April 30, 2001

For more information contact:

Stanley S. Jones, Jr.

404-817-6133

 There were a number of measures introduced this year, but many measures failed to pass. Much of this year’s Session focused on the State’s flag, teen driving, clean and plentiful water, and education. The following will provide the results of various bills, and such is not intended to be a comprehensive report on all legislation introduced or followed during the 2001 Session:

Legislation Passed

Highlights of the Budget which was passed in HB 175 for FY 2002 (after the Conferees made their Report):

Fund Availability: $14,433,000,000

Prior Year’s Surplus: $173,781,108 (this was increased from $166,000,000 which the Governor, House and Senate had all recommended)

Lottery Proceeds Estimate: $550,000,000

Indigent Care Trust Fund: $148,828,880

Tobacco Settlement Funds: $149,000,025

Department of Community Health (by item number order from the Tracking Document for HB 175; numbers 1, 6, 34, 42, and 44 are most important for hospitals):

1) To provide additional funds for increased utilization in Medicaid Benefits ($36,128,669)and increases in costs and utilization of pharmaceuticals for the Medicaid population ($54,193,003) netted against federal matching funds by utilization of upper payment limit (UPL) credits (Total funds of $222,357,637) – Governor recommended $20,621,672 and House recommended $9,018,115; Senate had recommended $2,018,115. Conference Committee: $20,621,672 State dollars

4) To reimburse physicians and physician-related providers based on 90% of the 1999 Resource Based Relative Value Scale with one year of inflation applied (bringing this to Total Funds of $15,106,738). Governor recommended $6,136,357 and House recommended $7,136,357 (the extra $1 million raises the inflation factor from 3.6% to 4.1%). Senate had also proposed $7,136,357. Conference Committee took this back to Governor’s Recommendation of $6,136,357.

5) To adjust reimbursement rates for nursing home providers using the base year 2000 cost report and growth allowance for one year (Total funds: $20,556,189 by Governor; Total Funds of $23,223,855 by Senate; Total Funds of $40,488,400 by Conference Committee. Governor and House had recommended $8,349,924; Senate had recommended $9,349,924. Conference Committee recommended $16,300,630.

6) To increase reimbursement rates for inpatient hospital providers by adding an additional year of DRI inflation to base rates (Total Funds: $19,032,922). Governor, House, Senate and Conference Committee kept this at $7,731,173.

14) To provide funds for 2 additional positions and related operating costs in Health Planning for a compliance manager and an assistant architect necessary to support the review of CON applications (Governor and House had this funded at $149,890; Senate had decreased this to one position for $75,000). Conference Committee took this to zero.

17) To transfer the State matching funds for MR waiver services from DCH to the Dept. of Human Resources to support DHR administration of Medicaid waiver services. Governor had recommended ($51,246,606); House had recommended zero; Senate had recommended ($43,409,614). Conference Committee placed this at ($43,409,614).

18) To transfer the State matching funds for community mental health services from DCH to DHR to support DHR administration of Medicaid services. Governor and Senate had shown this as ($37,138,648); House had reflected zero. Conference Committee kept this at ($37,138,648).

22. To authorize funding for 5 pediatric resident positions at Morehouse School of Medicine (for total funds of $98,800) – Governor had added language of ‘yes’ and House had recommended $33,000. Senate had recommended 5 positions for $98,800. Conference Committee agreed to just use language of ‘yes.’

24) To provide Medicaid coverage for children in families with incomes up to 150% of the FPL (Total Funds: $7,407,920; House reflects PeachCare match rate). Governor had recommended $3,009,097 in State Funds; House, Senate and Conference Committee had this at $2,126,097 in State Funds.

26. To reimburse 100% of cost for cost-based outpatient services for hospitals which provide indigent care equal to 5% of their adjusted gross revenues as determined by DCH (Total Funds of $2,926,241) – Governor recommended $1,188,639 and House recommended the same. Senate had proposed $270,000 which would have decreased the Total Funds to $664,697. Conference Committee took this to zero.
27. To expand community health, rural health and migrant health centers to promote access to primary health care for uninsured populations – Governor recommended $1,500,000 as did the House. Senate cut this in half; Conference Committee cut it further to $500,000.
28. This item, along with item (29), would provide funds to an implementation of a waiver for persons over 18 with sickle cell and cystic fibrosis with incomes under 235% of FPL, respectively. Governor had these at $1,949,760 and $1,631,476 and the House recommended $1,374,760 and $1,231,476, respectively. Senate took each to $1,000,000. (Discussions in the Senate had targeted the dates for startups for these programs as being around October 1, 2001 – thus, neither needed the full amount of funds. The Conference Committee took all the money out for Sickle Cell; and increased the money for cystic fibrosis to $1,631,476.

31. To increase reimbursement rates by 5% for home health providers who provide indigent care equal to 5% of their Medicaid revenue and who participate in the Community Care Services Program (Total Funds: $110,362). Governor, House and Senate had this at $44,829. Conference Committee placed no funds in the budget for this.

34. To continue evaluating the feasibility of a Medicaid buy-in program that would allow working people with disabilities to receive healthcare through Medicaid (Total Funds: $1,230,921). Governor, House, Senate and Conference Committee kept this at $500,000.

37. To provide for matching funds for an education initiative on folic acid – this was a new item added in the House of $100,000 which the Senate felt strongly about by increasing it to $150,000. Conference Committee reduced this back to $100,000.
38. To provide funds to increase Medicaid reimbursement rates for pediatric home health visits (Total Funds: $307,730). This was added in the House at $125,000; kept by Senate. Conference Committee also kept this at $125,000.
39. To provide funds to increase Medicaid reimbursement rates for rural home health providers (Total Funds: $677.006). House added $275,000; Senate kept. Conference Committee removed all money.
40. To provide funds for the Commission on Men’s Health. House had included $75,000; Senate had removed the money. Conference Committee replaced it with the $75,000.
41. To annualize additional funds provided in HB 174 for the Mercer School of Medicine – this was a new item added by the House. Language was added in House for ‘yes’; Senate agreed but added Morehouse School of Medicine. Conference Committee placed this at $7,700,000 and deleted language.
42. To authorize the DCH, subject to availability of funds, to increase Medicaid reimbursement rates for inpatient hospital providers through utilization of a more current cost report. House and Senate had placed ‘yes;’ Conference Committee agreed.
43. To annualize the increase in funding for non-emergency transportation provided in HB 174 (Total Funds: $6,641,279; Conference Committee Total Funds: $3,320,638). House and Senate had placed $2,714,955 in state dollars; Conference Committee reduced this to $1,357,477. NOTE: This item was stricken by Governor Barnes on the date that HB 175 was signed as a line item veto as non-emergency transportation providers had bid their costs of services. Thus, no funds will be allotted for this item.
44. To annualize the reimbursement rates for critical access hospitals provided in HB 174 (Total Funds $10,470,144; Conference Committee took $3,500,000 from Tobacco Settlement Funds for this). House and Senate had included $4,280,195; Conference Committee had reduced this to $780,195 in State funds.
45. To provide funds for the implementation of HB 156 (physician profiling bill). House had included $450,000; Senate had removed this. Conference Committee replaced the funds to $450,000.
46. To provide funds to the Composite State Board of Medical Examiners for the physician well-being program. Senate had put in $200,000 for this. Conference Committee removed the money.
47. To provide funds to reimburse historically minority-owned hospitals 100% of outpatient Medicaid costs. Senate had written in this item at $350,000. Conference Committee took this to $92,000.

Tobacco Settlement Funds:

1. To increase tobacco funds to compensate for a reduction in federal financial participation for the Medicaid eligibility expansion for pregnant women and infants under age 1 with incomes up to 235% of the FPL ($66,899) and the Independent Care Waiver Program ($17,553) - $84,452 (Governor, House and Senate agreed on this amount). Conference Committee kept this at $84,452.
2. To provide funds to identify and develop training for cancer caregivers ($2,125,000 – Governor and House agreed; Senate placed this at $2,000,000 and Conference Committee agreed with the Senate’s position).
3. To provide funds for the Ovarian Cancer Alliance (Senate inserted this for $125,000 and Conference Committee retained this amount).
4. To transfer matching funds for MR waiver services from DCH to the Department of Human Resources (DHR) to support DHR administration of Medicaid waiver services (Senate had this as ($7,836,992) which the Conference Committee agreed with.
5. To authorize funding for critical access hospitals ($3,500,000); Conference Committee likewise inserted language ‘yes’ to this.

Board of Regents (Unit A) – Tobacco Settlement Funds:

1. To provide funding for 5 positions and operating expenses for the Georgia Cancer Alliance. Governor, House, Senate and Conference Committee agreed to $921,821.
2. To establish programs and funding incentives to support 17 distinguished cancer clinicians and scientist. Governor, House, Senate and Conference Committee kept this at $3,340,000.
3. To provide equipment for 5 Georgia Research Alliance eminent scholars recommended in the FY 2001 amended general budget. Governor, House, Senate and Conference Committee agreed to put in $2,400,000 for this.

Both Budget bills, HB 174, Supplemental Appropriations bill for FY 2001, and HB 175, Appropriations bill for FY 2002, were signed by Gov. Barnes on April 26, 2001 with line item veto amendments made to each.

SB 30 – Sen. Billy Ray (Fulton, Forsyth, and Gwinnett Counties) introduced this bill concerning production and copying of health records. It amends O.C.G.A. § 31-33-2 and 31-33-3 and requires that any such record requested must be furnished to the patient in a ‘reasonable amount of time.’ This bill applies to "providers," which in the definitions found in O.C.G.A. § 31-33-1, includes health maintenance organizations (as well as hospitals, ambulatory surgical or obstetrical facilities, home health agencies, etc. and any person licensed to practice under Chapters 9, 11, 26, 34, 35, or 39 of Title 43). In the present law, it states in O.C.G.A. § 31-33-2, that upon written request from the patient, the provider…shall furnish a complete and current copy of that record... Further, SB 30 provides that:

• Allows charge of up to $20.00 for search, retrieval, and other direct administrative costs related to compliance with the request.
• Allows a fee for certifying the medical records not to exceed $7.50 for each record certified.
• Provides that the actual cost of postage incurred in mailing the requested records may be charged.
• Copying costs for a record, which is in paper form, shall not exceed $.75 per page for the first 20 pages of the patient’s records which are copied; $.65 per page for pages 21 through 100; and $.50 for each page copied in excess of 100 pages.
• Fees allowed by this Code section may be adjusted annually in accordance with the medical component of the consumer price index, calculated by the Office of Planning and Budget, which will become effective on July 1 of each year.
• Charges, to the extent the request for medical records includes portions of records which are not in paper form, including but not limited to radiology films, models, or fetal monitoring strips, may be charged by the provider, who shall be entitled to recover the full reasonable cost of such reproduction.
• Payment of fees and costs may be required by the provider prior to the records being furnished.
• These will not apply to records requested in order to make or complete an application for a disability benefits program.

Governor Barnes signed this bill on April 27, 2001, and it will take effect on July 1, 2001.

SB 51 – Sen. Nadine Thomas (DeKalb County) and others introduced this bill to amend the current law on emergency medical services and uses of an automated external defibrillator. It creates a new Code Section at O.C.G.A. § 31-11-53.2.

