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2013 Georgia General Assembly Legislative Summary

Dental Partners of Georgia continued to work for the benefit of your patients, your practice, and your profession communicating with lawmakers and state agency officials throughout the 2013 Session of the Georgia General Assembly.

The Georgia General Assembly convened the 2013 legislative session on Monday, January 14th and adjourned on Thursday, March 28th. The session started later than usual due to the second Monday in January being the 14th this year, but legislators sprinted to an early finish in 40 legislative days.

2013 marked the first year of the two-year legislative term, the House had over 40 new members and the Senate had 9 new members. The Republican majority holds 119 seats in the House and the Democratic minority holds 60 seats with 1 Independent. In the Senate the Republican majority is 38 members and the Democratic minority is 18 members. The Senate GOP holds a constitutional majority in the Chamber, meaning they can vote to place constitutional measures on a ballot among others items.

Governor Nathan Deal, Speaker David Ralston and Lt. Governor Casey Cagle worked closely on key issues. Cagle regained his traditional powers in the state senate. Sen. David Shafer was elected as the new Senate Pro Tempore and Sen. Ronnie Chance became Majority Leader. The House Leadership team remained the same, Speaker David Ralston, Speaker Pro Temp Jan Jones, Majority Leader Larry O’Neal and Majority Whip Ed Lindsey. Both Health Committee Chairs retained their positions -- Rep. Sharon Cooper, House Health & Human Services Committee and Sen. Renee Unterman, Senate Health & Human Services Committee.

The legislative session presented many challenges for medicine. Scope of practice issues and tort reform both arose during the 40-day session. The $19.9 billion 2014 fiscal year budget demands, gun control legislation and ethics reform took center stage in the press but medicine was under siege throughout the session.

Practice Issues & Scope of Practice Expansions

The medical community was called into action on many fronts as a torrent of legislation was introduced that directly impacted dental & medical practices and many constituted scope of practice expansions. Fortunately, most of the harmful scope expansion bills were stopped or greatly narrowed.

Practice Issues

HB 465 – Medicaid Single Dental Administrator, sponsored by Rep. Carl Rogers, the bill creates a single dental administrator for Medicaid providers. The bill enjoyed wide support but the state’s three CMOs opposed the legislation, as did Blue Cross Blue Shield. HELD OVER FOR 2014
HB 132 – Dental & Pharmacy Board transition to DCH, sponsored by Rep. Lee Hawkins, the bill moves the dental board and the pharmacy board from the Secretary of State’s office to become attached agencies of DCH, much like the Composite Medical Board.  PASSED
HR 107 – Joint House & Senate Medicaid Reform Study, sponsored by Rep. Donna Sheldon, the joint study committee will be comprised of legislators and stakeholders to study the current Medicaid system. PASSED
SB 163 – Medicaid Reform, sponsored by Sen. Bill Ligon, the bill requires DCH to study and identify options to reform Medicaid. HELD OVER FOR 2014
HB 57 – Controlled Substances, Schedule I & II, sponsored by Rep. Matt Ramsey, the annual update of the states’ dangerous drug list. Signed by the Governor
HB 178 – Pharmacy Audit Bill, sponsored by Rep. Andy Welch, the bill clarifies pharmacy audit procedures. PASSED
HB 332 – GA Board of Nursing, sponsored by Rep. Bruce Broadrick, the bill merges LPN, RN and APRN boards into one nursing board. PASSED

Scope of Practice Issues

HB 235 – Optometry Prescribing, sponsored by Rep. Earl Ehrhart, the bill was considerably narrowed from its original version and presented a setback for optometrists who only gained oral corticosteroids. A special thanks to Rep. Ben Watson, MD and Sen. Dean Burke, MD for their work to narrow the bill. PASSED
HB 315 – Nurse Continuing Education / Mandatory Reporting of misconduct by nurses, sponsored by Rep. Sharon Cooper, the bill requires nursing continuing education and mandatory reporting for violations of codes of conduct. PASSED
HB 676 & SB 268 – PA Schedule II Prescribing, sponsored by Sen. Chuck Hufstetler and Rep. Rusty Kidd; the bill allows for physician assistants to prescribe Schedule II drugs. HELD OVER FOR 2014
SB 85 – Pharmacists Vaccine Protocol, sponsored by Sen. Charlie Bethel, to allow pharmacist to administer vaccines. The Medical Association of Georgia opposed the legislation. Repeated attempts to add this language to several other different bills failed. HELD OVER FOR 2014
SB 94 – APRN Radiological Imaging, sponsored by Sen. Fran Millar, the bill allows APRNs to order radiographic imaging tests. HELD OVER FOR 2014
SB 134 – Pharmacy Prescriptive Authority, sponsored by Sen. Buddy Carter; the bill allows for prescriptive authority by pharmacists out of state. HELD OVER FOR 2014
Pain Management Issues & Prescription Form Fix

Pain Clinic Licensure – HB 178, by Rep. Tom Weldon and GA Attorney General Sam Olens, stemming from the state “pill mill” crisis, the bill requires all pain clinics to be licensed and authorizes the composite medical board to promulgate rules for all pain clinics. One new provision requires new pain clinics to be wholly owned by physicians. Existing clinics will be grandfathered in. PASSED

