Legislating health: The 2013 results

Photo of the Georgia Capitol Building

Health care providers received good budgetary news Thursday, the final day of this year’s Georgia General Assembly.

The agreement between the House and the Senate on fiscal 2014 (July 2013 through June 2014) eliminated cuts in payments for Medicaid services to dentists, nursing homes and other medical providers. Gov. Nathan Deal’s original budget proposed a 0.74 percent reduction for providers other than hospitals, hospices, primary care physicians, and some clinics.

“We haven’t had a pay increase in more than 12 years,’’ said Pat Cota, executive director of the Georgia OBGyn Society, praising the budget outcome. “Not to get a cut is a step in the right direction.’’

Pediatric subspecialists also won’t face an elimination of Medicaid payments for consultations on complex medical cases.

The $19.9 billion state budget contained funding for more waiver slots for people with disabilities to live in their homes and communities. “It’s great news,’’ said Dave Zilles, parent advocate for Unlock the Waiting Lists.

And an additional $1.5 million was injected into the Public Health budget to help those county departments losing money under the updated general grant-in-aid formula.

The health care funding additions make up a significant part of the increases in the budget, said Rep. Terry England (R-Auburn), chairman of the House Appropriations Committee.

The high-profile legislation to expand gun-carrying rights to colleges and churches, and allow school boards to arm school administrators, stalled over disagreement about the campus provision.

One surprise proposal from late in the session didn’t sustain its sudden momentum. It would have banned coverage for abortion in the State Health Benefit Plan. Though the controversial measure was introduced and approved in the Senate this week, it hit a snag in the House.

“That’s a tough issue,’’ House Speaker David Ralston told reporters early Thursday afternoon about the abortion legislation. He said such proposals require much more discussion than this one received this year. The AJC,  though, reported that Gov. Deal may seek to enact this coverage ban through a non-legislative avenue.

Also running out of time were the chances that supporters of a big Albany hospital merger would see legislation passed to buttress antitrust immunity for hospital authorities in Georgia.

The push to beef up the immunity language was seen as an effort to thwart the Federal Trade Commission’s legal fight against the deal. The FTC has been challenging the merger of Phoebe Putney Memorial Hospital and Palmyra Medical Center for two years, saying such an acquisition by a hospital authority is not immune from federal scrutiny under current Georgia law.

Last month the U.S. Supreme Court sided with the FTC on that point, putting the future of the merger in doubt.

Right out of the gate, the legislative session produced a major success for both medical providers and Medicaid beneficiaries. The Legislature approved a bill that eased the renewal of the Medicaid hospital provider fee, by transferring the power to levy the assessment from the Legislature to the Department of Community Health. (Here’s a GHN update on the provider fee.)

Lawmakers balked at major reforms of the state health care regulatory system (the certificate-of-need process) and of the medical malpractice system. But the two issues are expected to return next year.


The federal Affordable Care Act (ACA), also known as Obamacare, calls for health insurance “navigators” to help uninsured people and businesses use the new online health insurance exchanges, scheduled to debut in January. And recently, the Georgia Legislature passed a requirement that the navigators be licensed and regulated by the state.

Also approved was a bill that took a clear jab at Obamacare. The GOP-backed legislation would require health insurers to list how much of a policyholder’s premium increase is due to the ACA.

A supporter of the law, Cindy Zeldin of Georgians for a Healthy Future, said Thursday that the premium notifications will not provide “any information that’s constructive or useful for consumers.’’

“It’s taking a shot at the Affordable Care Act,’’ she said.

Also approved was legislation that would eventually eliminate temporary “conversion’’ policies for people who have lost group health insurance coverage. The legislation would also end the current “assignment” policies that cover an estimated 2,000 Georgians with medical conditions.

Consumers who lose that coverage are expected to obtain new insurance when the health exchanges, which are required under the ACA, are launched in the individual states. Zeldin said much of the impact of these insurance measures will depend on how they are implemented, largely by the office of state Insurance Commissioner Ralph Hudgens.


This week brought final approval of a bill that establishes medical protocols for school athletes to return to play after a concussion. Similar legislation to set protections for young athletes failed on the final day of the 2012 session.

A bill to ease medical use of epinephrine in schools also passed, in an effort to help children deal with an emergency allergic reaction.

The General Assembly approved a bill that would facilitate children’s use of playgrounds after school, clarifying liability concerns. Children’s advocates say the legislation will promote exercise for kids.

Meanwhile, legislation to allow fireworks sales in Georgia appeared to have died on the final day.


Advocacy groups hailed legislation that would expand the list of crimes on the books involving physical, mental and financial abuse of seniors, and to make some existing crimes felonies.

But advocacy groups such as AARP voiced concerns over budget reductions eliminating some workers in Adult Protective Services, which helps seniors in abuse cases. Even after the abuse law was passed, “people who will be helping enforce it will be cut,’’ said Kathy Floyd of AARP Georgia.

Medical practice and licensing

The General Assembly also approved a transfer of the licensing boards for dentistry and pharmacists to the Department of Community Health from the Georgia secretary of state’s office.

Secretary of State Brian Kemp fought the measure, House Bill 132, saying it would create more government bureaucracy and siphon money from the processing of licenses for hundreds of thousands of other professionals.

The proposal was supported by pharmacist and dentist organizations.

Pharmacists, though, failed to win approval for a bill that would have allowed them to administer adult vaccinations other than flu shots (which they can already give to consumers).

The Legislature approved a measure to combat illicit  “pill mills” in the state, giving  the state medical board the authority to license and regulate pain management clinics.

A bill that would have given advanced practice nurses the authority to order imaging tests failed to clear the House. Georgia is the only state that still restricts them from doing so, a nurses group say