Weeks 10 & 11

Weeks 10 & 11, while dramatic, were ultimately good ones for GPhA priority legislation. Week 10 saw HB 323 (update to pharmacy patient practice act) move through committee with passage in the Senate in Week 11. Not to be outdone, HB 233 (Pharmacy anti-steering) made up ground in week 11 via a unanimous vote in the Senate HHS committee after a contested hearing, flying through rules, and receiving unanimous support via a Senate floor vote. With one day remaining in legislative session, all that remains for both of these bills is to be agreed upon in the House.

The resistance has been tremendous on HB 233, with insurer, Medicaid managed care organizations, and pharmacy benefits manager lobbyists pulling out all of the stops in an effort to kill this legislation. Yet, despite the all out blitz to kill HB 233, the bill remains in a strong position to make its way from the legislature to the governor’s desk. The reason for that is you. GPhA members have stepped up like never before and have made their voices heard. For that, I cannot thank you enough. Also, a special thank you to Jennifer Shannon, Loren Peirce, and Ross Hays for having the courage to step up and speak on behalf of their patients and their profession, and who did so eloquently and passionately.

HB 63

Rep. Cooper’s step therapy legislation, this bill was favorably reported via substitute by the Senate Insurance & Labor Committee in week 10 and it passed on the senate floor in week 11. It now awaits agreement by the House.

HB 213

Rep. Corbett’ Hemp Farming Act was favorably reported out of the Senate Agriculture and Consumer Affairs Committee in Week 10; and was passed by the Senate and agreed to by the House in Week 11.

HB 290

Rep. Cooper’s bill providing for a pilot program to offer preexposure prophylaxis drug assistance or services to persons at risk of being infected with HIV was favorably reported by the Senate HHS Committee in week 10 and passed the Senate in week 11.

HB 324

Rep. Gravely’s update to Haleigh’s Hope Act (low THC oil) passed the Senate Regulated Industries and Utilities Committee via substitute in week 11. The substitute contained significant material changes to the bill including (1) the creation of a state commission that would have the authority to purchase low THC oil; (2) potential of Georgia University System to grow, cultivate, and research low THC oil; (3) the reduction to one class 1 and one class 2 producer licenses; (4) the allowance of 10 safe access retail licenses; (5) the requirement that any dispenser have a pharmacist employed or under contract to be made available to patients needing consultation; and (6) the ability of retail pharmacies to obtain a nontransferable specialty dispensing license to dispense low THC oil upon promulgation of rules by the Georgia Board of Pharmacy.

GPhA has remained engaged on the issue of low THC oil and the need for pharmacists to be made available to patients for consultation and is encouraged that the substitute contemplates a critical role for pharmacists in that regard. With the many significant changes to the legislation via the substitute, this bill will be going to conference committee to see if an agreement can be worked out.

HB 483

Our own Rep. Stephens annual drug update legislation was favorably reported by the Senate HHS Committee in week 10 and passed the Senate in week 11. It now awaits the Governor’s signature.

HB 551

Rep. Hill’s legislation dealing with the regulation of Kratom was favorably reported by the Senate HHS Committee, passed the Senate, and was agreed to by the House in week 11.

SB 103

Sen. Tillery’s legislation contemplating Medicaid waivers was favorably reported by the House Special Committee on Access to Quality Health Care in week 10, passed the House in Week 11, and was signed into law by Governor Kemp in Week 11. While this is the beginning of a long process to obtain waivers, it is a promising step and GPhA will continue to montior the process closely.

SB 115

Senator Unterman’s bill contemplating telemedicine licenses being issued to physicians who are licensed in other states passed the House via substitute and was agreed upon by the Senate, all in week 11. Additionally, and more pertinent for pharmacy, language from Rep. Stephen’s bill (HB 214) removing the requirement that a physician entering into a vaccine protocol agreement with a pharmacist must be in the same health district was added into this legislation. This is a positive development for multiple location pharmacies, streamlining the process and saving money.

SB 118

Sen. Unterman’s TeleHealth Act contemplating, amongst other things, a prohibition on insurers requiring insureds to use telemedicine, and to provide for pay equity for providers using telemedicine, passed the House via substitute and was the substitute was agreed upon by the Senate, all in week 11.

SB 121

Sen. Walker’s PDMP revision bill passed the House in week 10.

SB 142

Sen. Walker’s bill requiring fully insured plans include a statement saying so on health insurance identification cards was favorably reported by substitute in Week 11.

Week 9 of Georgia’s legislative session saw limited progress for GPhA’s priority legislation but plenty of activity.

With both bills yet to be heard in their assigned committee, Senate Health and Human Services, PBMs, insurers, and managed care organizations moving aggressively to try to kill HB 233.

As a reminder…

• HB 323 restricts PBM and insurer patient “steering,” strengthens anti-mandatory mail order, adds audit protections, prohibits PBMs from making knowing misrepresentations, and restricts patient data mining.

• HB 233 is a companion bill that prohibits pharmacies from profiting off self-dealt prescriptions “steered” from their PBM and insurance affiliates.

