Medicaid provider fee gets maximum priority

At an Atlanta panel discussion Tuesday previewing children’s health issues for the upcoming General Assembly session, one item stood out.

State Sen. Fran Millar (R-Atlanta) was officially on the panel to highlight ‘‘School Flexibility,’’ but he summed up what he sees as the urgency of passing a Medicaid hospital provider fee during the legislative session.

Approving the hospital assessment is “perhaps the most critical thing we have to do,’’ Millar said.

The session begins next week, and a fight over the provider fee could provide more drama than any of the health-related controversies of the last session.

Not passing the financing mechanism, also known as the “bed tax,’’ would effectively double the state’s current Medicaid shortfall of $400 million. Most of the program’s beneficiaries are children, and a loss of the assessment would probably lead some rural hospitals to close and induce more physicians not to take new Medicaid patients, said a Children’s Healthcare of Atlanta executive.

The forum, sponsored by Voices for Georgia’s Children and the Georgia Children’s Advocacy Network, also addressed upcoming legislative proposals on child care, sports concussions and human trafficking.

Bobby Cagle, commissioner of the state Department of Early Care and Learning, discussed an effort to require fingerprint-based background checks of all Georgia child care employees. Currently, only the directors of child care centers undergo such checks, Cagle said.

“We’re not certain about the background of the people’’ serving children, said Cagle. He cited the case of a person who ran a child care program in Macon who had previously committed a felony in Florida.

The Legislature also is expected to look again at requiring school teams to remove a student from a game who shows signs of having a concussion.

Last year’s “Return to Play Act,” which failed to make it through the closing hours of the session, would have required such a removal. It also would have required that the athlete be cleared by a health care provider before returning to play. In addition, it would have made it a requirement for coaches and other school system personnel to take a concussion education course.

State Rep. Margaret Kaiser (D-Atlanta), one of the panelists, said requirements on schools’ compliance with the bill were a concern last year among legislators. She said she is working to “create legislation that’s strong but doesn’t have mandates.’’

Another children’s issue will be reform of the Georgia juvenile justice system, which is plagued with high costs and high recidivism, noted state Rep. Mary Margaret Oliver (D-Decatur).

The chairman of the Senate Health and Human Services Committee, Sen. Renee Unterman (R-Buford), spoke of the need for passage of a bill to establish a state hotline to report human trafficking. Metro Atlanta has grappled with the trafficking issue for many years, with minors being exploited as prostitutes.

On the hospital provider fee, Unterman said, passage “will be a very difficult task.’’

Many new legislators have little knowledge of the Medicaid program, and informing them about  its importance will be crucial, said David Tatum, a Children’s Healthcare of Atlanta vice president, and one of the panelists.

Not renewing the fee could mean a huge reimbursement cut to Georgia hospitals, Tatum told the audience.

On the other side are legislators who see the issue as a matter of excessive taxation. Washington-based Grover Norquist, the nation’s most prominent anti-tax activist, has written a letter to Georgia legislators urging them to oppose renewal of the fee, which he calls a “bed tax.’’

Currently, the fee is not levied on individual patients or on hospital beds, but is based on hospital net patient revenue.

After hospitals pay a percentage of that revenue, the state then uses the money to draw down federal dollars, which are distributed to hospitals based on how much Medicaid business they do.

More than 40 states use such assessments to help cover the costs of their Medicaid programs.