December 4, 2018David Mannheim Brings Life Sciences, M&A Experience to Nelson Mullins in Raleigh
November 16, 2018
The Special Legislative Session of the Georgia General Assembly neared its end today as the State Senate began its consideration of the Governor’s three legislative initiatives in earnest. Appearing before the Senate Appropriations Committee this morning, Governor Deal and his floor leader, Sen. Larry Walker (R-Perry), introduced and discussed HB 1EX, the emergency spending proposal, and HB 5EX, the bill ratifying Governor Deal’s suspension of state sales tax collection on jet fuel. The Committee made quick work of the propositions, approving both and sending them (along with HB 4EX, the legislation providing tax incentives for the timber industry affected by Hurricane Michael approved by the Finance Committee) to the Senate Rules Committee. The State Senate will convene in a rare Saturday legislative day tomorrow, where it is expected to complete its consideration of the bills and adjourn the Special Legislative Session sine die. More on the closing hours of this extraordinary session and other news from the State Capitol in today’s #GoldDomeReport.
In this issue:
Senate to Complete Work Saturday, House Adopts Conditional Adjournment Resolution
In a post-adjournment meeting this afternoon, the Senate Rules Committee convened to set what is expected to be the Rules Calendar for the final legislative day of this Special Legislative Session. The three legislative proposals from the session, HB 1EX, HB 4EX, and HB 5EX, are slated to be considered by the full Senate beginning Saturday morning at 8:30AM. Once those propositions are passed, which is expected with little opposition, the Senate will have completed its work and be set to adjourn sine die. But while the State Senate is working on Saturday morning, the House chamber is expected to be quiet. Without any additional work left on its calendars, the House adopted an unusual adjournment resolution (HR 14EX) today that will essentially let a “skeleton crew” of members turn on the lights tomorrow and then gavel the chamber out if and when the Senate adopts the pending legislation without amendment. However, the resolution is uncharacteristically conditional—if the Senate happens to amend any of the pending legislation, lawmakers will be back to work on Monday morning. While such a result is unexpected, there remains the chance that the fun of the Special Legislative Session may not be over.
House Study Committee Discusses Insurers’ Retrospective Emergency Room Policies
After finishing consideration of the session’s legislation on the House floor yesterday, several members met to convene the House Study Committee on Retrospective Emergency Room Policies. The Committee, chaired by Rep. David Knight (R-Griffin), is focused on addressing the policies adopted by some health insurers concerning retrospective review and denial of emergency room claims by insureds. During the meeting, three patients and family members testified about extremely late payment by Anthem (which owns BlueCross BlueShield of Georgia) on a range of claims that started in the ER and resulted in hospitalization for serious conditions. The testimony focused on automatic denials and then extended delays in payment and phony appeal practices. The stories were dramatic, but not really examples of delayed reviews and denials for ER services or limiting payment for services retroactively deemed non-emergent. No testimony was provided by Anthem (BlueCross) or other insurer. Based on discussion among the Committee, a proposal could end up focusing on reasonable patient belief that ER condition exists (prudent layperson standard). This is what the insurance law specifies and what Anthem may be violating with its retrospective policy. The Committee also heard from Northeast Georgia Medical Center, which spoke primarily about uses of the ER by patients who have a range of payors and indigent patients. NE Georgia’s main point was that the administrative expense of large billing and collection staffs is growing rather than the retrospective policies themselves.
Legislators posed a wide range of questions relating to ER overuse, insurance claims complications and lack of insurer responsiveness, health manpower shortage, EMTALA, and lack of access to care. The Committee seems interested in how denials and appeal processes work and the transparency of insurer claims processing. They plan to meet once or twice again before the new legislative session.
Senate Democrats Elect Leaders for 2019-2020 Session
The Senate Democratic Caucus elected new leadership on Wednesday. Minority Leader Senator Steve Henson (D-Tucker) remains in place and other Democrat officers elected are:
The House Democratic Caucus is expected to meet and elect leadership on Monday.
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