In response, GPhA reached out to members and they sprang into action. A robust team of pharmacists walked the halls of the capitol meeting with senators and advocating for patient choice. Their presence was much needed and well received. Additionally, following a member alert, GPhA members worked the phones and wrote letters in support. These steps proved vital as there was much buzz about the legislation in the capitol and, the good news is we believe there will be a hearing for HB 323. With regard to HB 233, much resistance remains. GPhA has been in multiple high level meetings in an effort to move HB 233 forward and progress is being made.

A who’s who of Georgia’s contract lobbyists for PBMs, insurers, and Medicaid managed care organizations are pulling out all stops to try to kill this bill. While the legislative session is ticking down, we still have time to push HB 233 through. Look for important information to be sent to you via e-mail and fax later today from GPhA.

In terms of other legislation we are tracking, not much moved in Week 9 but we are anticipating Week 10 to be very robust and active.

Week 8

Week 8 saw legislative days 26-29 tick by much activity, particularly on day 29, which is known as crossover day.

Crossover day is the last day a bill may crossover from its originating chamber (e.g., from the House to the Senate). If a bill does not crossover, it is no longer viable that session, although its contents may be subsequently added to a viable bill.

In light of the importance of crossover day, tensions ran high with several bills vying to make the cut.

The good news for pharmacists and their patients is that GPhA’s priority legislation, HB 233 (pharmacy anti-steering) and HB 323 (update to Pharmacy Patient Protection Act) both crossed over on legislative day 26 thus alleviating much of the stress on crossover day itself. It is also worth noting that these bills passed the House in style with only one “no” vote between the two.

Here are the bills that GPhA is watching that made crossover … and those that didn’t.

Bills that made crossover

• HB 63 (step therapy override)
  HB 158 (HIV retroantiviral meds)
• HB 213 (hemp farming act)
• HB 290 (pilot program to provide preexposure prophylaxis drug assistance to at risk persons)
• HB 324 (Haleigh’s Hope – low THC cultivation & sale)
• HB 483 (annual drug update)
• HB 551 (kratom regulation)
   
• SB 56 (out-of-network “surprise” billing)
• SB 92 (restricting licensing actions based on federal student loan default)
• SB 106 (Patients First Act — Medicaid waivers)
• SB 118 (telemedicine/telehealth)
• SB 121 (PDMP revisions including access by AG in connection with DCH Medicaid fraud unit)
• SB 142 (requiring statement that health policy is fully insured on identification cards)
• SB 195 (Prescription Drug Benefits Freedom of Information Act — prior authorizations)

Bills that failed to crossover

• HB 42 (restricting licensing actions based on federal student loan default)
• HB 84 (surprise billing)
• HB 112 (age restrictions to purchase OTC cough syrup)
• HB 198 (Certificate of Need)
• HB 214 (vaccine protocol agreements revisions)
• HB 256 (requiring authorized handlers of controlled substances to be in possession only in usual course of business)
• HB 385 (requiring statement that health policy is fully insured on identification cards)
• HB 416 (establishing state vaccine consumer protection office)
   
• SB 74 (Certificate of Need)
• SB 145 (provide for tiered network standards)
• SB 151 (sought to create Office of Health Strategy and Coordination)
• SB 189 (production of medical records)
• SB 223 (kratom)

Days 21 through 25 of Georgia’s legislative session were good ones for GPhA’s legislative priorities.

HB 323, which would update the Pharmacy Patient Protection Act, passed the full House unanimously on Monday, March 4. The bill extends certain existing protections to other dispensers and their patients, strengthens anti-mandatory mail order provisions, restricts PBM steering, restricts sharing data for commercial purposes, looks to apply existing accreditation limitations to PBMs, and restrict PBMs from imposing fees/penalties in connection with audits.

Similarly, HB 233 passed the full House virtually unanimously, also on Monday, March 4. Offering testimony in support of the legislation was GPhA member Dr. Jennifer Shannon (owner of Lily’s Pharmacy in Johns Creek) and on behalf of the Georgia Society of Clinical Oncology was its president, Dr. Melissa Dillmon. Both did a wonderful job under trying circumstances.

A pleasant surprise was HHS Chair Sharon Cooper taking note of the more than 90 co-sponsors on this legislation — she pointed out that she doesn’t recall ever seeing so many cosponsors on a healthcare bill. (By way of reminder, this bill would prohibit PBM and insurer “steering” patients to the pharmacies they own, and would prohibit those pharmacies from receiving those prohibited referrals.

Pharmacists at the Capitol

We currently have one event scheduled and are in the process of setting one to two more. Please come to the Capitol and fight for your patients on Wednesday, March 13 from 10:00 a.m. to noon. Check out GPhA.org/atthecapitol and sign up!

Legislation introduced in week 7

HB 483: Annual drug update

Introduced by our own Representative Ron Stephens, this is the annual dug update bill keeps current Georgia’s dangerous drug and control substance code sections. This bill was not only introduced in Week 7 but it also was favorably reported by the Judiciary Non-Civil Committee.

SB 189: Record-request deadlines

Senator Cowsert introduced this bill which seeks to, amongst other things, impose a hard 30-day deadline (along with daily fines) on providers who are sent records requests from patients and also from litigants seeking medical records.

This legislation was opposed by several provider groups including GPhA and was tabled at its first committee hearing. GPhA has offered several suggested revisions and had a positive conversation with the bill’s author in that regard. We recognize that the ability of patients and litigants to obtain records promptly is important, and we look forward to working with the author to help address the issue while not exposing providers to potential liability for seeking to comply with the law while ensuring patient privacy is protected.

