As the legislative session nears its halfway point, Legislative Days continue to fill with committee meetings and floor action in the House and Senate. Indeed, the House took up its longest Rules Calendar so far this year and the Senate heard a lengthy presentation on the Amended FY 2019 budget before encamping in meeting rooms around the State Capitol to discuss weighty issues including balance billing and Certificate of Need. The action continues under the Gold Dome as of our deadline this afternoon, so check out today’s edition and be on the lookout for more in tomorrow’s #GoldDomeReport.

In this Report:

• House Greenlights Education and Health Measures
• Senate Signs Off on Amended FY 2019 Budget
• Committee Updates
• New Legislation
• Rules Calendars for Legislative Day 20

House Greenlights Education and Health Measures

Among the seven propositions approved by the House today were two pairs of bills focused on education and health issues in the state. First in the education duo, HB 59, authored by Rep. Dave Belton (R-Buckhead), amends Title 20 to allow children of active duty military personnel to register in a local school district based on the parent's official military orders rather than requiring the family to establish residency. The House passed the bill with a unanimous 166-0 vote. HB 130, authored by Rep. Randy Nix (R-LaGrange), amends Title 20 to authorize the Georgia Foundation for Public Education to apply for recognition as a 501(c)(3) not-for-profit organization. The House passed the bill by a 167-1 vote.

The House also considered two health bills. HB 160, authored by Rep. Katie Dempsey (R-Rome), amends Title 31 to reinstate a Department of Community Health pilot program for bariatric surgical procedures for the treatment and management of obesity and related conditions under the State Health Insurance Program. The bill passed with a 146-20. HB 186, authored by Rep. Rep. Ron Stephens (R-Savannah), amends Title 31 to allow a hospital authority to use the proceeds from the sale of a hospital to finance indigent care in a community. It also allows more flexibility for the investment of such proceeds. The bill passed by a 166-1 vote.

Senate Signs Off on Amended FY 2019 Budget

After revealing its version of the Amended FY 2019 Budget in its Appropriations Committee on Tuesday morning, the entire State Senate voted to approve the spending proposal. No changes were made from the draft unveiled on Tuesday, which includes the following notable additions:

• $8M in additional funds to the Georgia Development Authority to provide low-interest loans to farmers impacted by Hurricane Michael (for a total of $18M);
• $2M in funds to assist rural hospitals damaged by Hurricane Michael;
• $2.08M in additional funds to the Georgia Student Finance Commission for projected need in the Dual Enrollment Program;
• $500,000 in additional funds to DOE construct additional middle school coding labs in low wealth areas;
• $350,000 in additional funds to the Georgia Bureau of Investigation to expand the scope of the “See Something, Say Something” app;
• $250,000 in additional funds to the Department of Human Services to reduce the Meals on Wheels waiting list;
• $214,000 in additional funds to DOE for data storage device upgrades; and
• $33,000 in additional funds to DCH for the Champions for Children Program.

Reductions from the House version include:

• $1.5M reduction to DCH for the Health Coordination and Innovation Council.
• $1M reduction to DOE for State Schools to eliminate House line item provision of generators for the Georgia School for the Blind and Georgia School for the Deaf;
• $600,000 reduction to DCH for Departmental Administration due to actual hire dates for new quality assurance and program monitoring staff;
• $600,000 reduction to the Governor’s Office of Student Achievement for discontinued programs;
• $439,154 additional reduction to DBHDD for Child and Adolescent Mental Health Services due to implementation delays;
• $161,295 reduction to DOE for Non-QBE Formula Grants to reflect projected expenditures; and
• $100,00 reduction to the Board of Physician Workforce due to unused fellowships.

The Senate approved the budget by a unanimous 53-0 vote. Since there are differences between the House and Senate versions, leaders in both chambers are expected to hash out differences in a conference committee over the next several days. 

Committee Updates

House Education Committee

The House Education Committee, chaired by Rep. Rick Jasperse (R-Jasper), met to consider one bill today.  Rep. John Carson (R-Marietta) was called on to present HB 68, which amends Title 20 to prohibit certain entities from being student scholarship organizations. Specifically, the bill bars affiliates of entities that provide accreditation of elementary or secondary schools from operating as a student scholarship organization. Members of the Committee inquired into the number of entities that act as accreditation services along with the number of scholarship organizations. Rep. Carson explained that there are seven accreditation services and about 25 scholarship organizations. Rep. Tommy Benton (R-Jefferson) asked if this was a forward looking mechanism or if it deals with a problem we have seen often. Rep. Carson responded that the bill is forward-looking and we have not seen any issues of this kind yet. The Committee recommended the bill DO PASS.

