senate Judiciary
Committee for review. SB 271 – Sens. Kemp, Ray, and Haines have authored this
bill amending the code at Chapter 3 of Title 1 provide notice to the State’s
Attorney General of any challenge to the constitutionality of any statute of the
State. This bill has also been
forwarded to the Senate Judiciary Committee. SB 273 – This bill, introduced by Sen. Eric Johnson and
Sen. Vincent Fort, proposes to require the owner of a dangerous dog to provide
evidence of insurance in the amount of $100,000 or more covering the owner
against liability for personal injuries inflicted by a ‘dangerous’ dog or in
the alternative a surety bond in the amount of $100,000 payable to any person
injured by the dog. This bill would
be inserted in the Code at Article 2 of Chapter 8 of Title 4.
This has been forwarded to the Committee on Insurance and Labor. SB 280 – Sen. Thomas’s bill concerning the overview of
nursing homes and citations delivered by the Office of Regulatory Services as
required in Article 1 of Chapter 7 of Title 31 has now been referred to the
Senate’s Veterans and Consumer Affairs Committee. SB 282 – Sen. Hecht and others introduced this amendment
to the Patient Protection Act of 1996 in order to provide for standards and
procedures relating to the verification of benefits and precertifications by
managed health benefit plans. This
bill amends Chapter 20A of Title 33 in the Code.
It has now been referred to the Senate Health and Human Services
Committee. SB 287 – Sens. James and Scott have offered this Bill
amending Title 31 regarding the establishment of an “Rx Program” within the
Department of Medical Assistance in an effort to lower prescription drug prices
for uninsured and underinsured Georgians. This
would create the “Georgia Prescription Drug Fair Pricing Act” at O.C.G.A. §
31-46-1. The bill states that a
drug manufacturer or labeler (an entity or person that receives prescription
drugs from a manufacturer or wholesaler and repackages those drugs for later
retail sale, and that a labeler code from the Federal Food and Drug
Administration) in Georgia could voluntarily elect to enter into a rebate
agreement with the Department of Medical Assistance. The terms would be negotiated by the Commissioner – taking
in consideration the rebate calculated under the Medicaid Rebate Program, the
average wholesale price of prescription drugs, and any additional information
available. The drugs which do not
receive an agreed-to rebate would then be listed on the State’s prior
authorization list. A retail
pharmacy would discount the price of prescription drugs sold to Rx Program
participants: “(1) The department shall
establish discounted prices for drugs covered by a rebate agreement and shall
promote the use of efficacious and reduced cost drugs, taking into consideration
reduced prices for state and federally capped drug programs, differential
dispensing fees, administrative overhead, and incentive payments. Pharmacies would get reimbursed after submitting claims to the Department for verification; that reimbursement would occur on a weekly or biweekly basis. Further, the Department would be charged with collecting utilization data from the retail pharmacies in order to calculate the rebate amounts from the manufacturer or labeler. The bill does provide for resolution of discrepancies in rebated amounts. An “Rx Dedicated Fund” would also be established “to receive revenue from manufacturers and labelers who pay rebates and any appropriations or allocations designated for the fund. The purposes of the fund are to reimburse retail pharmacies for discounted prices provided to Rx Program participants, and reimburse the department for the costs of administering the program, including contracted services, computer costs, professional fees paid to retail pharmacies, and other reasonable program costs. The Rx Dedicated Fund is a nonlapsing dedicated fund. Interest on Rx Dedicated Fund balances accrues to the fund.” Additionally, the Department would be required to provide a report on enrollment and the financial status of the Program to the General Assembly by the second week in January of each year. SB 290 – This bill, authored by Sen. Charles Walker, is a
joint effort of the hospital association and the health plan association to deal
with the timely payment of hospital or ambulance service provider claims.
The bill would amend current law at Article 1 of Chapter 24 of Title 33
of the Insurance Code. The bill
deals with the processing of electronic and paper claims.
Further, the bill states that: “Every insurer shall, within 21
calendar days after receipt of an electronic claim and within 30 calendar days
after receipt of a paper claim, send to the hospital or ambulance service
provider either: The bill further restricts when an insurer may “pend” a
claim when one or more of the following exist: “(A) A lack of specific
information required by the insurer to pay or deny the claim;
Once the insurer receives the additional information from the hospital or
ambulance service provider, then the insurer has 21 calendar days after receipt
of the information to pay the claim, deny the claim, or send another written
reply to the hospital or ambulance provider or by electronic means a statement
as to all reasons for continuing to pend the claim and explaining why additional
information is necessary in order to satisfy the insurer’s request.