SB 195: Streamlining prior authorizations

Introduced by Senator Hufstetler, this legislation would address problems with prior authorizations, streamline the process, and create an advisory committee regarding the issue. Moving quickly, this bill was favorably reported by the Senate HHS Committee. GPhA is in support of this legislation.

SB 223: Kratom regulation

Senator Mullis introduced SB 223 after chairing a study committee on the issue of Kratom — something that’s proven to be a controversial subject in Georgia. Among other things, this bill would create a state identification of a standard level of kratom alkaloids; establish recommended dosages; restrict access to kratom to people under 18 years of age, and provide for package labeling requirements.

Updates on legislation previously introduced

HB 84: Surprise billing

Representative Richard Smith’s surprise billing legislation was favorably reported (i.e., passed) by the House Insurance Committee.

HB 213: Hemp farming

Representative John Corbett’s Hemp farming bill passed the House this week by substitute.

HB 290: HIV prophylaxis

Representative Cooper’s legislation creating a pilot program to provide pre-exposure prophylaxis drug assistance to people at risk of being infected with HIV was passed by the House via substitute.

HB 324: Low-THC oil production

Representative Gravely’s bill allowing the cultivation and sale of low-THC oil in Georgia was passed by the Regulated Industries Committee via substitute.

SB 106: Medicaid waivers

Senator Tillery’s legislation proposing key Medicaid waivers that would bring federal dollars into Georgia’s healthcare system was passed out of the Senate.

SB 121: PDMP data and law enforcement access

Senator Walker’s update to Georgia’s PDMP law was favorably reported by the Senate HHS Committee via substitute.

SB 142: Indication of insurance coverage

Senator Walker’s bill requiring that a statement indicating that a patient’s health policy is fully insured is included on their health insurance identification card was favorably reported by the Senate Insurance & Labor Committee.

Days 17 through 20 of Georgia’s legislative session were busy ones for all involved. GPhA continues to engage in stakeholder discussions on HB 233 and HB 323, both of which are expected to be heard in the upcoming week.

The heart of both of these bills is patient choice and anti-steering. With Georgia’s sickest and chronically ill patients being forced and steered to PBM-owned pharmacies in record numbers, these bills could not be more timely or more needed.

Please reach out to your Georgia representative today and ask them to support this legislation.

It’s easy to find your legislator. Just click here and enter your address.

Week 6 also saw GPhA’s second Day at the Dome event with students from Mercer and South walking the halls of the Capitol and advocating for GPhA’s priority legislation. The students all got to hear from pharmacy champions representative David Knight and Ron Stephens.

Pharmacists at the Capitol

Again, the issue is PBM patient steering. Not much more needs to be said. All the students in that photo came to the capitol to support our bills. Now we need pharmacists to come to the Gold Dome.

We have three dates for our Pharmacists Advocacy Teams — each is a group of 10 to 20 pharmacists who will join our advocacy team in meeting with legislators.

• Wednesday, February 27 – 10:00 a.m. to noon
• Wednesday, March 6 – 10:00 a.m. to noon
• Wednesday, March 13 – 10:00 a.m. to noon

Visit GPhA.org/atthecapitol and please sign up for one. Your presence makes a big difference!

Legislation introduced in week 5

HB 385/SB 142: Indication of insurance coverage

Introduced by Representative Lee Hawkins in the house and Senator Larry Walker in the senate, this legislation would require a statement indicating that a patient’s health policy is fully insured be included on his or her health insurance identification card.

This will allow providers and commissioner of insurance investigators to identify whether a plan is fully insured by an insurer or is a self-funded payor plan. While GPhA believes strongly that PBMs are subject to state oversight, GPhA is supportive of this bill to the extent it is helpful in identifying areas with clear ERISA preemption such as Georgia’s prompt pay laws.

SB 121: PDMP data and law enforcement access

Senator Larry Walker introduced this legislation which would make some targeted revisions to Georgia’s PDMP law. Specifically, it would increase the time prescription information is maintained from two to five years and would authorize the attorney general’s Medicaid Fraud Unit to access the PDMP database for enforcement purposes. GPhA is currently assessing this bill.

SB 145: Tiered network standards

Senator Harbin’s bill looks to provide for standards for tiered networks, require certain provider notifications prior to termination from a tiered network, and create certain other related requirements. This is a pro provider bill which includes protections for pharmacies.

SB 151: New healthcare office

Introduced by Senator Dean Burke, this bill seeks to create the Office of Health Strategy and Coordination for the purpose of, amongst other things, strategically coordinating the state’s healthcare system. It also contemplates the convening of a Georgia Data Access Forum composed of stakeholders and experts including representatives from pharmacy associations.

Updates on legislation previously introduced

HB 63: step therapy restrictions

Representative Cooper’s step therapy bill passed out of the House and had made its way to the Senate for its consideration. As a reminder, this bill seeks to protect patients from onerous step therapy requirements under certain circumstances including when a medication is contraindicated; and is expected to or has already proven to be ineffective. GPhA supports this legislation.

HB 158: Medicaid patients access to antivirals

Representative Silcox’s bill granting Medicaid recipients access to certain retro antiviral medications passed out the House. GPhA remains in support of this legislation.

