HB 1393: Hospitals; allow rural hospitals to join together to allow further purchasing power with third-party payors but retain their independence

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Discussed in meetings (11)

The House and Senate meetings that took this bill up, from their machine transcripts. Each account was written by Georgia Commons with AI and is not part of the record; the video is what was said.

1. House Health Committee, March 2, 2026

   From 0:42:44 · Watch on the General Assembly's Vimeo channel

   Summary by Georgia Commons: The sponsor said HB 1393 would let certain nonprofit rural hospitals collaborate on purchasing, staffing and insurance contracts while remaining independent, citing financial strain and large reimbursement differences. Members questioned eligibility as counties grow, participation by system-affiliated hospitals, staff sharing and protections against monopolies. Legislative counsel said federal antitrust immunity remained uncertain despite Supreme Court precedent. An attorney representing rural hospitals said the bill addressed gaps identified in a 2013 Supreme Court decision, would not eliminate federal oversight, and could help hospitals share services and prepare for new payment models. The attorney said some restructured, system-affiliated hospitals could qualify. The Evans Memorial Hospital chief executive urged immediate action, citing rising costs and opportunities to share staff and resources. Asked about Medicaid expansion, the executive emphasized operating efficiencies instead. A Georgia Association of Health Plans witness supported the goals but opposed the breadth of the antitrust protections. The chair initially limited the bill to a hearing, then allowed a vote after consulting counsel. Members adopted an amendment tying a provision treating hospital authorities as state subdivisions for antitrust purposes to their exercise of powers under the legislation. The committee approved the amendment and bill by voice votes.

2. House Rules Committee, March 4, 2026

   From 1:23:14 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 1881

   Summary by Georgia Commons: The presenter said HB 1393 would allow rural hospitals to collaborate on contracts. The presenter described it as a priority for Hometown Health, the hospital association and the state's 61 rural hospitals. No questions or decision followed.

3. House floor session, March 4, 2026 (legislative day 27, PM, part 1)

   From 2:15:21 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 1885

   Summary by Georgia Commons: The sponsor said the bill would let rural nonprofit hospitals jointly negotiate contracts for supplies, staffing and third-party payments while remaining independent. The sponsor said Georgia has 61 rural hospitals and explained that the bill was written to authorize cooperation under an exception to federal antitrust rules for state-authorized government action. One member said many rural hospitals have a week or less of cash available and supported pooling resources. Asked about insurance payments, the sponsor said joint negotiations were a major purpose, describing nearby hospitals receiving six to ten times different reimbursements for the same surgery because of their payer mix. The sponsor said the change would not necessarily produce urban hospital rates. Another member asked whether a large hospital system with a rural facility could participate. The sponsor said no, each participating entity must qualify as a rural nonprofit hospital. The House adopted the committee substitute and passed the bill 170-0.

4. House Rules Committee, March 4, 2026

   From 0:36:03 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 1881

   Summary by Georgia Commons: The committee added HB 1393 to the day's supplemental calendar under modified structured rules without stated opposition. No provisions were discussed.

5. Senate Health and Human Services Committee, March 23, 2026

   From 1:26:07 · Watch on the General Assembly's Vimeo channel

   Summary by Georgia Commons: The sponsor said the bill would let rural hospitals jointly purchase supplies, share staff and negotiate insurance payments while remaining independent, with protection from competition-law challenges. The Evans Memorial Hospital CEO said rural hospitals lacked bargaining power and received 20% to 30% less than comparable urban hospitals. Members questioned legality, cross-county cooperation and whether large systems could benefit. The sponsor said the bill restricted those benefits, but a Robins Government Relations witness argued its language extended protection to large systems affiliating with rural hospital authorities. That witness suggested narrowing its scope. A Georgia Association of Health Plans witness warned of higher prices and urged rejection. A Georgians for a Healthy Future witness said some staffing cooperation was already allowed, warned about consolidation and requested explicit state oversight. The sponsor disputed the price concerns, citing unequal reimbursements, and remained open to changes. The chair supported the underlying idea but requested further work to narrow the language. The chair also said Georgia would receive $218 million annually for five years through the Rural Health Transformation Program. This was a hearing only, with no vote.

6. Senate Health and Human Services Committee, March 25, 2026

   From 0:20:17 · Watch on the General Assembly's Vimeo channel

   Summary by Georgia Commons: The chair presented a substitute repealing certificate-of-need requirements except for skilled nursing facilities. A legal adviser said it would also let qualifying rural hospital authorities cooperate with protection from antitrust claims. The adviser described eligibility limited to groups of up to three rural hospitals, attorney general review within 180 days, annual eligibility confirmation and a ban on participating authorities using noncompete agreements with healthcare providers. An economist speaking personally and a Pacific Legal Foundation witness supported repeal, citing research they said linked certificate-of-need laws to reduced access and higher costs. A Georgia Association of Health Plans witness supported the substitute, saying revisions reduced antitrust concerns. A Georgia Hospital Association witness opposed broad repeal. A healthcare attorney urged against the substitute, arguing its cooperation limits, physician restrictions and application process would burden rural hospitals. The legal adviser said physician language could be revised to preserve specialist access. Members asked about federal antitrust immunity, severability and hospitals losing paying patients to surgery centers. The adviser explained the proposed state-entity exemption, said severability applies, and described lower surgery-center prices and hospital cross-subsidies. The chair promised continued work. The committee approved the substitute 8 to 5.

7. Senate Rules Committee, March 30, 2026

   From 1:06:13 · Watch on the General Assembly's Vimeo channel

   Summary by Georgia Commons: The vice chair selected HB 1393 for the floor calendar. No substantive explanation or debate followed. The committee unanimously approved the calendar containing it.

• Read aloud: House floor session, February 20, 2026 (legislative day 22), 0:43:49
• Read aloud: House floor session, March 3, 2026 (legislative day 26, AM), 0:49:31
• Read aloud: Senate floor session, March 6, 2026 (legislative day 28, part 1), 0:41:14
• Read aloud: Senate floor session, March 27, 2026 (legislative day 38), 0:27:24

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