The following bills were also assigned to subcommittee:

• HB 12 was assigned to the Academic Support Subcommittee
• HB 367 was assigned to the Academic Support Subcommittee

Senate Higher Education Committee

The Senate Higher Education Committee, chaired by Sen. Lindsey Tippins (R-Marietta), met to consider one bill today. SB 91 authored by Sen. Chuck Hufstetler (R-Rome), amends Title 20 to exempt dental schools which are accredited by the Liaison Committee on Medical Education and any national or regional accreditation agency from application the Nonpublic Postsecondary Educational Institutions Act of 1990. The President of the Board of Trustees of the Georgia School of Orthodontics briefly addressed the committee; testifying that because dental schools must undergo the same accreditation process as medical schools they should receive the same exemption. Kirk Shook, the executive director of the Georgia Non-public Secondary Education Commission answered questions from the committee about how the bill would affect the Commission. He also addressed queries from Sen. Hufstetler about the distinction between the schools covered by the bill and other non-public schools such as the Philadelphia College of Osteopathic Medicine. Mr. Shook, who was recently appointed to the position by Governor Brian Kemp, told the committee he would like another week to review the impact of the legislation. Chairman Tippins indicated he would entertain a motion for a recommendation DO PASS and any issues that arise could be fixed in a floor amendment or during the committee process in the House. The Committee approved such motion and passed the bill to the Rules Committee

Senate Insurance and Labor Committee

The Senate Insurance and Labor Committee, chaired by Sen. Burt Jones (R-Jackson), met today to consider three propositions:

• SB 124, authored by Sen. P.K. Martin IV (R-Lawrenceville), is a cleanup bill that changes the required capitalization in a Notice of Reduction in Coverage under O.C.G.A. 33-24-45. The Committee recommended the bill DO PASS and be sent to the Rules Committee.
• SB 27, authored by Sen. Emanuel Jones (D-Decatur), amends Title 34 to expand the definition of “unemployed” to include federal contract workers who have been furloughed for purposes of seeking unemployment benefits. Senator Lester Jackson (D-Savannah) noted that this legislation would apply to TSA employees and air traffic controllers who were required to work during the most recent federal government shutdown. Sen. Randy Robertson (Cataula) asked to confirm that the affected persons would not receive back pay. Sen. Greg Kirk (R-Americus) asked if the individuals are W-2 employees for which unemployment contributions have been made by an employer. Sen. P.K. Martin IV (R-Lawrenceville) asked for the fiscal impact of the bill. No action was taken on the bill today.
• SB 56, authored by Sen. Chuck Hufstetler (R-Rome), is the "Consumer Coverage and Protection for Out-of Network Medical Care Act". The bill amends Title 33 to establish standards for insurers and health care providers with regard to payment under a managed care plan in the provision of emergency medical care. The bill also provides for patient or prospective patient and insurer disclosures. In his presentation to the Committee, Sen. Hustetler stated that consumers are the main point of the bill, which is an attempt to get consumers out of the middle between insurers and providers. He noted that Georgia is number one state for narrow networks, and that exacerbates the balance billing problem. Sen. Hufstetler presented the Committee with a substitute bill that would establish a minimum benefit standard for settling claims between out-of-network providers and insurers that takes the average of the 80th percentile of billed charges and the 95th percentile of allowed charges for an out-of-network procedure, which he stated would be somewhere around 60-65% of the price in the Fair Health database.

Derek Norton with the Medical Association of Georgia spoke in support of the bill, noting that the key sticking point between physicians and insurers in the balance and surprise billing debate is settling on a fair payment standard. Physicians for Fair Coverage also spoke in support of the bill.

Allan Hayes of America’s Health Insurance Plans and Jesse Weathington of the Georgia Association of Health Plans noted that there is agreement between providers and insurers that surprise billing should end, and that there should be fair reimbursement and transparency. However, Mr. Hayes noted that any reimbursement model based on billed charges is a problem because it allows providers to drive up the reimbursement. Sen. P.K. Martin IV (R-Lawrenceville) noted that the issue appears to be that any balance billing legislation needs to establish a payment regime that sets rates high enough to encourage insurers to build networks but low enough to encourage physicians to join networks.

Shea Ross and Kirk McGhee of Kaiser Foundation Health Plan of Georgia spoke in opposition to the bill. Ms. Ross noted that while Kaiser supports banning balance billing and fair compensation for providers and insurers, the bill as presented has few actual consumer protections. She noted that transparency provisions are optional for providers and requires insurers to calculate a potential balance bill for insureds when it is the providers who get to choose what to bill. Ms. Ross testified that the legislation still allows for patients to get balance billed. Sen. Larry Walker (R-Perry) expressed concern with lines 227-240 of the bill which appear to require that a insurer recoup deductibles, to which Sen. Hufstetler stated he was amenable to discussing. Despite the concern, the Committee recommended the bill DO PASS and be sent to the Rules Committee.

Senate Regulated Industries Committee

In a lengthy committee hearing on two CON proposals (SB 74 and SB 114) that was still in session as of our deadline, the Committee heard from the authors of both bills to provide a high-level overview of their purposes. Chairman Bill Cowsert (R-Athens) indicated that the committee would take no action on either bill today, instead hearing from a long list of stakeholders in preparation for a vote on Tuesday. Check back tomorrow for a full rundown of the Committee’s proceedings.