HB 213: Hemp farming

The Hemp Farming Act, introduced by Representative Corbett was favorably reported by substitute via the Agriculture and Consumer Affairs Committee.

HB 290: HIV prophylaxis

Representative Cooper’s legislation creating a pilot program to provide pre-exposure prophylaxis drug assistance to people at rick of being infected with HIV was favorably reported via substitute by the House HHS Committee.

SB 56: Surprise billing

Senator Hufstetler’s surprise-billing legislation was favorably reported by the Insurance and Labor Committee via substitute.

SB 106: Medicaid waivers

Senator Tillery’s legislation proposing key Medicaid waivers that would bring federal dollars into Georgia’s healthcare system was favorably reported by the HHS Committee.

Week 5 of Georgia’s 2019 legislative session was a busy one for all involved, including GPhA. Several healthcare and pharmacy related bills were introduced this week (see below), including GPhA’s two legislative priority bills.

Additionally, several healthcare bills we are monitoring began to make their way through the general assembly. Through it all, GPhA continues to work to support pro patient/pro pharmacy legislation and to provide feedback on legislation which, while well intentioned, may have unforeseen consequences.

Pharmacists at the Capitol

For our pharmacist members, our Pharmacists at the Capitol events are an opportunity to get involved and be heard. With our anti-steering legislation set to hit the House floor, we need pharmacists at the Capitol now more than ever. The stakes couldn’t be higher.

Please signup today for one of our Pharmacists at the Capitol events by going to GPhA.org/atthecapitol.

• Wednesday, February 27 – 10:00 a.m. to noon
• Wednesday, March 6 — 10:00 a.m. to noon
• Wednesday, March 13 — 10:00 a.m. to noon

GPhA legislative priorities introduced in week 5

HB 233: PBM Anti-Steering

Introduced by Representative David Knight, this bill seeks to prohibit PBM and insurer-owned pharmacies from filling prescriptions that were received via prohibited referrals from their PBM and insurer affiliates.

The background: Pharmacies affiliated with PBMs and insurers are utilizing their relationships to target patients via steering and data mining. These practices compromise patient care and choice, and — despite assertions by PBMs and insurers to the contrary — can lead to waste and increase costs. That’s why most healthcare providers, including physicians, are subject to anti-steering/self referral laws. This bill seeks to rein in these practices by:

1. Prohibiting pharmacies owned by PBM and insurance affiliates from poaching patient information for profit (i.e., non-patient care purposes).
2. Prohibiting pharmacies from receiving and billing for self-dealing referrals from their affiliates;
3. Prohibiting pharmacies from mailing drugs when a physician indicates a direct pharmacy consultation is necessary;
4. Requiring pharmacies to disclose affiliates; and
5. Treating violations as an unfair and deceptive trade practice subject to attorney general oversight.

The nation is watching Georgia. Subjecting healthcare providers anti-self-referral laws is nothing new, but this legislation is already being closely monitored across the country. It represents a fresh approach to dealing with the plague of patient steering and how it negatively impacts patients who take specialty and chronic disease medications.

GPhA is working in close partnership with the Georgia Society of Clinical Oncology to advance this legislation — a bill that has enjoyed unprecedented support from the House of Representatives. We are proud to report this bill has more than 90 cosponsors including several key and prominent committee chairs. (The bill has been assigned to the House Health and Human Services Committee which is chaired by Representative Sharon Cooper, a top-five cosponsor of this piece of legislation and long-time champion of patient choice.)

Click here for the list of members of the House Health and Human Services Committee. If you are a constituent of one of these representatives, please reach out to let them know how important this bill is for Georgia’s patients and ask for their support.

HB 323

An update to the Pharmacy Patient Protection Act of 2017 (which became a national model) and a companion bill to HB 233, this GPhA-priority bill was also introduced by Representative Knight and enjoys support from key leaders in the Georgia House. This bill looks to do the following:

• Strengthen Georgia’s anti-mandatory-mail-order provisions;
• Prohibit prospective and retroactive fees including those that are performance based;
• Extend protections of the Patient Protection Act to patients of other dispensers such as oncologists;
• Prohibit PBM steering;
• Prohibit credentialing;
• Prohibit delaying care for prior authorizations; and
• Require PBMs to pass along rebate savings to patients.

This sweeping piece of legislation has been assigned to the House Insurance Committee. Click here for a link to the list of committee members. If your state representative sits on that committee, please be sure to reach out and let them know how important this legislation is and ask for their support.

Other legislation introduced in week 5

Beyond advocating for GPhA’s legislative priorities, GPhA also monitors other legislation that impacts the practice of pharmacy. We not only want to keep you abreast of changes, we also want to be sure, when necessary, pharmacists are heard on these issues.

HB 213: Hemp farming

Introduced by Representative Corbett, this bill seeks to create the Georgia Hemp Farming Act. The stated intent of this legislation is, amongst other things, to promote the exploration of the cultivation and processing of hemp (not marijuana), the potential to open up new commercial markets for farmers and businesses, and to explore the expansion of the state’s hemp industry.

This bill authorizes and sets forth a process for hemp growers to obtain a license for cultivation. Additionally, the bill empowers University System of Georgia universities/colleges to engage in research on hemp cultivation and use. GPhA will continue to monitor and report on this legislation.