• Bill defines ‘lay rescuer’ as a person "trained to provide cardiopulmonary resuscitation and to use an automatic external defibrillator, as defined in Code Section 31-11-53.1, and who is participating in a physician or medically authorized automated external defibrillator program."
• Provides guidelines for use:

• Expected users of the automated external defibrillator receive American Heart Association or American Red Cross training in cardiopulmonary resuscitation and automated external defibrillator use or complete an equivalent nationally recognized course;
• The defibrillator is maintained and tested according to the manufacturer's operational guidelines;
• There is involvement of a licensed physician or other person authorized by the composite board in the site's automated external defibrillator program to ensure compliance with requirements for training, notification, and maintenance; and
• Any person who renders emergency care or treatment on a person in cardiac arrest by using an automated external defibrillator activates the emergency medical services system as soon as possible and reports any clinical use of the automated external defibrillator to the licensed physician or other person authorized by the composite board who is supervising the program.
• Requires that any person or entity who acquires an automated external defibrillator shall notify an agent of the emergency communications or vehicle dispatch center of the existence, location, and type of automated external defibrillator.
• Bill also grants immunity from liability to those who are acting as a lay rescuer but such would not extend to an act of willful or wanton misconduct and shall not apply to a person acting within the scope of a licensed profession if such person acts with gross negligence.

The bill was signed by Governor Barnes on April 26, 2001 and goes into effect on July 1, 2001.

SB 132 – Sen. Connie Stokes (DeKalb County) introduced this bill on behalf of the Department of Community Health in order to transfer the certification and re-certification responsibilities for paramedics and cardiac techs from the Composite State Board of Medical Examiners to the Department of Human Resources. It amends Chapter 11 of Title 31. This measure was signed on April 28, 2001 and takes effect on July 1, 2001.

SR 134 – Sen. Charles Walker introduced this Resolution creating the Joint Study Committee on the Prevention and Emergency Care of Injuries in Georgia. In the end, the Resolution was amended in order to add additional study committees: Joint Study Committee on Georgia Border Communities; and creating the Commission on Work Force Security and Enhancement in the New Georgia Economy. This Resolution, from the healthcare prospective, addresses unintentional injuries:

• Injuries resulting from motor vehicle accidents, falls, bicycle and pedestrian mishaps, fires, and others
• Common cause of death in children and young adults (those up to age 34)
• These death rates in Georgia are higher than other states
• Costs associated with medical care, rehabilitation, and lost wages
• Educating the public about programs for prevention is necessary
• Public health surveillance programs can guide the type and placement of unintentional injury prevention programs, emergency transport, and trauma treatment centers
• Composition of the Study Committee, with the Chair selected by the Governor:
• 3 Senate members appointed by President of Senate
• 3 House members appointed by Speaker
• Director of the Governor’s Office of Highway Safety or such person’s designee
• Director of the Division of Public Health of the Department of Human Resources or such person’s designee
• President of the Georgia Hospital Association or such person’s designee
• A representative of the Medical Association of Georgia and Georgia State Medical Association or that person’s designee
• The Executive Director of Safe Kids of Georgia or such person’s designee
• The Director of Children’s Trust Fund or such person’s designee
• The Commissioner of the State Department of Community Health
• The Director of the Injury Control Center of the Rollins School of Public Health or such person’s designee to be appointed by the Governor with such person’s consent.

SB 53 – Sen. Walker’s (Richmond County – Majority Leader) bill, introduced on behalf of Blue Cross Blue Shield, addresses unfair business practices and disciplinary actions against physicians. At O.C.G.A. § 10-1-393 (30.1) and (31) the bill adds language as to unfair practices relating to consumer transactions stating that:

• "Every contract between a physician and an insurer which offers a health benefit plan under which that physician provides health care services shall be in writing and shall state the obligations of the parties with respect to charges and fees for services covered under that plan when provided by that physician to enrollees under that plan. Neither the insurer which provides that plan nor the enrollee under that plan shall be liable for any amount which exceeds the obligations so established for such covered services and neither the physician nor a representative thereof shall intentionally collect or attempt to collect from an enrollee any obligations with respect to charges and fees for which the enrollee is not liable and neither such physician nor a representative thereof may maintain any action at law against such enrollee to collect any such obligations." This new Section applies to insurance contracts issued, delivered, or renewed on or after July 2, 2001.

• Further, the bill requires that a physician at O.C.G.A. § 43-34-37 (11.1) can be disciplined by the Composite State Board of Medical Examiners when he or she fails to inform a patient in a timely manner of their laboratory test results. The Composite State Board has until January 1, 2002 to promulgate the necessary rules.

Governor Barnes signed this measure on April 27, 2001, and it takes effect on July 1, 2001.

SB 75 - Sen. Donzella James introduced this measure amending O.C.G.A. § 43-34-64 which will allow chiropractors to practice acupuncture. Further, the bill deletes from current law the need to pass written and practical tests for such practice. The bill does have a sunset of July 15, 2002 and became effective upon signature of the Governor on

April 27, 2001. Specifically, it states:

• "An applicant for a license to practice acupuncture who does not meet the requirement of paragraph (4) of subsection (a) of this Code section but who does meet the requirements of paragraphs (1), (2), (3), (5), and (6) of subsection (a) of this Code section and who, in addition, has a minimum of 1,000 hours of training and experience in acupuncture and has registered a business in this state, with the expressed purpose of performing acupuncture, for at least three of the last five years; or has a minimum of 2,500 hours of training and experience in acupuncture and has registered a business in this state, with the expressed purpose of performing acupuncture, for at least one of the last five years may also be eligible for a license to practice acupuncture. An applicant who meets the requirements of this subsection may be issued a temporary license by the board, which license shall have the same force and effect as a permanent license and which shall be valid until the applicant takes an examination administered by a national certification agency accredited by the National Organization of Competency Assurance pursuant to a contract entered into by the appropriate state agency as provided by the board and the board is notified of the results of that examination, at which time the temporary license shall become void."
  

HB 223 – Rep. Buddy Childers’s bill amending O.C.G.A. § 43-11-74 relating to direct supervision of dental hygienists in order to authorize them to perform dental screenings without supervision, under certain circumstances, passed. Supervision would not be required when those dental hygienists are performing dental screenings in settings including schools, hospitals, clinics, state, county, local and federal public health organizations. Any other health fair settings would have to have Board approval. A written document would have to be provided to the parent or guardian if the person was a minor of the purpose and limitations of a dental screening and be advised to seek a more thorough examination by a dentist in order to determine whether problems exist that might not be discovered in the screening. Governor Barnes signed this on April 27, 2001 and it goes into effect on July 1, 2001.

SB 98 – Sen. Thompson’s (Cobb County) insurance mandate, inserted at O.C.G.A. § 33-24-56.2, requires that health insurers provide coverage for surveillance tests for women ages 35 and older who are at high risk for ovarian cancer. This was signed into law by Gov. Barnes on March 26, 2001.

• Women at "high risk" are those women with a family history (one or more family (first or second degree relative) members with ovarian cancer, clusters of breast cancer in female family members, or nonpolyposis colorectal cancer) or having tested positive with BRCA1 and BRCA2.
• "Surveillance" testing means CA-125 serum tumor marking testing, transvaginal ultrasound, and pelvic examination.
• This section applies to health benefit policies written, issued, delivered, or renewed on or after July 1, 2001.
• Benefits covered will be subject to the same annual deductibles and coinsurance established for all other covered benefits under such policy.

A Resolution was also adopted, HR 143 authored by Rep. Dorothy Pelote (Chatham County) in order to designate the month of April as Ovarian Cancer Awareness Month.

HB 355 – Rep. Nan Orrock (Fulton County) introduced this bill creating the Registered Nurse First Assistant Consumer Act in Article 1 of Chapter 24 of Title 33. Basically, this requires health plans to directly reimbursement Registered Nurse First Assistants who perform surgical first assistant services. Specific provisions:

• "Registered Nurse First Assistant" is:
  - a licensed registered professional nurse in the State of Georgia;
  - certified in perioperative nursing; and
  - successfully completed a registered nurse first assistant education program that meets the Association of periOperative Registered Nurses, Inc.’s education standard for the registered nurse first assistant; or that person was holding the title of and practicing as a registered nurse first assistant as of January 1, 1993.
• This would apply to any health benefit policy which is written, issued, delivered or renewed in Georgia on or after July 1, 2001.
• It would not apply to those Registered Nurse First Assistants employed by the requesting physician or if such person was an employee of a hospital where the services were rendered.

The bill was signed by Gov. Barnes on March 22, 2001 and becomes effective on July 1, 2001.

HB 565 – Rep. Mark Burkhalter (Fulton County), along with Rep. Jimmy Lord, introduced this insurance mandate to require that health plans provide coverage for autism. Originally, the bill included this in a health plan’s mental health coverage. In the final version of the bill, it would require health plans, if that insurer provides for benefits for neurological disorders, "shall not deny providing benefits in accordance with the conditions, schedule of benefits, limitations as to type and scope of treatment authorized for neurological disorders, exclusions, cost-sharing arrangements, or co-payment requirements which exist in such contract, policy, or benefit plan for neurological disorders because of a diagnosis of autism. The provisions of this subsection shall not expand the type or scope of treatment beyond that authorized for any other diagnosed neurological disorder." This is added to the Code at O.C.G.A. § 33-24-59.9. Once the bill passed out of the House, it was carried in the Senate by Sen. Susan Cable. Governor Barnes signed this bill on April 27, 2001. These changes take effect on July 1, 2001.

SB 205 – Sen. Tanksley (Cobb County) carried this bill for Gov. Barnes. This bill on privacy had a number of re-writes before it reached the passage phase. Eventually, a Conference Committee hammered out the bill’s details which amends O.C.G.A. § 50-18-72. Gov. Barnes signed this into law on April 19, 2001 and takes effect on July 1, 2001. The bill amends when such public disclosure shall not be required under Article 4 of Chapter 18 of Title 50.

• "An individual’s social security number, mother’s birth name, credit card information, debit card information, bank account information, financial data or information, and insurance or medical information in all records, and if technically feasible at reasonable cost, day and month of birth," shall be redacted prior to disclosure of any record requested pursuant to this article
• Such redaction would occur provided, however, that "such information shall not be redacted from such records if the person or entity requesting such records requests such information in a writing signed under oath by such person or a person legally authorized to represent such entity which states that such person or entity is gathering information as a representative of a news media organization for use in connection with news gathering and reporting; and provided, further, that such access shall be limited to social security numbers and day and month of birth; and provided, further, that this news media organization exception for access to social security numbers and day and month of birth and the other protected information set forth in this subparagraph shall not apply to teachers and employees of a public school."
• The bill does have exceptions such as the disclosure of information to a court, prosecutor, or publicly employed law enforcement officer, or authorized agent which is seeking records in an official capacity.

These changes will be implemented on July 1, 2001.

HB 158 - Another bill, HB 158, amending Article 4 of Chapter 7 of Title 31 in an effort to extend to non-profit corporations operating certain medical facilities an exemption from open records and open meetings passed. HB 158 was authored by Rep. Jack Connell (Richmond County). Specifically, it states:

• "no Georgia nonprofit corporation in its operation of a hospital or other medical facility for the benefit of a governmental entity in this state and no hospital authority shall be required by Chapter 14 of Title 50 or Article 4 of Chapter 18 of Title 50 to disclose or make public any potentially commercially valuable plan, proposal, or strategy that may be of competitive advantage in the operation of the corporation or authority or its medical facilities and which has not been made public. This exemption shall terminate at such time as such plan, proposal, or strategy has either been approved or rejected by the governing board of such corporation or hospital authority."

Governor Barnes signed this bill on April 28, 2001 and it became effective on that date.

