State Senate OKs transparency bill on quality, costs of care

The Georgia Senate approved legislation Tuesday to increase transparency of health care prices for consumers.

Senate Bill 303 would give insured Georgians the ability to query their insurer to learn their out-of-pocket costs before getting non-emergency services from a physician or hospital. Consumers could also get data on the medical providers’ quality of care.

Other health care developments at the Legislature on Tuesday included a House panel passing a wide-ranging bill to increase state oversight over assisted living facilities and personal care homes. The legislation has been spurred largely by a series in the AJC detailing abuse and neglect in such facilities.

The House Health and Human Services Committee also passed a bill to modernize HIV laws in the state, with the primary goal of reducing the stigma about the disease and provide correct information on  transmission.

The price transparency bill was approved in the Senate with just one dissenting vote.

The “Georgia Right to Shop Act’’ legislation, as it’s also known, would allow patients to ask their insurance company, either online or on the phone, on what out-of-pocket costs they would face if they use a particular medical provider. Consumers would also get data on the quality record a doctor or hospital has in providing that medical service.

Republican Sen. Ben Watson, a Savannah physician who is the bill’s lead sponsor, said on the Senate floor that “if we drive quality, we drive cost.’’

The bill “does not change the payment structure’’ involved in the medical procedure, Watson said.

Atlanta-based consumer advocate Clark Howard testified in favor of the bill at a hearing earlier this month. Howard, nationally known as an author and broadcaster, pointed out that even some patients with health insurance pay a lot out of their own pockets because of high deductibles. The national average is $1,600 before coverage kicks in, he said.

“The quality of care and outcome is not at all determined by the price you pay,’’ Howard told the committee, so consumers need to be able to find out what’s the best deal.

Later in the day, the House Health and Human Services Committee passed the HIV code revisions unanimously.

“Georgia’s criminal code contains harsh criminal sentences even when no transmission has occurred,’’ said Cathalene Teahan, president of the Georgia AIDS Coalition.

The bill would update the laws on HIV created in the 1980s, said its lead sponsor, Rep. Deborah Silcox (R-Sandy Springs).

Currently, people can go to prison for up to 10 years for not disclosing that they have HIV in situations like sharing a needle, donating blood, or having unprotected sex, WABE reported. The new proposal would punish people with up to one year behind bars only if the intent to infect someone could be proved.

According to the Williams Institute at the UCLA School of Law, there were 571 arrests in Georgia under these laws between 1988 and 2017, WABE reported.

House Bill 719 would amend the criminal code to require that the HIV-positive person has to have acted with the intent to transmit HIV in order to be charged. It also would change the criminal charge for non-disclosure of HIV status from a felony to a misdemeanor and require proof that the conduct had a significant risk of transmitting the disease.

It would also buttress the protections from liability of needle exchange programs, which were approved last year by the General Assembly. Georgia has among the highest rates of new HIV diagnoses in the nation.

Martinez

Nina Martinez, an HIV-positive person, said the current criminal code in Georgia “is ineffective, dangerous and unnecessary.’’

Martinez, of Atlanta, became the first living HIV-positive kidney donor in the world last year when she transferred her organ to a recipient who is also HIV-positive. She was diagnosed with the disease when she was 6 weeks old.

The senior care legislation has been steered by the House panel’s chairman, Rep. Sharon Cooper (R-Marietta.) The bill would raise the fines for abuse and neglect by assisted living facilities and personal care homes, set new staffing requirements, and add new safeguards for memory care units.

“We have a lot of good assisted living facilities in the state,’’ Cooper said. But she added that Georgia also has some “bad guys’’ running senior care facilities.

Here’s more from the AJC on the legislation.

Cooper at hearing. Photo: AJC