HB 214: Vaccine protocol agreements

Representative Stephens introduced this legislation seeking to remove geographic limitations on physicians entering into vaccine protocol agreements with pharmacists. This would mean a pharmacist no longer has to be located within the county (or even in a contiguous county) of a physician. GPhA supports this legislation.

HB 256: Controlled Substance Act exceptions

Introduced by Representative Scoggins, this bill looks to revise the exception to the controlled substances act allowing persons authorized by law to dispense, prescribe, manufacture, or possess controlled substances to specify that the exception applies only when such persons are acting in the usual course of their business or employment.

GPhA and several other provider groups are engaged with the author of this legislation in an effort to ensure there are no unforeseen consequences to providers acting on behalf of their patients but perhaps outside of the norm in terms of everyday usual course of business.

HB 290: HIV prophylaxis

Representative Cooper introduced this legislation that would create a pilot program to provide preexposure prophylaxis drug assistance or services to persons at risk of being infected with HIV. GPhA is supportive of this legislation.

HB 324: Low-THC oil cultivation and sale

Introduced by Representative Gravely, the bill would allow the cultivation and sale of low-THC oil to patients with certain conditions authorized to receive it for treatment. It would create an Office of Low THC Oil Control (under the Department of Community Health) and would set requirements for certain production license classes and retail outlets.

While GPhA remains neutral on the issue of cultivation and sale of marijuana in Georgia, we believe that, if low-THC oil is to be sold in Georgia for medical purposes to patients with designated conditions, those patients should be afforded access to the care of pharmacists for, amongst other things, consultation; drug regimen review; and monitoring for drug interactions, adverse effects, and medication adherence.

As of now, the bill does not include patient access to a pharmacist, so GPhA will engage with legislators on this issue in the weeks to come. GPhA also continues to review and assess other elements of this bill.

SB 106: Medicaid waivers

This bill, introduced by Senator Tillery, would grant the Department of Community Health the authority to seek a Medicaid waiver to expand Medicaid benefits to some Georgians via bringing in more federal dollars.

Titled the Patient’s First Act, the bill authorizes DCH to submit a waiver request to the U.S. Department of Health and Human Services and for the governor to submit applications for federal funds via waiver of applicable provisions of the federal Patient Protection and Affordable Care Act. This bill appears to be a priority for Governor Kemp and is supported by GPhA.

Updates on legislation previously introduced

HB 42: Student loan default protection

Representative Turner’s bill restricting state boards from taking action against licensees based on federal student loan default was favorably reported by the House Higher Education Committee.

HB 63: Anti-step therapy

Representative Sharon Cooper’s step therapy bill was favorably reported out of the House Insurance Committee. This bill seeks to protect patients from onerous step therapy requirements under certain circumstances including when a medication is contraindicated; and is expected to or has already proven to be ineffective.

HB 158: Medicaid patients access to antivirals

Representative Silcox’s bill granting Medicaid recipients access to certain retro antiviral medications was favorably reported by the House HHS Committee. GPhA remains in support of this legislation.

While we may have had a slow start, in week four, legislative session was in full swing with bills continuing to be introduced and bills previously introduced beginning to make their way through the legislative process. Through it all, GPhA continues to be at the capitol daily, advocating for pro-pharmacy, pro-patient legislation and engaging with legislators on the finer points of several pieces of legislation.

Of special note, this week saw our first Day at the Dome event with students from UGA and PCOM storming the Capitol and engaging legislators on the practice of PBM patient steering. The 280 students were visited by notable friends of pharmacy, U.S. Representative Buddy Carter and Georgia State Representative Ron Stephens. We knew the day was a success when legislators reached out to GPhA to find out more about these egregious practices. Well done!

Finally, thank you to our members that picked up the phone and engaged their legislators this week. You were heard and it made a huge difference. Our first bill seeking to prohibit PBM and insurer owned pharmacies from filling prescriptions that were received via prohibited referrals will be introduced in week five and the support we have received is unprecedented. Indeed, As of print, the bill has over 90 cosponsors in the House which will send a huge message to those who will seek to oppose this legislation.

Legislation introduced in week 4

HB 112: Prohibit dextromethorphan sales to minors

Introduced by Representative LaHood, this bill looks to prohibit the sale of over the counter drug products containing dextromethorphan to minors under the age of 18.

Pharmacists at the Capitol

For our pharmacist members, our Pharmacists at the Capitol events are an opportunity to get involved and be heard. With our anti-steering legislation set to hit the House floor, we need pharmacists at the Capitol now more than ever. The stakes couldn’t be higher.

Please signup today for one of our Pharmacists at the Capitol events by going to GPhA.org/atthecapitol.

• Wednesday, February 17 — 10:00 a.m. to noon
• Wednesday, March 6 — 10:00 a.m. to noon
• Wednesday, March 13 — 10:00 a.m. to noon

Be on the lookout for more dates to be scheduled soon.

Student pharmacists from UGA and PCOM headed to the Gold Dome on Tuesday to meet with legislators and let them know they’re invested in their future careers.

Check out the pic — and imagine those hundreds of students walking the halls of the capitol!

While week 2 was relatively quiet at the Dome, week 3 was anything but quiet … and absolutely more exciting than a certain football game.