HB 156 – Rep. Larry Walker (Houston County – Majority Leader) introduced this bill, at the urging by Blue Cross Blue Shield, to create the Patient Right to Know Act of 2001. In the waning hours of the Session, this bill was amended in order that the Georgia Hospital Association’s bill, SB 238, could be attached. Language from SB 238 addresses evaluating quality and efficiency of healthcare services rendered and the confidentiality associated with review organizations. The bill is amended at O.C.G.A. § 31-7-133 which provides:

• Notwithstanding the foregoing, the Department of Human Resources may inspect and copy peer review materials maintained by certain providers when it is determined by the department to be necessary in the performance of the department’s licensure and certification responsibilities under Code Section 31-7-15; provided, however, such inspection and copying shall not waive or abrogate the confidentiality of such peer review materials as set forth in this Code section and in O.C.G.A. § 31-7-15.
• The Patient Right to Know Act will create a physician profile system within the Composite State Board of Medical Examiners (which was funded in the State’s budget bill, HB 175).
• A standard form will used for the collection and dissemination of this data (physicians will be given 30 days to respond to any amendment if the amendment deals with malpractice, hospital staff privileges, or disciplinary action).
• Profile requirements:

(1) "The full name of the physician;
(2) Names of medical schools attended, dates of attendance, and date of graduation;
(3) The location and dates of graduate medical education;
(4) Specialty board certification, if applicable. The toll-free number of the American Board of Medical Specialties shall be included to verify current board certification status;
(5) The fact that a license has been granted by reciprocity under Code Section 43-34-31, if applicable;
(6) The number of years in practice and locations;
(7) Current hospital privileges;
(8) The location of primary practice setting;
(9) If requested by the physician, identification of any translating services available at the primary practice setting;
(10) Participation in the Medicaid program, if applicable;
(11) Criminal convictions for felonies, irrespective of the pendency or availability of an appeal;
(12) Felony charges to which a plea of nolo contendere was entered;
(13) A description of any final, public disciplinary action by a regulatory board and a description of any second or subsequent final private reprimand by a regulatory board. As used in this paragraph, the term 'regulatory board' refers to:
(A) The Composite State Board of Medical Examiners and its counterpart in any other state; and
(B) Any state licensing board in Georgia or in any other state;
(14) A description of any final revocation or any final disciplinary action resulting in any restriction of hospital privileges, either involuntary or by agreement, for reasons related to competence or character in the most recent ten years. No such revocation or restriction taken prior to the effective date of this chapter shall be included in the physician’s profile;
(15) Resignation from or non-renewal of medical staff membership or the restriction of staff privileges at a hospital taken in lieu of or in settlement of pending disciplinary action related to competence or character in the most recent ten years. No such action taken prior to the effective date of this chapter shall be included in the physician’s profile;
(16) Final medical malpractice court judgments or medical malpractice arbitration awards entered on or after the effective date of this chapter in which payment in excess of $100,000.00 is awarded against the physician to the complaining party. No such judgments or awards prior to the effective date of this chapter shall be included in any physician’s profile. No such medical malpractice court judgments or medical malpractice arbitration awards which occurred more than ten years prior to the date of the profile shall be included in any physician profile;
(17)(A) Medical malpractice settlements, including the monetary amount of each such settlement, in which payment in excess of $300,000.00 is made by or on behalf of and attributable to the physician to the complaining party. No such settlement occurring prior to the effective date of this chapter shall be included in any physician profile. No such settlement which occurred more than ten years prior to the date of the profile shall be included in any physician profile.
(B) Medical malpractice settlements, including the monetary amount of each such settlement, if three medical malpractice settlements have been made by or on behalf of and attributable to the physician to the complaining party and payment in excess of $100,000.00 has been made by or on behalf of and attributable to the physician in any one or more of such settlements. No such settlement occurring prior to the effective date of this chapter shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether three medical malpractice settlements have been made by or on behalf of and attributable to the physician. No such settlement which occurred more than ten years prior to the date of the profile shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether three medical malpractice settlements have been made by or on behalf of and attributable to the physician.
(C) All medical malpractice settlements, including the monetary amount of each such settlement, if four or more medical malpractice settlements have been made by or on behalf of and attributable to the physician to the complaining party, regardless of the amount of the payment made by or on behalf of and attributable to the physician in any such settlement. No such settlement occurring prior to the effective date of this chapter shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether four or more medical malpractice settlements have been made by or on behalf of and attributable to the physician. No such settlement which occurred more than ten years prior to the date of the profile shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether four or more medical malpractice settlements have been made by or on behalf of and attributable to the physician.
(D) Any disclosure under this paragraph shall be accompanied by the following statement: 'Settlement of a claim may occur for a variety of reasons which do not necessarily reflect negatively on the professional competence or conduct of the physician. A payment in settlement of a medical malpractice action or claim should not be construed as creating a presumption that medical malpractice has occurred.';
(18) Pending malpractice claims shall not be disclosed;
(19) The board may, in its discretion, include additional statements describing the experience or pattern of awards, judgments, or settlements of the physician. Information concerning paid medical malpractice claims may be put in context by comparing an individual licensee’s medical malpractice judgments, awards, or settlements to the experience of other physicians within the same specialty;
(20) Any complaint or grievance filed with the board and upon which the board took disciplinary action, including a description of the nature of the complaint and the resolution; and
(21) All violations of this chapter."

• Profiles may include:

(1) Appointment to medical school faculties within the most recent ten years;
(2) Articles in professional publications and journals; and
(3) Professional or community service membership, activities, and awards.

• Profiles may be obtained by anyone upon request (telephone, written, or electronic mail).
• The Board must respond to the request for the profile within 3 business days. Fees may be charged for such.
• Patients may obtain information, prior to treatment, the costs of routine office visits, routine treatments, and lab visits.
• A patient, or any person that the Board deems to have a legitimate interest, may file a grievance about a physician, office, staff, or treatment received. Once such complaint is received, the Board must respond within 60 days.
• Violations by physicians, or authorized personnel, are subject to fines for each day or instance of the violation.
• Profiles must be ready by July 1, 2002 and Board must be able to respond to requests for such at that time.

This bill was signed by Gov. Barnes on April 11, 2001 and became effective on that date. Regulations and rules must be promulgated on or by July 1, 2001.

HR 371 – The House adopted a Resolution, authored by Rep. Michele Henson (DeKalb County) creating the House Study Committee on Hepatitis C on March 21, 2001. This Study will look at this issue as a major public health issue which causes 36,000 new infections in the United States which affects 4,000,000 Americans and 100,000 Georgians. The Committee will be comprised of five House members designated by the Speaker and will meet five days unless additional days are authorized. A report of this Committee’s findings will be made on or before December 31, 2001.

HB 352 – Rep. Jimmy Lord (Jefferson and Washington Counties) introduced this measure outlining licensure requirements, following the Gramm-Leach-Bliley Act, for resident and non-resident insurance agents (or those persons that sell, solicit or negotiate insurance) amends the current law in Article 1 of Chapter 23 of Title 33. The bill allows for reciprocity of state licensure – thus, if an insurance agent is licensed in Georgia, then he or she may also be licensed in other states (and vice versa). Other specifics:

• Bill would not apply to:

(1) "An attorney at law admitted to practice in this state, when handling the collections of premiums or advising clients as to insurance as a function incidental to the practice of law or who, from time to time, adjusts losses which are incidental to the practice of his or her profession;
(2) Any representative of ocean marine insurers;
(3) Any representative of farmers’ mutual fire insurance companies as defined in Chapter 16 of this title;
(4) A salaried employee of a credit or character reporting firm or agency not engaged in the insurance business who may, however, report to an insurer;
(5) A person acting for or as a collection agency;

(6) A person who makes the salary deductions of premiums for employees or, under a group insurance plan, a person who serves the master policyholder of group insurance in administering the details of such insurance for the employees or debtors of the master policyholder or of a firm or corporation by which the person is employed and who does not receive insurance commissions for such service; provided, further, that an administration fee not exceeding 5 percent of the premiums collected paid by the insurer to the administration office shall not be construed to be an insurance commission; or
(7) Persons exempted from licensure as provided in subsection (h) of Code Section 33-23-4."

• A license as an insurance agent shall not be required of the following:
  "(A) An officer, director, or employee of an insurer or of an insurance agent or agency, provided that the officer, director, or employee does not receive any commission on policies written or sold to insure risks residing, located, or to be performed in this state and: (i) The officer, director, or employee’s activities are executive, administrative, managerial, clerical, or a combination of these, and are only indirectly related to the sale, solicitation, or negotiation of insurance;
  (ii) The officer, director, or employee’s function relates to underwriting, loss control, inspection, or the processing, adjusting, investigating, or settling of a claim on a contract of insurance; or (iii) The officer, director, or employee is acting in the capacity of a special agent or agency supervisor assisting insurance agents where the person’s activities are limited to providing technical advice and assistance to licensed insurance producers and do not include the sale, solicitation, or negotiation of insurance;
  (B) A person who meets the criteria set forth in paragraph (6) of subsection (b) of Code Section 33-23-1;
  (C) An employer or association or its officers, directors, or employees or the trustees of an employee trust plan to the extent that the employers, officers, employees, directors, or trustees are engaged in the administration or operation of a program of employee benefits for the employer’s or association’s own employees or the employees of its subsidiaries or affiliates, which program involves the use of insurance issued by an insurer, so long as the employers, associations, officers, directors, employees, or trustees are not in any manner compensated, directly or indirectly, by the company issuing the contracts;
  (D) Employees of insurers or organizations employed by insurers who are engaging in the inspection, rating, or classification of risks or in the supervision of the training of insurance agents and who are not individually engaged in the sale, solicitation, or negotiation of insurance;
  (E) A person whose activities in this state are limited to advertising without the intent to solicit insurance in this state through communications in printed publications or other forms of electronic mass media whose distribution is not limited to residents of the state, provided that the person does not sell, solicit, or negotiate insurance that would insure risks residing, located, or to be performed in this state;
  (F) A person who is not a resident of this state who sells, solicits, or negotiates a contract of insurance for commercial property and casualty risks to an insured with risks located in more than one state insured under that contract, provided that the person is otherwise licensed as an insurance agent to sell, solicit, or negotiate insurance in the state where the insured maintains its principal place of business and the contract of insurance insures risks located in that state; or
  (G) A salaried, full-time employee who counsels or advises his or her employer relative to the insurance interests of the employer or of the subsidiaries or business affiliates of the employer provided that the employee does not sell or solicit insurance or receive a commission."
• Provisions of this Code Section take effect on July 1, 2002 and rules and regulations will be prepared by the Department of Insurance.
• An additional provision in the bill, amending current law at O.C.G.A. § 33-29A-8, relating to rules and regulations concerning individual health insurance coverage availability and assignment systems, now states at (b):
  "(b) The rules and regulations developed by the Commissioner shall include provisions for applications for GHIAS and GHBAS to be submitted by licensed insurance agents and for such agents to be compensated at a commission rate of not less than 3 percent from the premiums received by the issuing health insurer or managed care organization. For purposes of applications for GHIAS and GHBAS, licensed agents shall not be subject to the certificate of authority requirements of Code Section 33-23-26."

Governor Barnes signed this bill on April 27, 2001, and it takes effect on July 1, 2002.

