By: Sen. Larry Walker (R – Perry)
As I have discussed before, our legislative business doesn’t end when we Sine Die. Our work continues year-round, as we serve the varying needs of the great people of this state. To that point, Governor Brian Kemp has recently signed into law a number of pieces of legislation that attempt to resolve some of our state’s most pressing challenges related to healthcare. Given the current climate, and the continuing escalation of COVID-19 cases throughout the nation, the health and safety of Georgians remains paramount. These bills aim to improve access, affordability and transparency of healthcare for our citizens, and subsequently serve to improve the well-being and financial security of healthcare consumers in Georgia. I would like to highlight a few of these bills here today.
The first piece of legislation, and arguably the one that will have the biggest impact, is House Bill 888 that addresses surprise out-of-network medical bills. This is a topic that has been discussed at length, not only throughout this past legislative session, but also over the course of several years. House Bill 888 takes the consumer out of the middle when, unexpectedly, services are provided at an in-network facility by providers that are out-of-network. Common examples are out-of-network emergency room physicians, anesthesiologists and radiologists contracted by an in-network hospital. When this occurs, the health insurance company will pay for the services and the provider can either accept the amount received as sufficient or request an additional amount from the insurer. If the two parties can’t agree, then the bill will be settled through an established system of arbitration. This removes the consumer from the negotiation process and consumers will no longer receive “balance bills” from the provider, which can wreck their credit and even lead to bankruptcy. Over time, this should limit disputes between healthcare providers and insurance companies, as the arbitration process will naturally establish reasonable charges. The hope is that this bill will allow insured Georgians to receive the procedures and care that they need, without having to worry about unexpected bills that can lead to financial ruin.
Related to that, the General Assembly also passed a number of measures that will extend regulations for pharmacy benefit managers (PBMs) and in relation, reduce instances of steering and price gouging. The first bill, House Bill 946, mirrors Senate Bill 313 by revising the regulatory guidelines for PBMs through a number of different areas including, but not limited to, increased licensing fees, required reporting and national drug acquisition costs, and new rebate provisions. House Bill 918 similarly delves deeper into the process of licensing and auditing, and further prevents unfair manipulation. These two bills combined should lower the costs of prescription drugs and provide greater support to our local pharmacies.
Lastly, are pieces of legislation designed to increase transparency. The first bill, Senate Bill 303, is referred to as the “Georgia Right to Shop Act” and establishes a database within each insurer to document the costs and quality metrics for nonemergency treatments. This allows consumers to make informed decisions about the healthcare treatments they would like to move forward with, while Senate Bill 482 creates the Georgia All-Payer Claims Database. The premise for all of these is to provide Georgians with information in order to make more informed decisions regarding their healthcare.
As we continue to see the progress of our legislative efforts this session, I would also like to take a brief moment to wish everyone a great back to school season. Although this year looks a little different, with greater virtual learning systems and new social distancing protocols, our commitment to educating generations of Georgians remains as strong as ever. With new testing reductions established through Senate Bill 367 and federal funding through the CARES Act, we can ensure that despite current challenges, our children are able to still achieve a bright future in whatever industry they desire. Just as with everything else, we are able to come together to make sure Georgia remains a great place to raise a family. I will continue to give you updates throughout the interim, but if you have any questions or concerns about what I discussed or changing circumstances in our state, please don’t hesitate to reach out. It is an honor to continue serving you during this time.
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Sen. Larry Walker serves as Caucus Vice Chairman for the Majority Party. He represents the 20th Senate District, which includes Bleckley, Houston, Laurens and Pulaski counties. He may be reached by phone at (404) 656-0095 or by email at larry.walker@senate.ga.gov.