Although GPhA’s priority legislation has yet to be introduced, GPhA achieved a major success in week 3: Georgia’s four Medicaid Managed Care organizations all agreed to stop spread-pricing in their next PBM contracts. Instead, the MCOs will move to a pass-through pricing model. (Click here for details.) The change is a monumental first step towards fairer treatment for pharmacies participating in Georgia’s Medicaid program, and GPhA was able to obtain this commitment without the need to bring legislation or seek state agency action.

This news, which is garnering significant attention, follows in the footsteps of the one-of-a-kind concessions Georgia’s commissioner of insurance obtained in connection with the CVS-Aetna merger.

With these two victories under our belt, GPhA will look to continue the momentum with the introduction of anti-steering legislation in partnership with the Georgia Society of Clinical Oncology.

We anticipate this legislation will be introduced in the next week or two and we are working hard and garnering impressive support for the legislation. Once introduced, we will be announcing several key advocacy dates in which teams of pharmacists will be invited down to the capitol to advocate for their patients and profession.

Finally, week 3 saw several healthcare bills introduced in the House that we are closely following. As always, we not only want to keep you abreast of changes, we also want to be sure, when necessary, pharmacists are heard on these issues.

HB 42: Student loan default

Introduced by Representative Turner, this bill looks to prohibit state licensing boards, including the Board of Pharmacy, from talking licensing actions based upon federal student loan default.

HB 63: Step Therapy

Introduced by Representative Sharon Cooper, this bill addresses step-therapy protocols by requiring (1) clinical review criteria be based on clinical practice guidelines; (2) patients and prescribing practitioners to have a way to request that step therapy requirements be overridden; (3) step therapy override requests be granted under certain circumstances; and (4) step therapy override determinations be made within 24 hours in an urgent healthcare situation and 72 hours in a nonurgent healthcare situation. GPhA strongly supports this pro-patient bill.

HB 84: Surprise billing

Introduced by Representative Richard Smith, the chairman of the House Insurance Committee, this bill seeks to address the issue of surprise billing by requiring providers, hospitals, and insurers to take certain actions and provide certain information to patients/enrollees.

With regard to providers, of which pharmacists are included in the definition, the bill looks to, amongst other things, require that they disclose to patients in writing or on a website all health plans in which a provider participates. Due to how pharmacies contract and confirm coverage, this provision would have proved impossible for pharmacies to comply with. There is a provision that was added at the request of GPhA last year that would, as an alternative, allow providers to confirm coverage prior to providing service.

While the General Assembly did not convene in Week 2, also known as “budget week,” the House and Senate appropriations committees held a series of joint budget hearings, and Governor Brian Kemp presented his budget recommendations for the amended current and upcoming fiscal years to the committees.

The joint appropriations committees and subcommittees also met and began reviewing the governor’s recommendations in order to turn those recommendations into actual legislation that will guide our state’s spending.

Though there were no floor sessions, as always, GPhA was in attendance at the Gold Dome daily, monitoring hearings and laying the ground work for our legislative agenda by meeting with legislators and stake holders. 

The General Assembly will convene in Week 3 for legislative days 5-7 and GPhA expects a number of healthcare related bills to be introduced during that time. 

1.5 hours CPE
Price: $29 member / $49 non-member
Instructor: Carlie Traylor, PharmD

Target audience: Pharmacists, pharmacy techs.

Medication synchronization and adherence programs are a necessity in today’s pharmacy practice. Learn about the most effective programs available today, including the latest practice improvements from med sync and other adherence programs.

Learning objectives

After completing this session, learners will be able to:

• list different practice models for medication synchronization/adherence programs as well as their strengths and weaknesses;name the benefits for creating a medication synchronization/adherence program;
• discuss potential barriers to creating a medication synchronization/adherence program and methods to solve those barriers;
• construct a method for quality control within a medication synchronization/adherence program.

Click here to register!

CPE info

Activity Type: Knowledge
0142-0000-16-066-H04-P/T
Release date: 01/31/2017; expiration date: 01/31/2020

1.5 hours CPE
Price: $29 member / $49 non-member
Instructor: Pedro Valentin

Pharmacy technicians need to develop their knowledge and skills in pharmaceutical calculations procedures. This session, led by certified technician Pedro Valentin, gives addresses measurement, medication dispensing calculations, pharmacy mathematical procedures, and calculation tools and techniques

Target audience: Pharmacists, pharmacy techs.

Learning objectives

After completing this session, learners will be able to:

• recognize and interpret metric and apothecary units of measurements;
• interpret and convert household measurements to metric or apothecary units of measurements;
• determine proper medication dosing or administration using the basic mathematical formula or ratio and proportion.

Click here to register!

CPE info

Activity Type: Knowledge
0142-0000-16-085-H04-P/T
Release date: 07/31/2017; expiration date: 07/31/2020

Georgia’s 2019 legislative session opened Monday, January 14, and GPhA was there. As we do every year, GPhA will be in attendance at the Gold Dome daily, monitoring legislation and meeting with legislators and other stakeholders to help ensure that Georgia pharmacists have a voice on all issues impacting the practice of pharmacy in the state. And as we do every year, we’ll provide weekly updates on bills we are watching, and, from time to time, issuing legislative alerts and asking you to take action.