HB 478 – Speaker Murphy (Haralson, Paulding and Polk Counties) introduced this legislation. After a number of negotiations between the trial lawyers and insurers, this agreement came about. Specifically, it amends O.C.G.A. § 33-4-6:

"(a) In the event of a loss which is covered by a policy of insurance and the refusal of the insurer to pay the same within 60 days after a demand has been made by the holder of the policy and a finding has been made that such refusal was in bad faith, the insurer shall be liable to pay such holder, in addition to the loss, not more than 50 percent (previously the law was 25%) of the liability of the insurer for the loss or $5,000.00, whichever is greater, and all reasonable attorney’s fees for the prosecution of the action against the insurer. The action for bad faith shall not be abated by payment after the 60 day period nor shall the testimony or opinion of an expert witness be the sole basis for a summary judgment or directed verdict on the issue of bad faith. The amount of any reasonable attorney’s fees shall be determined by the trial jury and shall be included in any judgment which is rendered in the action; provided, however, the attorney’s fees shall be fixed on the basis of competent expert evidence as to the reasonable value of the services based on the time spent and legal and factual issues involved in accordance with prevailing fees in the locality where the action is pending; provided, further, the trial court shall have the discretion, if it finds the jury verdict fixing attorney’s fees to be greatly excessive or inadequate, to review and amend the portion of the verdict fixing attorney’s fees without the necessity of disapproving the entire verdict. The limitations contained in this Code section in reference to the amount of attorney’s fees are not controlling as to the fees which may be agreed upon by the plaintiff and the plaintiff’s attorney for the services of the attorney in the action against the insurer.
(b) In any action brought pursuant to subsection (a) of this Code section, and within 20 days of bringing such action, the plaintiff shall, in addition to service of process in accordance with Code Section 9-11-4, mail to the Commissioner of Insurance and the Consumers’ Insurance Advocate a copy of the demand and complaint by first class mail. Failure to comply with this subsection may be cured by delivering same."

The bill also creates a new cause of action at O.C.G.A. § 33-4-7 for violations:

"(a) In the event of a loss because of injury to or destruction of property covered by a motor vehicle liability insurance policy, the insurer issuing such policy has an affirmative duty to adjust that loss fairly and promptly, to make a reasonable effort to investigate and evaluate the claim, and, where liability is reasonably clear, to make a good faith effort to settle with the claimant potentially entitled to recover against the insured under such policy. Any insurer who breaches this duty may be liable to pay the claimant, in addition to the loss, not more than 50 percent of the liability of the insured for the loss or $5,000.00, whichever is greater, and all reasonable attorney’s fees for the prosecution of the action.
(b) An insurer breaches the duty of subsection (a) of this Code section when, after investigation of the claim, liability has become reasonably clear and the insurer in bad faith offers less than the amount reasonably owed under all the circumstances of which the insurer is aware.
(c) A claimant shall be entitled to recover under subsection (a) of this Code section if the claimant or the claimant’s attorney has delivered to the insurer a demand letter, by statutory overnight delivery or certified mail, return receipt requested, offering to settle for an amount certain, the insurer has refused or declined to do so within 60 days of receipt of such demand, thereby compelling the claimant to institute or continue suit to recover, and the claimant ultimately recovers an amount equal to or in excess of the claimant’s demand.
(d) At the expiration of the 60 days set forth in subsection (c), the claimant may serve the insurer issuing such policy by service of the complaint in accordance with law. The insurer shall be an unnamed party, not disclosed to the jury, until there has been a verdict resulting in recovery equal to or in excess of the claimant’s demand. If that occurs, the trial shall be recommenced in order for the trier of fact to receive evidence to make a determination as to whether bad faith existed in the handling or adjustment of the attempted settlement of the claim or action in question.
(e) The action for bad faith shall not be abated by payment after the 60 day period nor shall the testimony or opinion of an expert witness be the sole basis for a summary judgment or directed verdict on the issue of bad faith.
(f) The amount of recovery, including reasonable attorney’s fees, if any, shall be determined by the trier of fact and included in a separate judgment against the insurer rendered in the action; provided, however, the attorney’s fees shall be fixed on the basis of competent expert evidence as to the reasonable value of the services based on the time spent and legal and factual issues involved in accordance with prevailing fees in the locality where the action is pending; provided, further, the trial court shall have the discretion, if it finds the jury verdict fixing attorney’s fees to be greatly excessive or inadequate, to review and amend the portion of the verdict fixing attorney’s fees without the necessity of disapproving the entire verdict. The limitations contained in this Code section in reference to the amount of attorney’s fees are not controlling as to the fees which may be agreed upon by the plaintiff and his or her attorney for the services of the attorney.
(g) In any action brought pursuant to subsection (b) of this Code section, and within 20 days of bringing such action, the plaintiff shall, in addition to service of process in accordance with Code Section 9-11-4, mail to the Commissioner of Insurance and the Consumers Insurance Advocate a copy of the demand and complaint by first class mail. Failure to comply with this subsection may be cured by delivering same."

Governor Barnes signed this legislation on April 26, 2001, and it takes effect on July 1, 2001.

HB 241 – Rep. Lester Jackson (Chatham County) introduced this bill amending Article 2 of Chapter 11 of Title 43 so as retired dentists may practice under a special license, as long as they are serving in non-compensated positions with public agencies or institutions and not-for-profits, in areas where there are indigent patients and which are underserved or there are areas of critical needs. This is to be known as the Georgia Volunteers in Dentistry Act. The bill does address liability of those persons practicing dentistry and under and in compliance with the special license issued as well as the liability of their employers. That liability will be governed by O.C.G.A. § 51-1-29.1. The license would only be provided to those who are currently not engaged in the practice on a full time or part time basis and prior to retirement maintained full licensure in good standing in Georgia. A ‘sunset’ provision is included of July 1, 2004 and any such license issued would expire at that time. Gov. Barnes signed this measure on April 19, 2001. The bill takes effect on July 1, 2001.

HB 383 - This bill, authored by Rep. Sistie Hudson (Baldwin, Glascock, Hancock, McDuffie, Taliaferro, and Warren Counties), amends O.C.G.A. § 43-34-103 and changes the current law regarding supervision of physician’s assistants. It now allows that four such physician’s assistants may be under the control of a physician. Previously, the law only provided for two. This was signed by the Governor on April 27, 2001, and the new changes go into effect on July 1, 2001.

SR 143 – Sen. Jack Hill (Bulloch, Effingham, Evans, Jenkins, Screven, and Tattnall Counties) introduced this Resolution recognizing Rural Health Day. This was adopted by the Senate on February 9, 2001.

Hospital and Facility Issues (including Medicaid):

HB 263 – Employees of nursing homes must undergo records checks prior to employment. Rep. Nikki Randall (Bibb County) introduced this bill amending Article 14 of Chapter 7 of Title 31. A satisfactory determination must be obtained by the nursing home that a person for whom such check was performed was found to have no criminal record prior to employment. If a nursing home hires an applicant for employment with a criminal record, it shall be liable for a civil monetary penalty in the amount of the lesser of $2,500.00 or $500.00 for each day that a violation of O.C.G.A. § 31-7-351(a) occurs. The penalty would be imposed only from the time the nursing home administrator knew or should have known that the nursing home has in its employ an individual with a criminal record and until the date the individual is terminated. There were a number of discussions concerning this bill and in the end a Conference Committee had to resolve various differences. Governor Barnes signed this on April 27, 2001, and this bill takes effect on July 1, 2001.

HB 264 – Rep. Nikki Randall authored this amendment to O.C.G.A. § 31-2-6 concerning actions against applicants or licensees under Chapters 7, 13, 22, and 23 of Title 31 and Chapter 5 of Title 49. Specifically, it addresses penalties imposed:

• "When any civil monetary penalty is recommended and imposed against such facility, and the department does not re-survey the facility within 48 hours after the date by which all items on a plan of correction submitted by the facility are to be completed, the accrual of any resulting civil monetary penalties shall be suspended until the facility is resurveyed by the department." In addition, if the Dept. of Human Resources "resurveys such facility beyond 48 hours after the final date for completion of all items on the plan of correction submitted by the facility, and the facility is not in substantial compliance with the applicable standards, any civil monetary penalties imposed shall relate back to the date on which such penalties were suspended."

Governor Barnes signed this bill on April 28, 2001, and it also takes effect on July 1, 2001.

HB 470 – Rep. Mickey Channell (Greene, Oglethorpe, and Putnam Counties) introduced this for the Department of Community Health. This bill now allows Critical Access Hospitals to participate in the State Health Benefit Plan. Further, it does the following:

• it allows the Department of Community Health at O.C.G.A. § 31-5A-4(6) to be authorized "to appoint a health care work force policy advisory committee to oversee and coordinate work force planning activities;" and to be "authorized to solicit and accept donations, contributions, and gifts and receive, hold, and use grants, devises, and bequests of real, personal, and mixed property on behalf of the state to enable the department to carry out its functions and purposes;"
• it amends O.C.G.A. § 31-8-153.1 concerning the Indigent Care Trust Fund money transferred so as to authorize the transfer to the trust fund those monies paid to the State by a healthcare facility as a monetary penalty for a violation of an agreement to provide a specified amount of clinical health services to indigent patients pursuant to a certificate of need held by such facility;
• it allows Indigent Care Trust Fund dollars to be matched by funds from a public or charitable source;
• it allows the Department of Community Health at O.C.G.A. § 43-34-24.1(e) to hire the necessary staff for Composite State Board of Medical Examiners to conduct any examinations;
• it requires that health benefit plans at O.C.G.A. § 49-4-148: "(1) Cooperate with the department in determining whether a person who is a recipient of medical assistance may be covered under that insurer's health benefit plan and eligible to receive benefits thereunder for the medical services for which that medical assistance was provided; (2) Accept the department's authorization for the provision of medical services on behalf of a recipient of medical assistance as the insurer's authorization for the provision of those services; and (3) Comply with the requirements of Code Section 33-24-59.5, regarding the timely payment of claims submitted by the department for medical services provided to a recipient of medical assistance and covered by the health benefit plan, subject to the payment to the department of interest as provided in that Code section for failure to comply;" and
• it allows in O.C.G.A. § 49-4-152 "subject to the availability of funds, the department is authorized to establish pilot projects to provide health care coverage and access to essential health care services or benefits to the uninsured and underinsured, including but not limited to pharmacy assistance programs."

Governor Barnes signed this bill on April 28, 2001, and it became effective upon signature.

HB 673 – Rep. Jeanette Jamieson authored this measure requiring that additional smoke detectors be required in nursing homes. Specifically, the bill amends Chapter 2 of Title 25 of the Code and requires such a detector in each patient’s room. Governor Barnes signed this legislation on April 27, 2001, and it becomes effective on July 1, 2001.

HB 510 – This bill, authored by Rep. Bobby Parham (Baldwin County), was the annual pharmacy code update found at O.C.G.A. §16-13-71. This includes the addition of the "dangerous" drug, "docosanol," when that drug is used in a preparation to treat cold sores and fever blisters. In addition, the bill also adds language concerning controlled substances (O.C.G.A. § 16-13-25 (5)) and penalties associated with misdemeanor violations under O.C.G.A. § 16-13-56 which makes a defendant provide restitution if he or she is found guilty of contributing to the release of a hazardous waste (producing products in a metamphetamine laboratory). Governor Barnes signed this bill on April 27, 2001, and it became effective on the date of signing.

SB 1 – Sen. Phil Gingrey, carrying this measure in part for the Lt. Governor, authored this bill concerning driver’s licenses and especially the licensing of young drivers and specifically amends Article 2 of Chapter 5 of Title 40. On or after January 1, 2001, no Class D driver’s license will be issued unless that person has: (A) Has completed an approved driver education course in a licensed private or public driver training school and in addition a cumulative total of at least 20 hours of other supervised driving experience including at least six hours at night, all of which is verified in writing signed before a person authorized to administer oaths by a parent or guardian of the applicant or by the applicant if such person is at least 18 years of age; or (B) Has completed a cumulative total of at least 40 hours of supervised driving experience including at least six hours at night, and the same is verified in writing signed before a person authorized to administer oaths by a parent or guardian of the applicant or by the applicant if such person is at least 18 years of age. Further, the bill also requires that any class D license holder shall not drive a class C motor vehicle on public roads, streets, or highways in Georgia between the hours of midnight and 6:00 a.m. There are also changes to instruction permits, graduated licensing, temporary licenses, suspensions and revocations of such licenses for persons under age 21. The bill generally takes effect on January 1, 2002 but certain parts (such as training requirements) take effect on July 1, 2001 (for purposes of promulgating rules and/or regulations). Governor Barnes signed this into law on April 11, 2001.

