Healthcare and Health Insurance Policy
Hospital and Managed Care Fees
On Thursday April 1, the State Senate passed
House Bill 307, which enacts a 1.45 percent hospital provider fee to be deposited in the Indigent Care Trust Fund.
As negotiated with the hospitals, the fee will sunset after three years (at the end of FY 2013) and will be used to fund base operations as well as provider reimbursement rate increases in Georgia's Medicaid program. These rate increases are expected to be included in the House of Representatives version of the fiscal year 2011 budget that will likely be released when the General Assembly returns the week of April 12.
The Senate version of the bill includes three amendments to the version the House passed. The first amendment is a technical amendment to allow the Department of Community Health to adjust the rate for a subset of hospitals if it is needed to comply with federal law.
The second amendment would allow hospitals to count their provider fee payments as "indigent care" for the purposes of meeting state Certificate of Need requirements.
The third amendment would eliminate the state portion of the insurance premium tax for all health insurance products if the state's Revenue Shortfall Reserve reaches $500 million.
The House may now choose to agree with the Senate changes to the bill, or can instead disagree and work out the differences in a conference committee.
For more information about the hospital provider fee in general and about the governor's original budget proposal that included this fee,
read Senior Healthcare Analyst Timothy Sweeney's
analysis and
testimony before a House subcommittee examining the proposal. Also, read the
Medicaid fact sheet that examines the Medicaid funding gap the provider fee seeks to address.
Health Insurance Regulation Several bills dealing with insurance regulation, as well as the oversight and regulation of Georgia's Medicaid program passed their original chamber by the 30th day, but are still awaiting action in the House and Senate.
Both chambers passed bills to allow private companies to sell individual health insurance products that are primarily regulated by other states. The Senate version --
Senate Bill 407 -- was amended to ensure that products sold in Georgia under these provisions must still contain almost all of the coverage mandates required of products currently sold in Georgia. This bill has been assigned to the House Committee on Insurance.
The House version of the bill --
HB 1184 -- does not include these provisions. Under the provisions of HB 1184, out-of-state insurers would be exempted from state laws governing required benefits and consumer protections. This bill has been assigned to the Senate Committee on Insurance and Labor.
The Senate has also passed
SB 443, which creates a legislative oversight committee to review and evaluate the Care Management Organizations (CMO) that currently operate a portion of Georgia's Medicaid program. This bill has been assigned to the House Committee on Health and Human Services.
The House passed
HB 1407, which requires a single Medicaid administrator for dental services and carves out the administrative contract from beneath the CMOs that operate the bulk of the Medicaid program. This bill has been assigned to the Senate Committee on Health and Human Services.
Bills Related to National Health Reform In the final week before Crossover Day, both the House and Senate considered several bills seeking to prevent the implementation of health insurance reforms passed on the national level. Two bills that passed the Senate and that are now in the House include:
SB 399 seeks to prevent any state agency or department from implementing any portion of the federal health insurance reform legislation without explicit state legislation authorizing the implementation activities. This bill has been assigned to the House Committee on Governmental Affairs.
SB 317 would make it a state law that Georgians could not be compelled to "participate in any health care system," and that the purchase or sale of health insurance products and/or direct healthcare services could not be prohibited. This bill has been favorably reported by the House Committee on Health and Human Services.
Although these bills are aimed at provisions in the national health insurance reform legislation enacted by the U.S. Congress that assess penalties for individuals who do not obtain health insurance (with exceptions related to affordability) through the federal income tax system, it is unclear as to whether these bills enable Georgians to escape the federal rules if they are enacted.