While legislative days 1 through 4 were light on legislation introduced, it proved be a busy week for all involved.

Georgia’s new governor, Brian Kemp, was sworn into office along with the new Lt. Governor Geoff Duncan and more than 38 new state legislators. Committee assignments were announced with one noteworthy change in the Senate’s Health and Human Services Committee, with Senator Ben Watson named as the new chairman.

We look forward to working with Senator Watson in his new capacity. Former chair Renee Unterman remains an HHS committee member and so we also look forward to continuing to work with her — and we thank her for all of the work she did as chairman of HHS on behalf of Georgia’s citizens, pharmacists, and their patients.

Legislative plans

This year, our focus continues to be our patients and addressing practices that adversely impact the care that they receive. More specifically, GPhA plans to engage with the General Assembly in an effort to address the fast-growing practice of PBM patient steering — a practice that has resulted in many of Georgia’s sickest and chronically ill patients being forced from pharmacies of their choice into PBM-owned mail order and retail pharmacies.

Patient steering not only severs the relationship that pharmacists have with long-time patients, but it also jeopardizes patient care. Clinical outcomes are at risk when patients are forced to use multiple pharmacies; decreased face to face contact not only means less monitoring of patients by a healthcare professional, it can easily lead to an increased risk of medication interactions and even delay in treatment.

We look forwarding to addressing this issue and doing so with new allies who are willing to fight for Georgia’s patients.

Pharmacists at the Capitol

While GPhA is at the Capitol daily advocating for pharmacists and their patients, the true voice and the true strength of the association lies with you, our members. That is why is so important that your legislators hear from you, their constituents, on issues that impact pharmacy.

With GPhA’s legislative priorities soon to be introduced, it is critical that our member pharmacists continue to participate in GPhA’s Pharmacists at the Capitol events. Stay tuned as we will be releasing our first dates soon.

Week 1 Legislation

Week 1 was a light week in terms of legislation introduced that will impact the practice of pharmacy but rest assured, that will change soon enough. To that end, GPhA has already engaged with several different legislators and stake holders regarding likely legislation which may impact pharmacy.

2018 Legislative Session Wrap-up

Day 40 of Georgia’s 2018 legislative session, sine die, meant the end of the line for many healthcare related bills while others went on to the Governor’s desk for consideration. The Governor has 40 days to consider, sign or veto, those bills passed by the General Assembly. If he does neither, the bills become law on their effective date (July 1 unless otherwise specified).

For pharmacists, in what was supposed to be a quiet year, Day 40 marked the end of a remarkable legislative session, and a truly historic biennium (2017 and 2018 legislative sessions collectively).

Indeed, while 2017 saw the passage of the pharmacy patient fair practices act which has served as a model across the nation and the right to correct clerical errors made in connection with Medicaid claims, 2018 saw the passage of legislation significantly expanding in point of care testing and a budget pass with an eye toward bringing transparency to PBM practices in connection with state health benefit plan and managed care prescription drug claims.

These bills, and others which passed are set forth in more detail below. However, while not exhaustive, several bills which failed to achieve passage are also set forth below. It is worth taking a read as it helps put into perspective, just how hard it can be to pass legislation and how effective pharmacy can be when they engage and lead.

And so, as I write this, my final legislative report for GPhA, I am grateful to have had the opportunity and privilege of advocating on your behalf. Thank you, Georgia pharmacists.

SB 422

This bill, introduced by Senator Unterman and carried by Representative Cooper in the House SB 422 updates the law to allow pharmacists to perform all tests approved by the FDA for home use to screen for disease risk factors and drug use. Pharmacists can currently perform capillary blood tests (finger prick tests) to screen for disease but are restricted from performing simpler less invasive tests such as saliva testing.

This update will also facilitate improved care as pharmacists can assist with patient education and will make reasonable efforts to notify patients’ physicians of test results. Finally, this bill will allow pharmacist testing to evolve with technology as it does not limit pharmacists to any particular test method, but rather, is tied to tests approved for home use, regardless of testing method.

This bill is expected to take effect beginning July 1, 2018.

HB 684 – Budget

One of the recommendations made by the House Rural Development Council was to seek transparency in connection with PBM models. In that regard, the House looked to make significant steps towards the goal of transparency by including a directive to DCH in connection with state health benefit plan contracts and managed care contracts in connection with pharmacy claims. While opposition was fierce and some changes were made — the final budget includes first of its kind language requiring the reporting to DCH of pharmacy claim information.

More specifically, plan sponsors will be required to annually report all pharmacy claims, itemization of all administrative fees, rebates, or processing charges associated with each claim. The Department will then be tasked with providing a report utilizing aggregated data to the chairs of the House and Senate Appropriation Committees.

While there are some ambiguities, these reporting requirements are significant and will be the first-time plan sponsors in Georgia have been required to report on all pharmacy claims. Once again, Georgia finds itself ahead of the curve when it comes to shining a light on PBM practices.

Finally, while this language is incredibly significant, we believe this is just the first step in bringing transparency to PBM practices and GPhA looks forward to working with DCH and House leadership to ensure that the proper information is reported, information is put in the appropriate context, and further steps are taken to shine a light on PBM practices.