The Commissioner of Insurance will monitor this process and its
compliance – every insurer shall pay, deny or pend 95% of the electronic
claims within 21 calendar days of receipt; every insurer shall pay, deny or pend
95% of all paper claims within 30 calendar days of receipt; and every insurer
shall pay or deny 95% of the number of all claims within 60 calendar days of
receipt. Each insurer will be
making a report to the Commissioner of Insurance on or before the 45th
day after each calendar quarter with various pieces of information (names of
providers, name of health benefit plan, whether claim was received
electronically, date of receipt of claim, dates of original disposition and
final disposition (if any), nature of disposition and reason(s) for pending
claim, amount of charges and amount paid by the insurer to claimant, and any
additional information deemed necessary by the Commissioner.
The Commissioner will then publish quarterly compliance performance.
Sanctions by the Commissioner may be applied to the insurer where an
insurer fails to comply. Interest
at 18% per annum will be applied on the amount owed for every claim neither paid
nor denied in good faith within 60 days of the insurer’s receipt of the claim
– interest on electronic claims would begin accruing 22 calendar days after
receipt of the claim and interest on paper claims would begin accruing 31
calendar days after receipt of the claim. Should
a hospital or ambulance provider fail to respond within 18 days to a reply from
an insurer when requesting additional information, then any interest payable by
the insurer shall not begin accruing until the date the reply is received.
If passed into law, this would go into effect on July 1, 2001 and would
sunset on June 30, 2003, at which time the provisions of O.C.G.A. § 33-24-59.5
would once again apply to claims submitted by hospitals and ambulance service
providers. SR 277 – Sen. Hecht and others have authored this
Resolution proposing to direct the Department of Community Health to adopt
certain reimbursement methodologies for nursing facilities. The Resolution applies to nursing homes.
The Resolution is an effort to provide better financial incentives for
nursing homes in order that they can recruit, train, and retain staff and to
implement innovative methods of management and/or service delivery to address
the staffing shortages. HB 784 – Majority Leader Larry Walker has reintroduced
his office-based physician surgery regulation bill which amends Article 2 of
Chapter 34 of Title 43. This bill,
pushed by the Medical Association of Georgia, has now been assigned to the
Health and Ecology Committee. HB 802 – This bill was authored as an amendment to
O.C.G.A. § 15-6-77 (f) by Rep. Bannister and others in order to change the fees
for filing and indexing financing statements, amendments to financing
statements, continuation statements, termination statements, release of
collateral, or other filings. The first page for filing such would be raised
from $10 to $18. HR 432 – This Resolution has been introduced by Rep. Gail
Buckner and others in an effort to create a Joint Task Force on Developing a
Federally Funded Drug Benefit for Low-Income Elderly Citizens.
This has now been forwarded to the House Rules Committee. Floor Activity
With tears flowing from many, including Speaker Murphy and
Rep. Sally Harrell, HB 498 passed out of the House by Floor Substitute with some
amendments. Originally, HB 498 was
introduced by Speaker Murphy and Rep. Carl Von Epps in an effort to eliminate
the regional service boards created by HB 100.
In the end, this bill would “mend” not “end” these regional
boards. The bill strikes O.C.G.A.
§ 31-3-12.1 in its entirety concerning the board of health contracts held with
the regional boards and community service boards in their provision of home and
community based services. The bill
further amends O.C.G.A. §37-2-4.1 concerning the current regional boards which
will become regional planning units. “
Effective July 1, 2001, the regional mental health, mental retardation, and
substance abuse boards created by the prior provisions of this Code section
shall become regional mental health, mental retardation, and substance abuse
planning unit boards. Except for
the duties associated with planning, the department, on and after that date,
shall succeed to the powers, duties, obligations, and functions of regional
mental health, mental retardation, and substance abuse boards unless otherwise
provided by this chapter. The
rights, privileges, entitlements, and duties of parties to contracts, leases,
agreements, and other transactions entered into before July 1, 2001, by any such
regional board and which pertain to the powers, duties, obligations, and
functions retained by the regional mental health, mental retardation, and
substance abuse planning unit boards or transferred to the department by this
chapter shall continue to exist; and none of these rights, privileges,
entitlements, and duties are impaired or diminished by reason of such retention
or transfer. In all such instances,
the department shall be substituted for such regional board and the department
shall succeed to the rights and duties under such contracts, leases, agreements,
and other transactions.”
The bill also redefines a community service board and its duties. A new O.C.G.A. § 37-2-5.3 is included which states that each
community service board created and existing on January 1, 2001 shall continue
in existence on and after July 1, 2001 but it shall become a CSB and shall: “1) Be constituted as provided in this Code section; 2) Provide disability services within the same area served by that community service board immediately prior to its becoming a CSB, until that CSB area is changed pursuant to law; 3) Be a public corporation and an instrumentality of the state; and 4) Have the powers and duties
provided in the provisions of this Code section other than subsection (b).” HB 498 passed by a vote of 160 yeas to 1 nay.
The House also passed out HB 455 which was introduced by Rep. Stan Watson
as an alternative to the Commissioner of Insurance’s bill on the
Gramm-Leach-Bliley Act requirements relating to privacy.
