House Health Committee, February 23, 2026 Video: https://vimeo.com/1167366750 (a timestamp t plays at https://vimeo.com/1167366750#t=s) Page: https://georgiacommons.org/meetings/2026-02-23/house-health This is a machine transcript of the General Assembly's video, made by a speech-recognition model. It is not an official record and can mishear words, names, and numbers. Speakers are not identified. The video is the record: every timestamp links to the moment it plays. [0:12:15] All right. Uh, we have a quorum of, we do, two, four, six, seven. Thank you. [0:12:28] Everybody trying to [0:12:32] get home right now. [0:12:33] Yeah. All right. [0:13:05] Let's go ahead and get started. We have a quorum, and we have some more coming in, so that's great. We're gonna start off with, uh, representative or Chair Lady Cooper's bill, um, what, HB1295. Go ahead. [0:13:22] Thank you very much, Mr. Chairman. Uh, HB1225 is another compact, uh, and basically no different than other compacts we have done, which are becoming very popular, um, in the healthcare field because they make it easier, uh, to, for f- um, physicians, uh, different people that have them, it makes it easier for them to move from state to state. [0:13:55] Uh, the, the pacts have certain things that the people, um, whatever they are, whoever they are, whether they're a physician's assistant or they're a physician, certain standards they must meet that are in the compact. And then if we have a compact, they still must meet the requirements of the state in which they want to work. And if they stay in that state for any extended time, uh, then they must also apply for a regular license under that state. [0:14:31] Um, so this one, this compact was done for physician's assistants, and it basically follows the same program, uh, of the other compacts. And, uh, the one thing that they are not doing right now, the Board of Medicine, which the physician assistants report back to and are, are governed by, they do not do background checks, and there is a provision in here for background checks, uh, to be made. [0:15:02] The, that board is moving toward having background checks on everybody in all the different professions underneath it, but they don't have it yet. But we made sure that that was put in this one so that it would adhere to it to match up. Um, I do have ... And because of that, I do have a proposed m- amendment. It would be in, uh, section five, which would read, "For planning and readiness purposes for the compact, this act shall become effective on July 1st, 2026. [0:15:36] However, for the purpose of any licensure, the act shall be effective on July 1st, 2027." That's to give the board the time, uh, to get the procedures and the rules for, uh, getting the background checks done. I talked to the medical board this morning, and they say that date is fine, that they can make those two dates. [0:15:58] All right. [0:16:00] I'll be glad to, um, answer any questions. [0:16:04] Are there any questions? I see none. Do I hear a motion on the bill? [0:16:10] Motion. [0:16:12] Oh, do we have- [0:16:12] Thank you. [0:16:13] Oh, excuse me. I couldn't read that. Chair Hutchinson, do you wanna speak? Can you keep it short? [0:16:22] Oh. Yes, sir. [0:16:23] Amendment. [0:16:23] I would, I would suggest. [0:16:25] Appreciate the help. [0:16:26] Right. [0:16:26] I think the amendment just does two things. One, it changes the effective date to July 1, um, to July 1, 2027, to give the Composite Medical Board ample time for the criminal background check, and it also, um, is the compact language is not underscored in the bill, and, like, council just realized that, so the amendment also underscores it. [0:16:44] Right. [0:16:44] So thank you for your support. [0:16:45] Thank you. Uh, I see no questions. Do I hear a motion? [0:16:50] Moved. [0:16:51] Do I hear a second? [0:16:52] Second. [0:16:53] Okay, we have a motion on the bill. Now on the amendments, do I hear a motion on the amendment? [0:16:59] So moved. [0:17:00] Second? [0:17:01] Second. [0:17:01] Thank you. [0:17:02] Thanks. [0:17:02] All right. All those in favor of the amendments say aye. [0:17:05] Aye. [0:17:06] All those against say nay. The amendment's passed. Now to the main body of the bill, all those in favor of the bill say aye. [0:17:13] Aye. [0:17:13] All those against say nay. Congratulations. You got your bill. [0:17:16] Thank, thank you very much. And I will tell you that- [0:17:19] It's amended [0:17:20] ... that, right. The boards are, the, the boards and the Secretary of State's office, so you will know, they are moving as fast as they can to make it easier for people to get licensure in our state. And so we have more people to cover our sick. And they keep saying from the Secretary of State's office, "Anything we can do with re- reciprocity, reciprocity, reciprocity. Check people out. If they meet our standards, please give them their license." So we're working toward that to help us get more people. [0:17:50] Thank you. [0:17:51] Thank you. [0:17:52] All right. Up next, uh, Representative Frye, are you okay if I let, uh, Representative Newton go first? [0:18:00] Yes, sir. My, um, my meeting got postponed for another hour, so I'm good. [0:18:05] Okay. But I wanted to check with you 'cause we had a prior conversation. [0:18:09] Oh. [0:18:09] Okay, let's go ahead and hear HB1275, Representative Newton, Chairman Newton. [0:18:16] Uh, thank