Other legislation that passed

HB 65

This bill creates the Joint Study Commission on low THC medical oil access for the purpose of studying in-state access of medical cannabis and lot THC oil. The bill also adds to the list of conditions eligible to possess low THC oil in Georgia.

HB 769

Sponsored by Representative Jasperse, in connection with implementing certain recommendations of the House Rural Development Committee relating to rural healthcare this bill does several things in connection with rural healthcare including the establishment of micro-hospitals (institution in a rural county which has at least two and not more than seven beds and which provides services seven days per week and 24 hours).

With regard to pharmacy, this bill updates and improves the ability of hospital pharmacies to utilize remote order entry. It allows remote order entry when (1) a licensed pharmacist is not physically present in the hospital, the hospital pharmacy is closed, and a licensed pharmacist will be physically present in the hospital pharmacy within 24 hours or the next business day; or (2) when there is at least one licensed pharmacist physically present in the hospital (does not have to be in the hospital pharmacy). Additionally, pharmacists performing remote order entry no longer have to be located within the state so long as they are licensed in the state and the pharmacy with which they are employed or contracted with hold either a license in this state or a nonresident pharmacy permit in this state.

This bill was not without controversy but GPhA worked with stake holders and the bill sponsor to ensure that the Georgia Board of Pharmacy has appropriate oversight of these activities. GPhA thanks those stake holders as well as Representative Jasperse and believes this bill brings Georgia into line with the rest of the nation and will allow smaller rural hospitals and their patients to access critical pharmacy care services.

HB 818

Introduced by Representative Lee Hawkins, this bill seeks to bring transparency to the insurance reimbursement process and to give healthcare providers (including pharmacists) the ability to choose to be reimbursed via check as opposed to electronic credit cards.

HB 830

Introduced by Representative Harden, this is the annual drug update bill which updates the Georgia code with regard to controlled substances and dangerous drugs.

SB 321

Senator Blake Tillery’s bill revises penalties for Medicaid false claims to bring penalties in line with federal penalties for civil False Claims Act violations.

SB 357

Senator Burke’s bill creates the Healthcare Coordination and Innovation Council in order to improve coordination of the state’s healthcare system. The bill contemplates 18 members, with several by appointment. Significantly, the bill requires the Council always includes a pharmacist. While the initial bill did not specifically contemplate a pharmacist, GPhA worked with the legislators to ensure that pharmacy have a voice on this Council.

SB 407

SB 407 was amended to include revisions to the PDMP which were contemplated in HB 782. The bill makes certain narrow revisions to Georgia’s PDMP as recommended by the Department of Public Health, which administers the program. This looks to ease requirements in connection with prescriber and dispenser delegation (delegates no longer have to licenses or registrations) while at the same time allowing DPH to share PDMP info with other state PDMPs as well as prescriber or healthcare facility electronic medical record systems.

Resolutions

There were several resolutions that passed, each creating a study committee.

HR 1160

Introduced by Representative Brooks, this resolution creates a House study committee on risks associated with Kratom.

HR 1194

Brought by Representative Knight, this resolution created a study committee on the issue of retrospective emergency room policies instituted by insurers.

SR 489

Introduced by Senator Ligon, this resolution creates a study committee on prescribing patterns for antidepressants and other psychotropic medications. The Resolution contemplates a pharmacist on the Committee.

SR 832

Senator Mullis introduced this resolution which creates a Senate study committee on the risks associated with Kratom.

Bills GPhA monitored that crossed over but failed to pass

• HB 519 (step therapy override)
• HB 927 (APRN bill increasing supervising physician to APRN ration)
• HB 678 (surprise billing)
• SB 184 (creation of Integrated Health Data Project)
• SB 325 (Interstate Medical Licensure Compact)
• SB 334 (remove Board of Nursing from Sec. of State to DCH)
• SB 352 (creating Commission on Substance Abuse and implementing new anti-kickback prohibitions)
• SB 359 (surprise billing for emergency medical providers)
• Bills GPhA monitored which failed to crossover and pass
• HB 716 (Georgia Pre-Arrest Diversion for Drug and Mental Health Treatment Act)
• HB 747 (unrestricted access to medications for hemophilia patients)
• HB 755 (pre-exposure prophylaxis drug assistance to at risk persons pilot program)
• HB 868 (low THC OIL eligible condition expansion)
• HB 872 (insurer selection standards for provider network participation)
• HB 873 (PBM prior authorization regulation)
• HB 875 (requiring payors to reimburse providers for services reimbursable under federal/state plans)
• HB 895 (prohibiting sale to those under 18 and requiring ID checks for most OTC cough syrups)
• HB 943 (requiring reimbursement for less addictive opioids)
• SB 300 (healthcare premium assistance)
• SB 322 (imposing certain requirements in connection with sale of personal assistive mobility devices)
• SB 344 (creation of Georgia retail marijuana code)
• SB 346 (repeal of low THC registry)
• SB 471 (mandatory e-prescriptions)

We sent GPhA members an URGENT call to action yesterday related to the upcoming legislative session.  If you’ve not yet responded to it, check your email box, for goodness sake!  We need you to reach out to your legislator pronto. This one is a big deal, so please read the call to action and click through to send a message to your legislator.  We’ve made it easy for you; IT WILL ONLY TAKE ABOUT TWO MINUTES TO RESPOND.  Thanks!