SB 14 – Sen. Charles Walker (Majority Leader – Richmond County) authored this measure which provides that the State’s minimum wage law is amended in order to provide for an increase in the minimum wage. The new wage would be not less than $5.15 per hour but the law, according to revisions in O.C.G.A. § 34-4-3, also would not be applicable to the following:

"(1) Any employer that has sales of $40,000.00 per year or less;
(2) Any employer having five employees or less;
(3) Any employer of domestic employees;
(4) Any employer who is a farm owner, sharecropper, or land renter;
(5) Any employee whose compensation consists wholly or partially of gratuities;
(6) Any employee who is a high school or college student;
(7) Any individual who is employed as a newspaper carrier; or
(8) Any individual who is employed by a nonprofit child-caring institution or long-term care facility serving children or mentally disabled adults who are enrolled in such institution and reside in residential facilities of the institution, if such employee resides in such facilities, receives without cost board and lodging from such institution, and is compensated on a cash basis at an annual rate of not less than $10,000.00.

The bill also would not "apply to any employer who is subject to the minimum wage provisions of any act of Congress as to employees covered thereby if such act of Congress provides for a minimum wage which is greater than the minimum wage which is provided for in this Code section."

Governor Barnes signed this bill on April 16, 2001 and will go into effect on July 1, 2001.

SB 57 – A piece of legislation designed to help with the issue of domestic violence, this bill amends Chapter 13 of Title 19 and creates the Family Violence and Stalking Protective Order Registry Act. Governor Barnes signed this bill on April 2, 2001 and it takes effect on July 1, 2001. The registry associated with this will become effective 180 days after the rules are promulgated.

SB 130 – An initiative by the Governor, this bill was handled by Sen. Steve Thompson (Cobb County) in an effort to address Georgia’s growing needs for a clean, plentiful water supply. It amends Chapter 5 of Title 12 of the Code and creates the Metropolitan North Georgia Water District. Among the bill’s provisions include:

• provision of powers and duties of this District;
• provision for waste-water management planning for the district area;
• provision for water supply and conservation management planning for the district area;
• promotion of public education and awareness;
• provision for meetings;
• provision for a budget and funding;
• provision for oversight; and
• provision for powers and duties of the Board of Natural Resources and the director of the Environmental Protection Division of the Department of Natural Resources with respect to requirements and standards for plans and for water resources.

Governor Barnes signed this legislation on April 6, 2001, and it becomes effective on May 1, 2001.

SB 161 – Sen. Charles Walker (Richmond County) along with others authored this bill amending Title 45 in order to allow for the provision of certain incentive award programs and incentive compensation plans for state employees which would be established by the State Personnel Board. Such incentive payment would be a one-time lump sum payment and would not become a part of a person’s salary. These awards would be given for employees who "perform a special, extraordinary service, act, or achievement in the public interest, beyond the ordinary demands of duty, and in connection with or related to state government or its instrumentalities." Examples would include heroism, response to an unanticipated problem or opportunity for the state employer, innovative or unique success, where other efforts have failed, etc. Any cash awards would not be less than $10.00 but no more than $5,000. This Board could also award certificates of merit, certificates acknowledging periods of service, pins, buttons, or other emblems. SB 161 was signed into law, and took effect upon signature, on April 26, 2001.

SB 198 – Sen. Ed Harbison (Chattahoochee and Muscogee Counties) authored this measure amending Article 1 of chapter 1 of Title 10, relating to retail installment and home solicitation sales, so as to provide for changes in delinquent charges for installment contracts or revolving accounts’ payments that are not paid within ten days from the date that those payments are due. Specifically, this bill strikes subsection (a) of O.C.G.A. § 10-1-7 and adds a new subsection which states that "a retail installment contract or a revolving account may provide for payment by the buyer of a delinquency charge on any installment which is not paid within ten days from the date the payment is due." The charge may not exceed $13.00 and such delinquent charge shall not be collected more than once for the same default. "A retail installment contract or a revolving account may provide for the payment of reasonable attorney’s fees, if referred for collection to an attorney not a salaried employee of the retail seller, and for the payment of court costs." Governor Barnes signed this into law on April 26, 2001, and it takes effect on July 1, 2001.

SB 213 – The Secretary of State helped in crafting this legislation regarding elections, primaries and voting in an effort to make a number of changes including nonpartisan primaries. It also establishes the Twenty-first Century Voting Commission and establishes a pilot project to "test electronic recording voting systems during the 2001 municipal elections." Governor Barnes signed this bill on April 18, 2001, which becomes effective on July 1, 2001.

HB 16 – In calculated steps, the Governor and his appointed "helpers" including Rep. Tyrone Brooks, Rep. Larry Walker, Rep. Austin Scott, and others, moved quickly to ‘change’ Georgia’s state flag. The calculated steps had a presentation made in the House Rules Committee, including a passionate speech made by one of the House members which voted to amend the flag in 1956, the late Denmark Groover. The bill specifically amended Title 50. Once the bill reached the Senate, it again had gathered support of the Legislators and passed with a number of tearful speeches from the Well. Governor Barnes signed this bill into law on January 31, 2001 and by executive order, also dated January 31, 2001, declared that the new flag be flown.

HB 65 – Speaker Murphy and others authored this bill which amends the current law on public disclosure as required under Article 4 of Chapter 18 of Title 50 by amending O.C.G.A. § 50-18-72. The bill specifically prohibits the disclosure of the home address, home telephone number, or social security number, or the insurance or medical information about teachers and employees of public schools. Gov. Barnes signed this bill, which also took effect upon signing, on April 19, 2001.

HB 87 – Rep. Bob Irvin (Fulton County) introduced this amendment to Chapter 60 of Title 36 concerning provision regarding local government relating to their ability and authority to enter into certain contracts so as to encourage economic development. Local governments are authorized in O.C.G.A. § 36-60-14 to enter into one year or less contracts with private nonprofit organizations (exempt under the Internal Revenue Service as 501(c)(3) or 501(c)(6) entities in an effort to utilize those entities to identify, attract, and locate new business/industry to the local government. Limitations are made: "the authority provided under this Code section shall not affect or in any way apply to any contract under Code Section 48-13-51 regarding the expenditure of proceeds collected under Article 3 of Chapter 13 of Title 48 unless that contract is executed by the governing body of a county in which is imposed, prior to January 1, 2001, the homestead option sales and use tax authorized under Code Section 48-8-102." Governor Barnes signed this bill on March 28, 2001, and it became effective upon his signature.

HB 172 – Rep. Bob Lane (Bulloch and Screven Counties) offered this amendment to Title 27 providing for the opening and closing of the waters of Georgia to the taking of horseshoe crabs for bait and limiting such taking to those persons who possess a valid personal commercial fishing license. The bill also provides for interstate transport of these horseshoe crabs and the taking of these crabs for medical purposes. The bill adds new Code Section at O.C.G.A. § 27-4-172. It will now be unlawful for any person taking horseshoe crabs to take or possess more than 25 at any one time or be aboard a bat with more than 75 at any one time, whichever is less. The bill does state that this new Section shall not prohibit the taking or possession of horseshoe crabs for the purposes of collecting horseshoe crab blood for the production of amebocyte lysate or other approved medical uses, so long as the taker and possessor have permits issued by the Dept. of Natural Resources authorizing such taking possession. Governor Barnes signed this bill on April 19, 2001, and it became effective on that date.

HB 173 – Rep. Bob Lane along with Rep. Greg Morris (Montgomery, Toombs, and Wheeler Counties) authored this bill amending Part 1 of Chapter 4 of Title 27 concerning the minimum size allowable for certain fin fish species and prohibits the taking of various fish except in accordance with size specifications. Also, the bill prohibits the taking of any red drum in excess of 27 inches in total length. The bill also prohibits the taking of any Atlantic ‘bill fish’ which includes Atlantic blue marlin and Atlantic white marlin except for catch and release of such fish. HB 173 was signed into law on April 19, 2001 and became effective on that date.

HB 191 – A total re-write to Article 9 of Title 11, the Uniform Commercial Code, was undertaken this Session. Rep. Jim Martin (Fulton County) authored this undertaking. The bill had a number of revisions during the Subcommittee and Committee process before being passed by the House and Senate. It will amend the State’s current law on secured transactions. Changes will include the filing and recording of financing statements as well as the rights of parties to a security agreement. This initiative was signed into law on April 19, 2001 and becomes effective on July 1, 2001.

HB 248 – Rep. Alan Powell (Hart County), along with Rep. Parham (Baldwin County), introduced this amending O.C.G.A. § 40-8-76 relating to the requirements for children, under four years of age, to wear seat belts in passenger vehicles. The bill will allow parents to not use physical restraint devices on their children in passenger vehicles if those parents have obtained written permission from the child’s physician that a medical or physical condition prohibits the parent from placing the child in such a restraint. This bill was signed into law on April 26, 2001 and takes effect on July 1, 2001.

HB 289 – Rep. Rene’e Unterman (Gwinnett and Walton Counties) and others offered this bill which increases penalties for criminal offenses involving the abuse, neglect, and exploitation of disabled adults and elder persons by adding a new Code Section at O.C.G.A. § 30-5-8. If a person is found guilty of such charges, he or she would be guilty of a misdemeanor. Gov. Barnes signed this into law on April 19, 2001, and this legislation became effective on that date.

HB 538 – The bill which has appeared to have more lives than that of a cat, finally passed both houses this year and was signed into law on April 26, 2001. This bill, also authored by Rep. Alan Powell and others, strikes the current law on ticket scalping and amends the name, as well as composition of, the Georgia Boxing Commission, and provides under Chapter 1 of Title 10 and also amends the Title 43 of the Code so that ticket brokers may be used to resell tickets to events (athletic contest, concert, theatre performance, amusement, exhibition, or other entertainment event) so long as a service charge does not exceed $3.00 may be charged when tickets or other evidences of the right of entry are sold by an authorized ticket agent through places of established business licensed to do business by the municipality or county in which such places of business are located). Such ticket brokers would have to be licensed and be bonded with a surety company. There are other requirements for brokers: 1) must post purchaser’s right to cancel the purchase of the ticket from the broker; 2) disclose the refund policy; 3) disclose to purchaser in writing the differences between the face value of the ticket and the amount which the broker is charging for the ticket; 4) sell tickets only at the broker’s permanent office or place of business, provided that delivery of one or more tickets after the transaction is completed to a place other than the ticket broker’s office or place of business shall not violate such; 5) ticket broker would have to refund any payment received for the purchase of a ticket if the event is canceled and not re-scheduled; etc. This new law takes effect on July 1, 2001.

HB 601 – Rep. Charlie Smith (Floor Leader to Governor) carried this legislation which was signed into law on April 19, 2001. HB 601 amends O.C.G.A. § 45-12-93 relating to the revenue shortfall reserve by requiring that the State’s auditor reserve from the surplus an amount equal to not less than 3 nor more than 5% (thus raising the amount from 4%) as directed by the Director of the Budget to the extent that such surplus is available. This reserve would be in lieu of the working reserve for high-income and low-income periods provided that the Director of the Budget, with regard to the amount between 4 and 5%, direct the return of same to the State’s general fund for appropriation.

