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Georgia Legislation

Georgia Legislative Wrap-Up: Rural Healthcare

Georgia Legislative Wrap-Up: Rural Healthcare

The latest session of the Georgia General Assembly is in the books, and the healthcare industry has been impacted as usual. Below, we highlight just a few of the successful bills with particular relevance to rural healthcare.

Perhaps more consequential than any single bill passed this session, Georgia is reportedly reconsidering a Medicaid “expansion waiver” in the wake of the Affordable Care Act withstanding a recent Congressional challenge. The benefit of this waiver program could be huge for rural healthcare in Georgia, which suffers from low Medicaid reimbursement and limited Medicaid eligibility. 

SB 180 and SB 14 Tweak Existing Law to Aid Rural Hospitals

Senate Bill 180 passed both chambers of the Georgia legislature and is designed to encourage increased donations to rural hospitals in Georgia. SB 180  was amended to include provisions of unsuccessful House Bill 54. As previously discussed, House Bill 54 sought to raise the tax credit from 70 percent to 90 percent for individuals and corporations who donate money to rural hospitals. These provisions were added to Senate Bill 180.

If SB 180 is signed by the Governor, donors to rural hospitals will receive increased tax credits retroactive to January 1, 2017; eligibility for such tax credits will extend to hospitals in counties of up to 50,000 people (increased from 35,000); and hospital payments to third-parties soliciting, administering, or managing the tax credits will be capped at three percent (3%) of a hospital’s total donations.

Senate Bill 14 amends the Georgia’s Code to make ‘rural hospital organizations’ eligible for monetary grants from the state. Under the current Georgia Code, rural hospitals not operated by a hospital authority are only eligible for state grants in limited scenarios. The legislation defines a rural hospital organization as an acute care hospital, in a rural county that:

1.     Provides inpatient hospital services at a facility in a rural county;

2.     Participates in and accepts both Medicaid and Medicare patients;

3.     Provides services to indigent patients;

4.     At least 10% of their annual revenue is categorized as indigent care, charity care, or bad debt;

5.     Annually files an IRS Form 990;

6.     Maintains a 24-hour emergency room;

7.     Operated by a county or municipal authority, or is designated as a tax-exempt organization by the IRS.

The legislation allows qualifying rural hospital organization to apply for monetary grants for projects ranging from facility renovations, equipment purchases, personnel retention, or nontraditional healthcare delivery systems.

In addition, SB 14 expands the definition of what qualifies as a rural county for both hospital authorities and rural hospital organizations to any county having fewer than 50,000 residents (up from 35,000). Finally, SB 14 raises maximum grant allocations for eligible hospital authorities and rural hospital organizations from $200,000 to $500,000 for strategic planning grants, and from $1.5 million to $2.5 million for grants involving nontraditional healthcare delivery systems. Hospital authorities and rural hospital organizations are eligible for up to $4 million annually in grants from the state under the new statutory revisions.

House and Senate Pass Resolutions Focused on Rural Development

The Georgia House of Representatives adopted House Resolution 389. The resolution creates the House Rural Development Council, which will be composed of 15 House lawmakers appointed by the Speaker of the House, David Ralston. The Georgia Senate passed Senate Resolution 392, creating the Senate Rural Georgia Study Committee. The Senate committee will be composed of 7 Senators appointed by the President of the Senate, Lieutenant Governor Casey Cagle.

The appointed House and Senate members will be tasked with examining problems found in rural communities around Georgia, specifically population loss, lack of doctors or hospitals, poor infrastructure, educational achievement, job scarcity, and overall lack of economic growth. Beginning April 1, 2017, the appointed legislators will begin holding meetings throughout rural Georgia with local officials, educational and business leaders, healthcare providers, civic groups, and other interested individuals for input of how to address the identified issues.

Based upon these meetings and research, the appointed legislators will explore possible legislative solutions to the identified issues for rural Georgia and introduce corresponding legislation during the next session of the Georgia General Assembly in January 2018. In the context of healthcare, H.R. 389 and S.R. 392 represent an opportunity for lawmakers to better understand the healthcare needs of rural Georgians to ensure those needs are met in the coming years.

Multiple Successes in Fight Against Opioids

House Bill 249 is set to become the latest sweeping law aimed at combatting the opioid epidemic. The bill contains various efforts to reduce opioid overdoes, including codifying Governor Nathan Deal’s executive order allowing the sale of overdose antidote naloxone without a prescription, and strengthening the state’s Prescription Drug Monitoring Program, which requires physicians to report opioid prescriptions.

Another successful bill, Senate Bill 88, entrusts the Department of Community Health with substantial licensure and oversight controls over “narcotic treatment programs.” Lawmakers have expressed concern over clinics offering narcotic addiction treatment, which often involves opioid prescriptions to fight the patient’s addiction to other opioids, and placed a one-year freeze on such clinics last summer.

Cancelable Loan Program for Rural Practitioners Expanded

House Bill 427, the ‘Physicians, Dentists, Physician Assistants, and Advanced Practice Registered Nurses for Rural Areas Assistance Act,’ expands the types of healthcare providers eligible for cancelable loans if they agree to practice medicine in qualifying rural areas of Georgia. The legislation now makes dentists, physician assistants, and advanced practice registered nurses eligible for cancelable loans. Cancelable loans for healthcare providers in rural Georgia were previously limited to physicians. The goal of the new legislation is to address the shortage of physicians and other healthcare practitioners in rural Georgia.