New Legislation

The following legislation of interest was introduced in the House today:

• HB 381, authored by Rep. Chuck Efstration (R-Dacula), amends Title 19 to fix grammatical mistakes, provide modernization, and revise definitions for child support guidelines. This bill was referred to the House Judiciary Committee.
• HB 384, authored by Rep. Mike Wilensky (D-Dunwoody), amends Title 16 to make it illegal to store or keep a firearm in a home without securing it in a locked container. This bill was referred to the House Public Safety and Homeland Security Committee.
• HB 385, authored by Rep. Lee Hawkins (R-Gainesville), amends Title 33 to require that a statement indicating that a subscribers health policy is fully insured is included on a subscriber’s health insurance identification card. This bill was referred to the House Insurance Committee.
• HB 389, authored by Rep. Mike Wilensky (D-Dunwoody), amends Title 20 to allow a student that votes in an election for which a candidate for a statewide office appears on the ballot to receive an excused absence from school. This bill was referred to the House Education Committee.
• HB 390, authored by Rep. Tommy Benton (R-Jefferson), amends Title 47 to allow members of the Teachers Retirement System of Georgia to receive creditable hours for teaching internationally provided that they pay the full actuarial cost of obtaining the creditable service. This bill was referred to the House Retirement Committee.
• HB 395, authored by Rep. Sandra Scott (D-Rex), amends Title 35 to provide that when a law enforcement agency receives a report that a veteran or active duty member of the military, who is believed to have a physical or mental health condition related to their service, is missing shall immediately open an investigation to find their whereabouts. This bill was referred to the House…..
• HB 398, authored by Rep. Michael Smith (D-Marietta), amends Title 40 to allow local authorities to regulate the use of bicycles on sidewalks by individuals under the age of 16 or with disabilities. This bill was referred to the House Transportation Committee.
• HB 403, authored by Rep. Scott Holcomb (D-Atlanta), amends Title 42 to prevent any private entity from operating a detention facility in Georgia. This bill was referred to the House Public Safety and Homeland Security Committee.
• HR 291, authored by Rep. Sam Park (D-Lawrenceville), creates the House Study Committee on Increasing Access to Afterschool Programs. This resolution was referred to the House Special Rules Committee.

The following legislation of interest was introduced in the Senate today:

• SB 142, authored by Sen. Larry Walker (R-Perry), amends Title 33 to require that a statement indicating that a subscribers health policy is fully insured is included on a subscriber’s health insurance identification card. This bill was referred to the Senate Insurance and Labor Committee.
• SB 144, authored by Sen. Lee Anderson (R-Grovetown), amends Title 48 to provide for the issuance of special tobacco sales permit for off-premises sales of tobacco products. This bill was referred to the Senate Regulated Industries and Utilities Committee.
• SB 145, authored by Sen. Marty Harbin (R-Tyrone), amends Title 33 to require insurers develop selection standards for provider participation. This bill was referred to the Senate Insurance and Labor Committee.
• SB 147, authored by Sen. Emmanuel Jones (D-Decatur), amends Title 21 to make it illegal for an elected official of a local government to register as a lobbyist if they are compensated other than the salary of their elected position. This bill was referred to the Senate Ethics Committee.
• SB 148, authored by Sen. Randy Robertson (R-Columbus), amends Title 40 to change the provisions relating to seatbelts. The bill removes exemptions for vehicles being used for farming. The bill also removed a line stating that only passengers in the front seat of a vehicle must wear a seatbelt. Lastly, the bill prevents a seatbelt violation from being used as basis to cancel an insurance policy. This bill was referred to the Senate Judiciary Committee.
• SR 217, authored by Sen. William Ligon (R-Brunswick), creates the Senate Study Committee on Prescribing Patterns for Antidepressants and Other Psychotropic Medications. This resolution was referred to the Senate Special Health and Human Services Committee.

Rules Calendars for Legislative Day 20

The House is expected to consider the following measures tomorrow for Legislative Day 20:

• HB 99 - Insurance; provide for modernization and updates (Substitute) (Ins-Smith-134th)
• HB 167 - Insurance; employees of licensed property and casualty insurers to adjust residential property insurance claims of $1,000.00 or less without obtaining an adjuster license; allow (Ins-Taylor-173rd)
• HB 225 - Motor vehicles; reference date to federal regulations regarding the safe operation of commercial motor vehicles and carriers; update (MotV-Rich-97th)
• HB 246 - Evidence; revise manner by which depositions taken at the instance of state are paid (JudyNC-Silcox-52nd)

The Senate is expected to consider the following measures tomorrow for Legislative Day 20:

• SB 32 - Torts; conditions upon immunity from civil liability in instances of rendering emergency care; provide (Substitute) (SJUDY-32nd)
• SB 67 - Capital Outlay Funds; eligibility for regular funding, advance funding for educational facilities; destroyed by fire or natural disaster; provide (APPROP-11th)
• SB 99 - Department of Natural Resources' Online Licensing System; allow applicants to make an anatomical gift; provide (NR&E-7th)
• HR 1 - Nathan Deal Judicial Center; naming the forthcoming new state appellate judicial complex (SI&P-53rd) Ralston-7th