HB 610 – Rep. Jeanette Jamieson (Banks, Franklin, and Stephens Counties) authored this bill, geared towards economic development, in order to entice movie (film production companies) and broadcasting business to Georgia by allowing a sales tax exemption, on a one-time basis, for "production equipment" (cameras, camera supplies and accessories, lighting equipment, etc.) and it would also provide for an exemption for digital broadcast equipment ("equipment used for the origination or integration of program materials for broadcast over the airwaves or transmission by cable, satellite, or fiber optic line which uses or produces an electronic signal where the signal carries data generated, stored, and processed as strings of binary data"). This would not apply to repairs or replacement parts for such equipment. Various amendments were attempted to add additional sales tax exemptions (including one for purchases by churches) but in the end the Conference Committee struck all other references to additional exemptions. Governor Barnes signed this bill on April 13, 2001. The bill takes effect on July 1, 2001 with the exception that any production equipment sales tax exemptions would not be permitted until January 1, 2002.

HB 656 – This bill was a part of the Governor’s package and amended his Education Reform Act passed in 2000. This piece of legislation was signed on April 9, 2001 and became effective on that date. The bill amends Title 20. Some of the bill’s provisions include:

• an effort to create an early intervention program in order to serve kindergarten through fifth grade students who are at risk of not reaching or maintaining an academic grade level. This would include those students who are identified through the first grade readiness assessment

• changes the weights and teacher-student ratios under the Quality Basic Education Formula
• changes to salary increases for those teachers receiving certification from the National Board of Professional Teaching Standards (including that a portion of the participation fee may be paid by the State prior to certification in certain instances such when the teacher is teaching in a Georgia public school, etc.)
• amendments to local participation in school capital outlay projects
• provides that local boards of education shall develop and adopt a placement and promotion policy in accordance
• amends requirements for requirements to obtain PROMISE teacher’s scholarships

Legislation Failed

There were seven bills vetoed this Session: SB 122; HB 33; HB 876; HB 184; HB 317; HB 658; and HB 908. Specifically, one which has been covered in the Gold Dome Reports, is HB 184 the motorcycle headgear bill which proposes to remove the penalties assessment for a violation of the State’s law on headgear so that those would not be considered moving violations. Governor Barnes vetoed this bill as it did not improve on legislation passed in the 2000 Session (which he also vetoed) on this subject. In his veto message, Governor Barnes noted that this would "encourage motorcyclists to abandon protective helmets…" These types of laws on safety rules "protect lives, such laws are an important and necessary adjunct of daily life."

Other failed legislation include the following topics:

Adjustment rates of tires. HB 377, authored by Rep. Tyrone Brooks (Fulton County) attempted to amend Title 10 of the Code with this legislation which would require that automobile manufacturers to publish "for the benefit of consumers at each location in this state where such tires are sold. Purchasers of tires in this state shall be informed that adjustment records are available for their review and that they have the right to inspect the national adjustment rates for each of the brands or models of tires sold at said location." In the original bill, these published "adjustment rates" would have to be published by any entity which sells tires (such as dealers, distributors, etc.); however, in working the bill, various interests were addressed leaving this responsibility solely up to the manufacturers. This bill was assigned to the House Industry Committee where it remained in a Subcommittee throughout the Session.

Sexual harassment as a separate cause of action in a labor and employment relations. Rep. Barbara Mobley (DeKalb County) introduced this bill creating a new Chapter 5A in Title 34. Such an action would be required to be brought within 180 days of the incident. Damages resulting from such could not exceed $50,000 (general or special; direct or consequential; punitive; or other non-pecuniary damages). Specifics of the legislation, which remained in the House Judiciary Committee:

• Defines "employer" as "any individual sole proprietor, organization, governmental body, corporation, limited liability company, limited liability partnership, partnership, association, trustee, estate, insurance company, or legal representative, whether domestic or foreign, or the receiver, trustee in bankruptcy, trustee or successor thereof, and any common carrier doing business in or operating within this state, which has two or more but less than 15 employees in each of 20 or more calendar weeks in the current or preceding calendar year performing work for such employer; provided, however, that this definition of employer does not extend to a person who is an employee of an employer."

• Defines "sexual harassment" as form of sex discrimination and means unwelcome and nonconsensual sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when: (A) Submission to that conduct is made either explicitly or implicitly a term or condition of employment; (B) Submission to or rejection of such conduct by an employee is used as a component of the basis for employment decisions affecting that employee; or (C) The conduct has the purpose or effect of unreasonably and substantially interfering with an employee’s work performance or creating a sexually intimidating, hostile, or sexually offensive work environment to a reasonable person."

Franchise terminations by franchisor. Rep. Curtis Jenkins (Jasper, Jones, Lamar, and Monroe Counties) along with others introduced HB 809 in an effort to address issues relating to when franchisor could terminate franchise agreements. The bill passed out of the House but stalled in the Senate Finance and Public Utilities Committee. Restaurants which franchise were opposed to the legislation (including those such as Waffle House). Specifics:

• No franchisor could terminate a franchise prior to its term expiration unless good cause was shown

• Terminations would have to be in writing and would have to contain the a statement of the intent to terminate or not to renew such franchise with the various reasons as well as an effective date of the termination, non-renewal, or expiration of the agreement

• Failures by a franchisee to comply with its lawful requirements in its agreement would be required to be shown in proving ‘good cause’ and that would include a 90-day notice to cure any failures.

Medical records and release of information. One bill, SB 124 authored by Sen. Seth Harp (Harris, Marion, Muscogee, and Talbot Counties) proposes to amend O.C.G.A. § 24-9-21 concerning admissions and communications excluded on the grounds of public policy so as to include those communications between a physician and his or her patient. Further, it proposes to only allow the release of medical information provided in O.C.G.A. § 24-9-40 if that information is requested by court order (previously this allowed for use of a subpoena). At the end of the Session, the bill was in the Senate Judiciary Committee. SB 110, a bill by Sen. Steve Thompson, proposes to amend O.C.G.A. § 45-16-27 regarding coroner inquests in an effort to provide for subpoenas by medical examiners from the office of the Chief Medical Examiner. If such records were obtained, the costs would be borne by the medical examiner from state funds within 30 days after the bill for the records was submitted to the State. Another major piece of legislation, which failed passage, SB 210 authored by Sen. Charlie Tanksley in response to the King v. State decision, was amended numerous times – the last on the House Floor. SB 210 will be reviewed over the interim in an effort to address the concerns about release of medical information.

Contracts with hospitals. Specifically, there are two bills relating to managed care contracting which will be ‘alive’ in next year’s Session: HB 102 by Rep. Mary Squires and SB 148 by Sen. Tom Price. Both of these bills concern the exclusive contracting relationships between health plans and hospitals. Both HB 102 and SB 148, propose to amend O.C.G.A. § 13-8-2 relating to contracts contravening public policy. SB 148 has been assigned to a Subcommittee of the Senate Insurance and Labor Committee comprised of Sens. Cable, Lamutt, Hecht, Stokes, and Harbison to be reviewed over the summer. Also, there was HB 323, authored by Rep. Alan Powell, concerning a proposal to amend O.C.G.A. § 20-3-37 concerning the Board of Regents’ contracts with hospitals in an effort to restrict the surgical procedures by a physician so as to ensure that procedures conducted outside of a hospital setting were only those procedures which that physician had been trained to perform. HB 323 was never reported out of the Health and Ecology Committee.

Sales of hospitals. HB 471, another idea brought by Rep. Alan Powell, proposes to amend Chapter 7 of Title 31 concerning the exemption of certain rural hospitals from restrictions when they wish to either enter into a purchase, sale, or lease arrangement. This bill was heard by a Subcommittee of the Health and Ecology Committee but failed to get its approval.

Hospital authorities. Rep. Jeanette Jamieson’s bill, HB 119, which amends O.C.G.A. § 31-7-72 so as to prohibit any member of a county or municipal governing authority from appointment as a member of the board of a hospital authority. This bill stalled in the House Health and Ecology Committee.

Healthcare facilities. SB 165, another effort by Sen. Mike Polak which proposes to create a new category of healthcare facilities to be designated as "assisted living facilities Level I and Level II (which would amend O.C.G.A. § 10-1-393 changing the unfair or deceptive practices so as to change provisions relating to personal care services, O.C.G.A. § 25-2-13 regarding special hazards in buildings and change applicable building listings, Title 31, in order to provide for admissions, examinations, inspections, employees, licensing, staffing, etc. relating to the new levels, O.C.G.A. § 37-4-21 concerning care for mentally retarded persons, O.C.G.A. § 48-13-9 concerning the governing business and occupation taxes and change references to ‘personal care homes’, and O.C.G.A. § 49-4-142 regarding waivers authorized by Medicaid in an effort to allow eligible persons receiving care in assisted living facilities, in pilot programs, to participate). The legislation never passed out of the Senate Health and Human Services Committee. Also, another bill, SB 280 authored by Sen. Nadine Thomas, proposes to address regulation of hospitals and related institutions so as to require that citations of deficiencies of licensed nursing homes be accompanied by written concurrence of not fewer than 20% of the personal physicians of the residents of those facilities. This specifically amends O.C.G.A. § 31-7-17. SB 280 never was reported out of the Senate Veterans and Community Affairs Committee. SR 145, a measure introduced by Sen. George Hooks, proposes to recognize Community Health Centers Day; the measure was introduced on February 7, 2001. In an effort to provide oversight to a hospital authority, Sen. Tom Price authored SR 213 to create the Fulton – DeKalb Hospital Authority Overview Committee. This Resolution, similar to what was introduced in 2000 by Sen. David Scott, never passed out of the Senate Veterans and Community Affairs Committee.

Hospitals and staff. HB 268, a bill authored by Rep. Sistie Hudson, amending Article 1 of Chapter 7 of Title 31 concerning the regulation of hospitals which would repeal specifically O.C.G.A. § 31-7-71.. If the hospital offers or provides a service which is within the scope of practice of a person licensed as a doctor of podiatric medicine, doctor of osteopathic medicine, or doctor of dentistry, that hospital may not deny to any such licensee staff privileges at such facility solely upon that person’s license, board certification, or specialty membership in a professional association. HB 268 was assigned to the House Health and Ecology Committee where it remained.

Clinical laboratories. There were several bills concerning the regulation of laboratories. HB 8, authored by Rep. Bobby Parham, proposes to amend Chapter 22 of Title 31 concerning the transfer of regulation of these clinical laboratories from the Dept. of Human Resources to the Dept. of Community Health. Amendments, under this proposal, would also require the reporting of HIV test results to the Dept. of Community Health rather than the Dept. of Human Resources. This measure was assigned to the Health and Ecology Committee and was never favorably reported out of Committee. Another bill introduced by Rep. Parham relating to these clinical laboratories, HB 77, proposes to clarify an exemption pertaining to capillary blood tests by amending O.C.G.A. § 31-22-9 (b). Specifically, it proposes that this Section relating to clinical laboratory licensing shall not apply to pharmacists licensed under Chapter 4 of Title 26 who are performing "capillary blood tests and interpreting the results as a means to screen for or monitor disease risk factors and facilitate patient education as authorized in Code Section 26-4-4, so long as such capillary blood tests are available to and for use by the public without licensure of the user of the test, but such tests shall not be restricted to capillary blood tests which are only available (1) for home use; or (2) over the counter without prescription." This bill also remained in the Health and Ecology Committee. HB 825, authored by Rep. Michele Henson, which would amend Title 31 with a new Code Section at O.C.G.A. § 31-1-10 in an effort to prohibit health services purveyors from engaging in certain activities with respect to the referral of patients to other health services purveyors for clinical laboratory services. HB 825 was assigned to the Health and Ecology Committee where it remained. A Senate initiative was also introduced. SB 145, by Sen. George Hooks, proposes to amend Title 31 so as to prohibit health service purveyors from engaging in certain activities with respect to patient referrals to other health services purveyors (clinical laboratories) for specimen examinations. This proposal was assigned to the Health and Human Services Committee where it remained.