Prescription Form/Pad Correction & Drug Compounding – HB 209, by Rep. Ben Watson, MD, the bill allows for the use of CMS approved forms or continue using the state approved form for Schedule II drug prescriptions. It also addresses issues to ease the restrictions of access to compounded medications needed by physicians in their offices. PASSED

Department of Community Health

DCH – Commissioner David Cook is entering his third year as DCH Commissioner. The Commissioner has been accessible and his team has worked well with us this session. We expect some action in the coming months on the CMO contracts; as well as, the SHBP contract renewals. Though DCH had a very challenging budget year, providers were spared the .74 % rate cut. The Governor’s office and the Appropriations Chairs eliminated proposed language allowing DCH to seek supplemental rebates on drugs in Medicaid.

The DCH Board leadership has changed in the last year. Below is their current leadership:

DCH Board Members

Norm Boyd, Chairman
Jamie Pennington
Jack Chapman, MD
Mimi Collins
Clay Cox
Ron Jackson
Donna Moses, DMD
Kiera von Besser, MD, PhD
Bill Wallace, Jr.

Big Picture Issues of the Session

The General Assembly considered a wide-range of proposed legislation. There were 692 bills introduced in the House of Representatives and 272 in the Senate.

Lawmakers moved quickly in passing the 2013 amended fiscal year budget; as well as, the state’s 2014 budget, totaling $19.9 billion in state funds. The total 2014 budget with state and federal funds equals $37.1 billon. The total DCH budget is $12.8 billion, including state and federal dollars.

State agencies were again pressed to cut 2% from the administrative budgets as lawmakers crafted the amended FY 2013 budget and the FY 2014 budget. One of the first bills that was signed into law this year was SB 24 – Hospital Medicaid Financing Program Act (Bed Tax). The bill shifts authority for setting the tax rate from the General Assembly to the Department of Community Health, the statute only applies to hospitals and sunsets in 2017.

Firearm and gun legislation was heavily debated throughout the session and several bills passed the House but failed to make it through the Senate by the 40th day. Proposed legislation would have allowed conceal carry permit holders to carry firearms to an expanded list of locations where they are currently barred. One measure would have allowed college students to carry firearms on college campuses, and another proposed bill would have allowed school administrators to be armed. We expect renewed effort to push these measures in the next session.

HB 142 – Ethics Reform – Atlanta newspapers, the GA Tea Party and Common Cause GA citing the GOP and Democrat ballot initiatives from the 2012 primary elections where voters were polled on so called “gifts” from lobbyists, pressured the General Assembly to enact ethics reforms this session. Speaker of the House David Ralston introduced HB 142. As proposed the legislation banned all gifts, golf outings, meals, travel (unless for official state business), etc. The Senate took early action on the issue and implemented a new rule capping expenditures for Senators at $100. HB 142 was finally passed in the final hours of the session. The new cap on expenditures will be $75, as well as a ban on foreign travel, golf outings, sports and concert tickets effective January 1, 2014. Interestingly, in spite of getting nearly 100% of the stated ethics priorities passed, the Atlanta Press, largely the AJC, the GA Tea Party and Common Cause GA insist the legislation doesn’t go far enough and vow more must be done. The legislation will have little impact on the medical lobby which rarely expends large amounts for travel or gifts. PASSED

Campaigns Underway – 2014 Elections

Georgia’s Statewide Officials

All of Georgia’s Constitutional Officers, i.e. statewide office holders, are up for re-election in 2014. At this time, no opponents have announced an intent to run against any of the incumbents in the November 2014 General Election. Governor Deal has picked up a primary opponent in Dalton Mayor Doug Pennington who announced in early April that he plans to challenge Deal in the July 2014 republican primary election. It is still early and we expect that all of the statewide officials will face opponents in the General Election. Stay tuned!

US Senate & Congressional Campaigns

With the announcement earlier this year that senior US Senator Saxby Chambliss will retire at the end of his term in the US Senate, there has been a flurry of activity to fill his seat. Several members of the US Congress have announced their intent to run so there is much electioneering going on to fill those soon to be vacated seats.
Race for the US Senate – Contenders as of early April 2013

GOP announced candidates:
US Rep. Paul Broun, MD
US Rep. Phil Gingrey, MD
GOP candidates showing interest:
US Rep. Tom Price, MD
US Rep. Jack Kingston
Former Sec. of State
Karen Handel
Businessman David Perdue

At this time there is no announced Democrat in the race, though US Rep. John Barrow has shown signs of interest. Barrow represents the 10th Congressional District.

Congressional Races – Contenders as of early April 2013

GA 1st District (to replace Rep. Jack Kingston)
Sen. Buddy Carter (Pooler – R)
David Schwarz (Savannah – R)

GA 10th District (to replace Rep. Paul Broun)
Rep. Donna Sheldon (Dacula - R)
GA 11th District (to replace Rep. Phil Gingrey)
Former Congressman Bob Barr (Vinings – R)
Sen. Barry Loudermilk (Cartersville – R)
Rep. Ed Lindsey (Buckhead – R)
Trica Pridemore (Marietta – R)
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