In addition, the bill deals with the regulation of the dissemination of
financial information; provides a statement of the purpose of the provisions and
definitions as well as privacy notices and opt-out notices and limits on
disclosure of information. HB 455
came to the Floor by Committee Substitute by the House Insurance Committee and
passed today by a vote of 143 to zero with no additional amendments made on the
Floor.
SB 208, the bill which has been referred to as the “Webvan” bill,
that would enact in Title 10 of the Code the “Electronic Commerce Home
Delivery Act of 2001,” has now arrived in the House and has been assigned to
the House Committee on Agriculture and Consumer Affairs. Committee Activity
House Health and
Ecology Committee
A Subcommittee of the House Health and Ecology Committee met today to
take up the new version proposed for regulation of office-based physician
surgeries. HB 784 passed out of the
Subcommittee after the bill was presented by Rep. Garland Pinholster. The bill is to be engrossed on Friday. Rep. Pinholster explained that it was designed to protect
patients who have procedures in a physician’s office. It sets up a credentialing process at least every three years
for the physician and also for facilities.
Rep. Pinholster noted that there had not been widespread problems but
this was an effort to make such procedures more safe. This version of the legislation addresses certain concerns
raised by hospitals and limits their liability once they accredit a physician.
Later in the day, the full Committee took up HB 784 and passed it out.
There was opposition raised by certified registered nurse anesthetists
who claimed that this adding of requirements on physicians indirectly impacts
them. Also, the physicians
performing these surgeries will use only anesthesiologists rather than certified
registered nurse anesthetists. There will be some additional review of the issue as it makes
its way to the Senate or perhaps next Session to deal with these concerns. Senate Health and
Human Services
The first bill before the Committee was SB 54 concerning the movement of
physician investigations to the Composite State Board of Medical Examiners.
Sen. Price questioned the rationale behind this bill authored by Sen.
Harold Ragan. Further, the
Composite State Board rose in opposition to the bill as it poses a hardship on
staffing. There are certain powers
available now – such as the review to determine whether someone is practicing
the unauthorized practice of medicine. After more discussion, the bill was held in Committee.
Next on the agenda was SB 238 amending Chapter 7 of Title 31 as authored
by Sen. Charles Walker and others. This
bill is supported by the Georgia Hospital Association and proposes to amend peer
review organizations and change the provisions relating to confidentiality of
information shared between such peer review organization and a governmental
agency (the Office of Regulatory Services within the Department of Human
Resources). The confidential data
collected about an event caused by medical errors would be provided to the
Office of Regulatory Services. Information
would remain confidential. The
Association believes that the bill would tighten the confidentiality of data.
In discussing this bill, the Association also worked with the Office of
Regulatory Services and the Medical Association of Georgia.
Sen. Nadine Thomas stated that she was opposed to the bill as she already
had some issues with the Office of Regulatory Services (relating to some nursing
home problems and their surveys). Further,
the Georgia Nurses Association also thought the goal of patient safety was
laudable but had some concerns that this would interfere with a blame-free
environment of reporting such errors. After
discussing the bill at length, the bill was moved out of Committee.
The Committee also took up Sen. Donzella James bill relating to breast
feeding in public places. The bill,
SB 221, received the support of the Committee and thus makes its way to the
Rules Committee. It amends the
current law that mothers may only breast feed in a discreet and modest way by
eliminating the discreet and modest way language.
Finally, the Committee also had on its agenda SB 102, which would allow
psychologists an expansion in their scope of practice by allowing them to
prescribe medications under certain conditions.
The bill was held and it is believed that it will be placed on the
Committee’s Monday meeting agenda. Other News
The bill concerning the databases authored by Sen. Mike Polak is expected
on the Senate Floor tomorrow. SB
214 would create the Georgia Data Base Protection and Economic Development Act
of 2001. SB 253 has now been reported out of the Senate Judiciary Committee by Substitute. SB 253 amends the current law on Georgia’s Limited Liability Company Act. The bill amends the current law’s definitions on articles of organization, business entity, conflicting interest, contribution, corporation, distribution, electronic transmission, event of dissociation, foreign corporation, foreign limited liability company, foreign limited partnership, general partnership, limited liability company, limited liability company interest, limited partnership, manager, member, member or manager’s conflicting interest transaction, operating agreement, person, proceeding, related person, required disclosure, state and time of commitment. Unless stated in the articles of organization or a written operating agreement, the bill requires the unanimous vote or consent of the members to approve certain matters including the dissolution of the limited liability company, merger, sale, lease, exchange, or transfer of all other assets of the limited liability company, admission of a new member, an amendment to the articles of organization, any action to reduce or eliminate an obligation to make a contribution to the capital, any action to approve a distribution, or any action to continue a limited liability company under paragraph (4) of subsection (1) or paragraph (4) of subsection (b) of O.C.G.A. § 14-11-602. |
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