Abandoned babies. This year’s version of the Safe Place for Newborns Act of 2001 passed out of the House and stalled in the Senate Rules Committee. HB 360, authored by Rep. Judy Manning, proposes to create a new Chapter 10A of Title 19. It would allowed mothers of newborn babies to leave their babies at medical facilities (licensed general or specialized hospitals, institutional infirmaries, health centers operated by a county board of health, or facilities where human births occur on a regular basis and classified as a birthing center by the Dept. of Human Resources) without any prosecution as long as the babies were less than one week old and the mother shows proof of identity to the person where the newborn was left, and provides her name and address. Further, the bill addresses costs associated with care given to the newborn and such would be borne by the Dept. of Human Resources. The bill also would require the Dept. of Human Resources to take physical custody of the newborn within six hours upon notification by the facility that the newborn was medically ready for discharge. In some of the discussions regarding this bill, there were concerns raised about the conflicts with the State’s adoption laws as well as trying to use this bill as a vehicle for abortion legislation.

Torts, medical training programs. Rep. Doug Teper’s bill, HB 954, was introduced on March 19, 2001 and assigned to the House Judiciary Committee where it remains. The bill proposes to amend Chapter 1 of Title 51 so as to extend certain immunity to resident physicians and hospital authorities, medical facilities, and academic institutions employing or utilizing resident physicians. This would apply to any resident physician participating in medical residency training programs approved by the American Medical Association, operated in Georgia by a hospital authority or a designated teaching hospital.

Emergency admissions. Rep. Chuck Sims introduced HB 381, which remained in the Health and Ecology Committee, in an effort to amend Chapter 3 of Title 37 concerning the examination, treatment, and care for mental illness so as to change emergency admission procedures based on a physician’s certification or court order. It would allow that a physician to execute a certificate stating that he or she has personally examined a person within the preceding 48 hours and found, based on observations, that the person appears to be a mentally ill person requiring involuntary treatment. This certificate would expire after 7 days. The prior law allowed a peace office, within 72 hours, to take into custody that person named in the certificate and deliver that person to the nearest available facility serving the county in which the patient is found so as to receive an examination. The bill now allows:

"Any peace officer may, upon reasonable cause based upon his or her observations, bring a person whom he or she believes to be a mentally ill person requiring treatment before any physician within the officer’s jurisdiction who has been designated for such examination purposes for an examination and the execution of a certificate as set forth in paragraph (1) of this subsection." It also states that this physician’s certificate "shall be delivered to the sheriff of the county where the person is found or located. The sheriff or his or her deputy shall, within 72 hours after receiving such certificate, make diligent efforts to take into custody the person named in the certificate and to deliver such person forthwith to the nearest available state designated emergency receiving facility serving the county in which the person is found for the purpose of examination."

Another bill, HB 246, also relates to who may perform emergency examinations of persons who are mentally ill or alcoholic or drug dependent. HB 246 proposes to amend Title 37 in an effort to authorize a professional counselor or a marriage and family therapist to perform an evaluation. This proposal would broaden the current law which allows a psychologist, clinical social worker or a clinical nurse specialist in psychiatric/mental health to perform such. This bill also remained in the Health and Ecology Committee. SB 119, a bill authored by Sen. Charles Walker, proposes to amend Chapter 10A of Title 43 and would provide for the licensing of mental health therapists and associate mental health therapists. This proposal would also amend the Georgia Composite Board of Professional Counselors, Social Workers, and Marriage and Family Therapists Licensing Board to include these professionals as well. This initiative made it out of the Senate and was assigned to the House Committee on Human Relations and Aging. The bill was then recommitted once it reached the Floor.

Community Service Boards and Regional Service Boards. HB 332, a bill authored by Rep. Carl Von Epps, proposes to amend Title 37 concerning the powers, duties, functions, and compositions of community service boards (established under HB 100). This bill, which passed the House Human Relations and Aging Committee, stalled on the Floor of the House and was recommitted. Speaker Murphy and Rep. Sally Harrell both spoke passionately about this measure. Advocates for mental health as well as hospitals had concerns about the bill. In another bill, HB 498, Speaker Murphy proposed to amend the law by eliminating the Regional Service Boards which provide oversight of Community Service Boards. Like HB 332, this bill also stalled.

Provision of loss history on health insurance claims. There were two attempts in 2001. Both failed. HB 166, authored by Rep. Charles Bannister, attempted to obtain such information in a more broad fashion. SB 179 proposes to amend the Code at by adding a new section at O.C.G.A. § 33-30-13.1. SB 179, which was authored by Sen. Ed Harbison, was later incorporated into SB 177. The language in the Senate’s version was the additional effort in a more targeted fashion. SB 179 would require that all insurers furnish, regardless of the rating methodology used, its claims’ experience to group policy holders within 30 days, if that policy holder requests such. In providing claims experience to group policyholders under this Code section, insurers shall adhere to all state and federal laws regarding disclosure of protected health or personal information. However, an insurer does not have to so if such information has been furnished to the group policyholder within the preceding six months. Specifics:

• Such claims experience shall be furnished for all groups of 51 or more covered employees, members, or enrollees, not including dependents, and shall include, but shall not be limited to:

"(A) Earned premiums separated by policy year for at least the last two policy years, if applicable; (B) Total incurred claims, inclusive of any high amount or pooled claims, including both capitated and non-capitated expenses set forth in the same manner as premiums; and (C) Any amounts in excess of the individual pooling or stop-loss point applicable to the group."

There is an ‘out’ to this:

• "Insurers that utilize provider contracting methods including financial devices such as global fee arrangements to cover all medical expenses may make application to the Commissioner for approval of the use of an alternative form of claims experience reporting. The insurer must still provide Georgia experience on a group-specific basis or on such other reasonable basis as the Commissioner may approve for such insurer, in advance, based upon a submission of an explanation and supporting documentation. Any insurer that received approval for an alternative form of group claims experience reporting to policyholders shall be required to seek the Commissioner’s advance approval of a proposed response letter to group policyholders who request experience reporting. Such letter should describe the insurer’s reasons for seeking an alternative reporting process and describe the alternative form of reporting approved by the Commissioner."

Charges may be applied for this:

• "Insurers may charge a reasonable fee for providing this information to group policyholders. The schedule or amount of fees to be charged group policyholders for providing this information shall be filed by each insurer with the Commissioner."
  

Timely payment of benefits by insurer and refusal to pay claims. HB 169, authored by Rep. Mickey Channell and which proposes to amend O.C.G.A. § 33-24-59.5, was one effort, but it dealt with the issue on a more narrow scale. HB 169 proposes to amend the current law relating to interest charged on the failure to pay claims so as to prohibit any interest paid from being "applied toward any cap on benefits payable to the insured or other person claiming payments under the health benefit plan." SB 290, the bill introduced Sen. Charles Walker at the urging of the GHA and Georgia Association of Health Plans, attempted to address issues and concerns regarding payment of claims generated by hospitals and ambulance providers. Thus, SB 290 would have established certain mechanisms for the treatment of those claims that would be different from other claims such as those generated by physicians. One such provision included 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: (A) Payment; (B) A denial of the claim; or (C) A reply in writing or by electronic means which states all of the applicable reasons identified in paragraph (3) of this subsection that the insurer may have for failing to pay or deny the claim, either in whole or in part, and which specifies all additional information necessary for the insurer to fully process and pay or deny the claim." The Dept. of Insurance was against SB 290 as it believed that it would be impossible to establish regulations for such an initiative (the bill established different procedures for claims generated on an electronic basis versus a paper basis). We anticipate that the GHA will pursue some initiative to tighten the timely payment law. Another bill which dealt with an insurer’s refusal to pay claims and would require use of arbitration, HB 901 authored by Rep. Ben Bridges, is also a bill to watch. It proposes to amend O.C.G.A. § 33-24-91: "Any insured who is denied coverage by an insurer on a claim under a policy and any insured whose insurer fails or refuses to pay a claim under a policy within 60 days after the submission of the claim to the insurer shall have the right to request that the matter be submitted to non-binding arbitration through the department. The Commissioner is authorized to promulgate rules and regulations to provide procedures for such non-binding arbitration. The Commissioner shall provide neutral arbitrators to hear such matters and to render decisions in such cases."

Physician office-based surgery regulation. Two bills were introduced this year; both bills are technically still ‘alive’ although one bill gathered some additional steam as it addressed some concerns raised by those opposed to the initial bill (HB 632). The second bill, HB 784, assigned to the Health and Human Services Committee when it arrived in the Senate, is Medical Association of Georgia’s attempt to regulate such surgeries. HB 784 is being carried by Rep. Larry Walker and specifically amends Article 2 of Chapter 34 of Title 43.

Eye banks. Rep. Buddy Childers’s bill pertaining to the operation of eye banks stalled in the Senate Rules Committee after making its way to the Senate. HB 285 proposes to amend Chapter 23 of Title 31 and would require any facility, hospital, or medical school be a nonprofit organization and not be a subsidiary of a for-profit corporation or business entity if it is operating an eye bank.

Patient safety. HB 965, authored by Rep. Mary Squires, proposes to amend Title 31 in order to enact the Patient Safety and Health Care Reporting Act. The bill was assigned to the Health and Ecology Committee where it remained. It provides for ‘good faith report’ which is a "verbal or written notice based on the reasonable belief that the notice was necessary to prevent or correct a material violation by a health care facility of an applicable law, rule, regulation, or generally recognized professional or clinical standard and such violation would cause a material breach or material compromise of the care of the patient." No healthcare facility would be allowed to retaliate against any healthcare provider in its employ or otherwise providing professional services at that facility because the provider makes a good faith report relating to the facility. The facility would be required to ‘post’ in a "conspicuous place on the premises where notices to employees and applicants for employment are customarily posted a notice which is prepared and approved by the department setting forth the pertinent provisions of this Act. HB 244, introduced by Rep. Anne Mueller, proposes to amend Chapter 12 of Title 16 so as a woman must give an informed consent prior to an abortion. This bill remained in the House Judiciary Committee but did receive a hearing. Another bill, similar to this was introduced by Rep. Bill Hembree, HB 462, which also proposes to require that a female give her informed consent prior to obtaining an abortion. This bill also stalled in the House Judiciary Committee and would also amend Chapter 12 of Title 16.

Midwifery practice. A Resolution, HR 128, introduced by Rep. Barbara Mobley, proposes to create the House Study Committee on Certified Professional Midwifery in order to determine whether certified professional midwives can safely provide obstetrical care. This Resolution came out of the House Rules Committee and before the House where it was recommitted.

Medical treatment for prisoners. Rep. David Lucas authored HR 455 in an effort to create the Joint Study Committee on Medical Care for Prison Inmates. This measure passed out of the House on March 7, 2001 but stalled in the Senate where it was held in the Rules Committee. This Study proposes to look at the rising costs to the public of the provision of medical and hospital services to inmates and to determine the government’s responsibility in furnishing such care. It would be comprised of five members appointed by the Speaker of the House, including the House Committee on State Institutions and Property chair, and five members appointed by the President of the Senate, including the Senate Corrections, Correction Institutions and Property Committee chair.

Consumer negotiated health plans. Two bills were introduced this year: HB 434 and SB 63. Sen. Robert Brown indicated that SB 63, as it is assigned to the Senate Insurance and Labor Committee, would have hearings held concerning its merits over the interim. Sen. Tim Golden will be chairing those hearings. Both bills would have created the Georgia Consumer Choice Negotiated Health Insurance Plan Act allowing employers to pick what covered benefits they wanted for their employees.

