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Morris Manning & Martin, LLP

Georgia Legislative Year in Review

12.21.2020

The COVID-19 pandemic presented Georgia with an endless array of obstacles and issues this year. As a result, the state government signed a few notable bills into law in 2020.

Legislation to Curb Surprise Medical Billing Practices in Georgia

The headline of the 2020 legislative session was the passage of two bills aimed at curbing surprise healthcare billing in Georgia. The centerpiece of this effort is HB 888, the Surprise Billing Consumer Protection Act. HB 888 requires insurers to cover emergency services regardless of whether the provider is in a patient’s insurance network. Medical providers and insurance companies will enter an arbitration process to determine the amount of reimbursement, effectively removing patients from the billing calculus. A complete summary of the new law, which goes into effect on January 1, 2021, can be found here.

In addition, the legislature passed HB 789, which the Governor signed into law on July 16, 2020. HB 789, also known as the Surprise Bill Transparency Act, is a companion bill to HB 888 and creates a surprise billing rating system based on the number of provider specialty groups contracted with a hospital within a health insurer’s network. The new law requires insurers to include this surprise billing rating system online, in print, and in any advertising for in-network hospitals. The Surprise Bill Transparency Act went into effect on November 1, 2020.

Lastly, the General Assembly also passed SB 303, the Georgia Right to Shop Act, which provides for greater transparency for prices of non-emergency healthcare services and the disclosure of pricing information via insurer websites to allow Georgia consumers’ better access to compare prices. In essence, SB 303, effective on July 1, 2021, requires insurers to provide potential customers with an online tool to navigate and compare pricing of healthcare services to make more informed and cost-effective medical decisions regarding non-emergency matters.

Update on Medicaid Expansion in Georgia

In March 2019 the General Assembly passed legislation SB 106, allowing the State to seek permission from Centers for Medicare and Medicaid Services (CMS) to expand Medicaid in Georgia to individuals earning up to 100% of the poverty level, compared to the 138% maximum as called for in the Affordable Care Act (ACA). In November 2019, Governor Kemp, on behalf of the State, unveiled a 1115 waiver proposal titled Georgia Pathways that called for partial Medicaid expansion, effective in July 2021, that would cover adults age 19-64 with income up to 100% of the poverty level. The 1115 waiver did include a work or “community engagement” requirement. A month later, Governor Kemp submitted the Georgia Pathways proposal to CMS for review and approval. However, the Georgia Pathways waiver requested that CMS provide Georgia with full Medicaid funding (i.e. 90% of total expansion cost) despite the fact that the waiver proposed only a partial expansion of Medicaid.

In late October 2020, CMS approved the Georgia Pathway’s waiver, but with a stipulation that CMS will only cover 67% of costs to reflect the gap between Georgia’s proposal to cover individuals up to 100% of the poverty level versus the ACA allowable 138% maximum.   

In July 2020, Governor Kemp signed an additional bill to expand maternal Medicaid benefits. The bill, HB 1114, allows the State to request an expansion of Medicaid coverage to include lactation care and other services provided to pregnant and lactating women and their infant children. Additionally, the bill increases the amount of time qualified beneficiaries can receive Medicaid benefits, from two to six months after childbirth. This expansion will be funded by the State.

Legislation Limiting Tort-Based COVID-19 Liability

Another legislative undertaking that was not on the General Assembly’s radar prior to COVID-19 was liability protection for the healthcare sector in Georgia. However, as the pandemic continued to rage across Georgia, the General Assembly saw fit to pass SB 359, the Georgia COVID-19 Pandemic Business Safety Act. The Act, signed into law and effective as of August 5, 2020, specifically shields healthcare providers, entities and individuals from liability for damages resulting from any COVID-19 liability claims against the aforementioned list unless the claimant can show gross negligence, willful and wanton misconduct, reckless infliction of harm, or intentional infliction of harm.

Likewise, the Act grants healthcare facilities and providers immunity from liability claims resulting from a claimant allegedly contracting COVID-19 while in the facility and/or on the provider’s campus as long as the facility/provider has posted a warning at a point of entry to the premises a sign warning against liability for contraction of the virus, and did not act with gross negligence or willful and wanton misconduct.  

Amendments to Disabled Adults and Elder Persons Protection Act

Introduced prior to the pandemic, HB 987, is an extensive bill aimed at increasing the protections afforded to elderly persons and others residing in personal care homes and assisted living facilities. In short, the bill increases penalties for elder abuse and retaliation following reports of same, strengthens financing and staffing requirements for personal care homes and assisted living facilities, increases the allowable amount of nursing services that may be provided in an assisted living community, and creates a framework for licensure of nursing home and Long-Term Care Hospital (LTCH) facility administrators in order to increase accountability of administrators at these facilities. The bill was signed into law and is effective as of June 30, 2020.

Changes to Physician Supervision Rules

Effective January 1, 2021, physicians may now delegate to physician assistants and advanced practice registered nurses new services, including the order of radiographic imaging in non-life-threatening situations.  

If you have any questions about this legal update, please contact a member of the MMM healthcare group.