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Physicians

Key panel gives doctors a pay raise for Medicaid

A state Senate panel gave Georgia primary care doctors a potential financial boost Wednesday, putting millions of dollars into the state budget for a pay raise to deliver services to Medicaid patients.

The Senate Appropriations Committee passed a budget that awards $5.9 million in state funds for a Medicaid pay raise to ob/gyns, and $13.6 million to internists, pediatricians and family medicine physicians.

Dr. Evelyn Johnson of Brunswick says the pay raise will keep some doctors from closing their practices.

Dr. Evelyn Johnson of Brunswick says the pay raise will keep some doctors from closing their practices.

Those amounts surpass the House’s allocation of $3 million and $1.6 million to the respective groups.

The state funds would be matched by federal money.

The doctors can’t count on the raise yet. The Georgia budget has a ways to go before being finalized. full story

Legislators look at overhauling insurance laws

Georgia lawmakers considered insurance bills Wednesday that would create major changes in health plan networks in the state.

Sen. Chuck Hufstetler

Sen. Chuck Hufstetler

The Senate Insurance and Labor Committee first heard testimony on Senate Bill 143, which would require the state employee and teacher health plan to include the state’s five Level 1 trauma centers as “in-network” facilities.

That would help Grady Health System, a trauma center in Atlanta that is now “out-of-network” for Blue Cross and Blue Shield of Georgia members.

Blue Cross is the main insurer in the State Health Benefit Plan. So approval of Senate Bill 143 would make Grady in-network for the plan’s 630,000 members.

The state of Georgia has similar requirements with the health plans that serve Medicaid and PeachCare members, said Sen. Chuck Hufstetler (R-Rome), lead sponsor of the bill. full story

27% of state’s hospitals earn top safety rating

One in four Georgia hospitals earned an “A’’ grade in recently released ratings on patient safety.

clipboardThe 27 percent figure put Georgia hospitals roughly in the middle of the pack among states, according to the Leapfrog Group’s safety scores report.

The ratings measure the ability of hospitals to prevent errors, injuries and infections. The report on the ratings is intended to help consumers as they choose a facility for health services.

More than 1,000 people die each day in the United States because of preventable hospital errors, according to the Leapfrog Group, a nonprofit, Washington-based organization that focuses on patient safety.

Nationwide, one in 25 patients actually picks up an infection in the hospital.

full story

State takes action on Blue Cross contracts

Georgia’s insurance commissioner, in a rare regulatory action, has told the state’s largest health insurer to rescind newly added amendments to contracts with thousands of physicians.

clipboardPhysicians had complained that the Blue Cross and Blue Shield of Georgia contract revisions lacked clarity on the insurer’s payment rates for medical services.

“I heard from doctors all over the state about the heavy-handed approach taken by Blue Cross regarding their contract changes,” said Commissioner Ralph Hudgens in a statement.  “I want doctors spending time caring for their patients, not being stonewalled by an insurance company.”

Consumers should not be affected by the move, insurance department officials say, as the existing physician contracts remain intact.

Blue Cross said in a statement Thursday that it had been working with Hudgens and the insurance department for several weeks to resolve the issue. full story

Is Georgia’s medical access law too weak?

The state insurance department is looking at possible ways to strengthen a Georgia law that requires health insurers’ networks to give consumers adequate access to doctors and hospitals.

“Georgia is not alone: The feds and all the states are looking at the issue,’’ Trey Sivley, director of the Division of Insurance and Financial Oversight for the Georgia agency, told GHN recently.

Healthcare CostThe National Association of Insurance Commissioners is working on a redraft of its model for a network adequacy law. Georgia is studying the NAIC proposals, Sivley said. But he added that the state’s interest in the details “doesn’t mean that we’re going to adopt” the national group’s plan.

Such regulatory changes, if enacted, would coincide with an accelerating trend of health insurers offering consumers more limited choices of medical providers. The resulting health plans have become known generally as “narrow networks.” full story

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