Centralized credentialing of healthcare providers. Another initiative with two bills in play. HB 356 and SB 131 are both subject to the process in 2002; both bills are held in their respective Rules Committees. If a uniform form is established and adopted, then some of the problems associated with these pieces of legislation might not be an issue.

Gramm-Leach-Bliley Act privacy provisions. Two bills were introduced. Rep. Stan Watson’s bill, HB 455, made it out of Insurance Committee in the House and was in the Senate Banking Committee when it ran aground. Numerous amendments were made to the bill but there were still issues with it. Some of those issues were concerns raised by the Consumer’s Insurance Advocate.

Insurance mandates. Specifically, we can anticipate further work being conducted on Rep. Channell’s bill requiring coverage for colorectal cancer screenings and treatments, HB 951. Such coverage proposes to include:

• Annual fecal occult blood tests with three specimens and flexible sigmoidoscopy screening every five years for any person who is:
  (A) At least 50 years of age; or
  (B) At least 40 years of age and who has or had a first degree relative having colorectal cancer with onset after 60 years of age; or
• Colonoscopy for any person 65 years or younger and not covered by Medicare or who has or had:(A) A first degree relative with onset of colorectal cancer or adenomatous polyps before 60 years of age; or (B) Two or more first degree relatives with onset of colorectal cancer or adenomatous polyps at any age, which colonoscopy shall be covered beginning at the earlier of age 40, or ten years before the age at which the youngest first degree relative met the criteria in subparagraph (A) or (B) of this paragraph, and which colonoscopy shall be covered when repeated every two years.

Another bill relating to insurance coverage, offered by Rep. Bobby Parham, HB 79 failed to pass. This initiative, which would amend Article 3 of Chapter 24 of Title 33, was to change certain provisions relating to coverage for inpatient care and follow-up visits after mastectomies. Rep. Parham was trying to make certain that cancer policies or special coverage policies would contain such language. This bill, heard by a Subcommittee of the House Insurance Committee, was then favorably reported out to the full Committee. It was later recommitted after it stalled in House Rules.

Pre-certification of procedures. In the final days of the Session, HB 169, which originally related to timely payment of benefits, was amended to include language addressing pre-certification of procedures. As of Sine Die, HB 169 was in the Senate Rules Committee. The bill now defines "pre-certification" and "verification of benefits." It would require that health plans operate a twenty-four hour, seven day per week telephone line in order to pre-certify procedures. This follows similar language in SB 282 authored by Sen. Greg Hecht which remained in the Senate Health and Human Services Committee. Sen. Hecht’s proposal would created the Consumer’s Health Insurance Protection Act at Chapter 20A of Title 33. The Consumer’s Insurance Advocate is very interested in this issue.

Explanation of benefits. Rep. Harrell’s HB 525 which would have required healthplans to notify an expectant mother of her maternity benefits will probably be seen again. This bill was in the Senate Rules Committee at the end of the Session. Also, Rep. Harbin has a bill, HB 720, while introduced had not made any progress and it also dealt with explanation of benefits. In this bill, Rep. Harbin proposes to require that a written explanation of benefits be given to both the insured as well as the health care provider following each service provided to a patient, within 5 days of the date that payment is made by the insurer, or payor, to the healthcare provider. Each would include:

• Full name of payor;
• Full name of physician network accessed for discount, if applicable;
• Telephone number for claims information and eligibility;
• Full name of insured;
• Full name of patient;
• Member identification number;
• Patient account number; and
• An explanation of all charges, discounts, and payments for the particular date of service itemized by the following:
  (A) Date of service;
  (B) CPT code;
  (C) Charged amount;
  (D) Allowed amount;
  (E) Discount amount;
  (F) Patient responsibility amount; and
  (G) Amount paid by health insurer or health claim payor.
  

Three meetings are scheduled during the interim with members of the Georgia Association of Health Plans along with the American Academy of Pediatrics.

Contracting initiatives with physicians. HB 716 would modify the Fair Insurance Business Practices Act. Some of this bill’s provisions include an amendment to O.C.G.A. § 33-20A-63:

"(a) Every physician contract entered into, amended, extended, or renewed after July 1, 2001, by a carrier shall contain a specific provision which shall provide that any physician who is terminated from the physician contract while treating an enrollee or enrollees of such carrier for pregnancy or for a degenerative, disabling, or terminal condition shall continue to be allowed to treat such patient under the terms of the physician contract and shall continue to be compensated under the terms of the physician contract for a period of at least 90 days following such termination.
(b) In the event that a patient’s insurance carrier or health benefit plan terminates that patient’s physician from the patient’s health care benefit plan while the patient is being treated for pregnancy or for a degenerative, debilitating, or terminal condition, the patient shall within a period of 30 days following such termination have the option to change his or her health insurance coverage to include the consumer choice option described in O.C.G.A. § 33-20A-9.1 without the necessity of waiting for an open enrollment period or other such limitation on changes in insurance coverage during the plan year."

The bill also proposes to prohibit an insurer, its network, physician panel, or intermediary from terminating or failing to renew, at O.C.G.A. § 33-20A-64 "any physician contract or the employment or other contractual relationship with a physician or otherwise penalize any physician without first providing to the physician a detailed explanation in writing of each and every cause for such action." No actual hearing took place on this bill.

Notification procedures once policies are canceled. HB 750 proposes to require all insurers to notify all covered persons under a policy if that policy were canceled. Concerns were this would be cumbersome and expensive. An example of where the employer did not pay the premiums was given; thus, the policy was canceled not because of the insurer but due to the policy holder’s failure to pay premiums. Exact language:

 

"Notice to the group members shall be required by this Code section when a group or blanket accident and sickness policy is canceled by an insurer for nonpayment of any premium at the expiration of the 31 day grace period as required by O.C.G.A. § 33-30-4. Such notice of cancellation shall be delivered to each group member affected either in person or by depositing the notice in the United States mails to be dispatched by at least first-class mail to the last address of record of the group member and receiving the receipt provided by the United States Postal Service, or such other evidence of mailing as prescribed or accepted by the United States Postal Service."

Pharmacy benefit manager regulation. HB 585 introduced by Rep. Bobby Parham and vigorously opposed by Merck MedCo once the bill reached the Senate, is still alive in the Senate Committee, Senate Health and Human Services. This will require any pharmacy benefit manager to be licensed as pharmacy.

Pharmacy recognition. A Resolution, HR 415 by Rep. Ron Stephens, proposes to declare February 21, 2001 as Pharmacy Day at the State Capitol. This Resolution was introduced on February 27, 2001 and no action was taken.

Abortion regulation. HB 953, introduced late in the Session by Rep. Bob Irvin and thus not making it out of the House Judiciary Committee, proposes to regulate certain facilities and offices where first trimester abortions are performed. This proposal would amend O.C.G.A. § 16-12-141 and would limit those procedures to only hospitals and/or health facilities licensed as abortion facilities by the Dept. of Human Resources and those facilities in which five or more first trimester abortions are performed would have to be licensed as an abortion facility by the Dept.

Uninsured initiatives. While some initiatives were passed (such as HB 470), there were others which did not make it through the process such as HR 342 authored by Rep. Jimmy Lord proposing to create the Blue Ribbon Commission Individual Health Insurance Availability and Its Effect on the Employer Based Health Insurance Market, SB 298 authored by Sen. Tom Price in an effort to allow the State’s health benefit plan enrollees an opportunity to purchase optional healthcare coverage plans, and SB 299, also authored by Sen. Tom Price which suggests a pilot program for Medicaid vouchers so recipients may purchase healthcare coverage, etc. Another bill, introduced as an annual effort, is HB 638. Rep. Bob Holmes’s proposal would amend Title 31 and proposes to create the Georgia Health Care Act – it would establish a state healthcare budget; it would create healthcare regions in the state; etc. HB 638 remained in the Health and Ecology Committee.

Refusal by insurer to issue insurance based on race, ethnic origin, etc. HB 24, authored by Rep. Rich Golick, was introduced and passed out of the House but never made it out of the Senate Committee where it was assigned, Senate Insurance and Labor. It proposes to amend O.C.G.A. § 33-6-4 (b)(8)(A)(iv).

Provision of drugs for seniors. HR 432, authored by Rep. Gail Buckner, was one initiative in this regard. HR 432 proposes to create the Joint Task Force on Developing a Federally Funded Drug Benefit for Low-Income Elderly Citizens. Another such proposal introduced, HB 711 by Rep. Jim Stokes, proposes Georgia Care Cards for citizens who are 62 years or older. Sen. Horacena Tate also introduced a measure, SR 262, to create a Joint Task Force on Developing a Federally Funded Prescription Drug Benefit for Low-Income Elderly Citizens.

Healthcare workforce shortages. This includes both shortages of nurses as well as other allied healthcare professionals. HB 652 made it to the Senate but was then stalled, probably due to Sen. Nadine Thomas. She made the objection that the problems associated with the shortages of nurses should not be combined with the shortages of other healthcare professionals. HB 652, originally was the work of the GHA and would have tracked data by gathering information in a survey at the time that licenses were renewed. An initiative proposing the use of a multi-state compact, HB 968, by Rep. Tom Bordeaux, also failed. This bill, introduced late in the Session, was assigned to the Health and Ecology Committee. This would amend Chapter 26 of Title 43 and would provide that nurses have a coordinated licensure system so nurses would not be required to sit for additional nursing board examinations once licensed in another state. SR 428, a Resolution offered by Sen. Nadine Thomas, also proposes an effort to review the nursing shortage by creating the Senate Health Care Work Force Shortage Study Committee (includes members from the Senate, representatives from: the GHA, Georgia Nursing Home Association, Georgia Nurses Association, Allied Health Association, Managed Care Association, Medical Association of Georgia, Georgia Public Health Association, Georgia State Medical Association, and Pharmaceutical Association of Georgia). SR 428 was assigned to the Health and Human Services Committee where it remained.

Scope of practice issues. A bill concerning the licensing of "clinical perfusionists" was introduced by Rep. David Graves. HB 69 proposes to amend Chapter 34 of Title 43 relating to physicians, physician’s assistants, and respiratory care and add the licensing of clinical perfusionists. This new Article would be known as the "Clinical Perfusionist Licensure Act." These perfusionists would be regulated by the Composite State Board of Medical Examiners. As defined in the bill, "perfusion" is:

"means the functions necessary for the support, treatment, measurement, or supplementation of the cardiovascular, circulatory, or respiratory system or other organ, or a combination of such activities, and to ensure the safe management of physiologic functions by monitoring and analyzing the parameters of the systems under the order and supervision of a physician, including, but not limited to:
(A) The use of extracorporeal circulation; long_term cardiopulmonary support techniques, including extracorporeal carbon dioxide removal and extracorporeal membrane oxygenation; and associated therapeutic and diagnostic technologies; (B) Counterpulsation, ventricular assistance, autotransfusion, blood conservation techniques, myocardial and organ preservation, extracorporeal life support, and isolated limb perfusion; (C) The use of techniques involving blood management, advanced life support, and other related functions; and (D) In the performance of the acts described in subparagraphs (A) through (C) of this paragraph:
(i) The administration of:
(I) Pharmacological and therapeutic agents; or
(II) Blood products or anesthetic agents through the extracorporeal circuit or through an intravenous line as ordered by a physician; or
(ii) The performance and use of:
(I) Coagulation monitoring and analysis;
(II) Physiologic monitoring and analysis;
(III) Blood gas and chemistry monitoring and analysis;
(IV) Hematological monitoring and analysis;
(V) Hypothermia and hyperthermia;