you, Mr. Chairman and members of the committee. I'm bringing, uh, HB 1275. Um, 1275 is informed by some things have been going... in recent years, there's been s- significant medical advances in the use of stem cell-based therapies from human birth tissue. Uh, these therapies are being studied and utilized for things like pain mitigation in joints following orthopedic procedures, and really furthering progress in many other more life-threatening conditions as well. None of these have been around long enough to be studied well and, and by the FDA, so, so current research is still going on, but also therapy. [0:18:48] And currently, Georgia law does permit using and distribution of, of these non, these non-FDA-approved substances, the stem cell products, within the state, but they can only be manufactured out of the state. Um, certain states such as Florida and Utah have passed legislation that allow, um, uh, regulated regenerative medicine manufacturers and distributors to make and sell these non-FDA-approved products in their states. But right now, Georgia-based physicians and, uh, patients don't have the same in-state access. [0:19:18] There's actually companies doing this in the, in the city of Atlanta right now, w- th- but they can only sell out of state. HB 1275 would allow regulated Georgia-based companies to manufacture and distribute stem cell-based products within Georgia. That would support investment, some high-skill job creation, growth in the state's life sciences sector. At the same time, it would improve patient access by reducing reliance on out-of-state production, ensuring Georgia remains competitive in this rapidly evolving field of regenerative medicine and biomedical innovation. [0:19:49] Uh, it's similar to, i- i- in a small way, it's similar to the way we look at organ donation, is these are d- this is donated tissue. And by the way, several lines in the bill are very specific, like line 15 and 16, and then lines 54, that these are, this has nothing to do, this is not aborted tissue or anything to do with abortions. This is donated tissue, most typically, uh, uh, umbilical cords that are donated. There's a, a gelatinous material, a connective tissue in there which is really high in these, uh, mesenchymal stem cells, or what we call stem cells, that seem to have great p- um, potential for, uh, actually regeneration and healing in certain injury areas, in particular in orthopedics or other pain-related. [0:20:28] Could be wound healing. Uh, there's even some cornea-related things that can be done, um, with this fairly unique tissue, from donated tissue. So that's, that's what the bill would do. It would allow the companies that do this, um, to, uh, to both produce it in Georgia and sell it in Georgia, or sell it or distribute it to, um, to different, uh, practices and physicians and studies that are, uh, going on in the state, so. We do have a couple of people, sir, that would like to speak on it that can speak with a little more, uh, in-depth knowledge, if, if you don't mind, but I'm glad to answer any questions in the meantime. [0:21:00] That's what I was gonna ask of the committee first. Are there any questions from the committee? Um, Dr. L- uh, Representative Lim, is that you? [0:21:09] No, that's me. [0:21:10] Oh, Representative Douglas. [0:21:11] It's a friendly question. Thank you, Mr. Chair. Um, is this gonna be on humans or animals? [0:21:17] This is all human. [0:21:18] Oh. [0:21:18] Has nothing to do with animals. This is donated... I mean, this, this has been going on a while with the donations of umbilical cord and related tissue. Um, a- a- and, you know, there's some very good companies that, that arrange that. The, there, then there's different groups that actually process it to ensure the sterility and the, um, uh, the safety of the tissue. I- in a small way, similar to the way we try to assure the, the, uh, sterility or the, the safety of organ tissue that's donated. [0:21:45] It's a good bill. I j- I was just checking 'cause, uh, I don't see... She's already left. Chair- Chairwoman Cooper would have a fit if it was messing with her, uh her animals. [0:21:54] We're not, uh, no. We're not, not doing a xeno- [0:21:58] Okay [0:21:58] ... uh, whatever. We're not doing any, um, uh, transfers back and forth. Thank you. [0:22:03] Thank you for the warning. [0:22:04] You got it. Very, very wise to look out f- for that. Thank you. [0:22:08] Representative Gisler. [0:22:10] Yeah. [0:22:10] Welcome. [0:22:11] Um, hey, I think it, it's a great bill, too. Um, I, I, I've just heard from people in the industry that the Georgia restriction could, or do you think that it could limit access to materials that might actually restrict research in the state? [0:22:25] That, that current law would, or- [0:22:28] That- [0:22:28] ... th- that this is somehow introducing a new restriction instead of a relaxation? [0:22:35] Lines- [0:22:36] If you would [0:22:36] ... what is it, about 66 through 69 says that everything has to be retrieved, manufactured, stored in facilities located in Georgia. I'm wondering if that's gonna be a restriction to medical research. [0:22:50] We, um, as far as that, that, that they be registered with the FDA or, um, certified by one of those following entities on line 70 and beyond, um... [0:23:01] No, it's more the located in Georgia part. I'm, I'm just curious. [0:23:05] I think, uh, maybe Mr. Skin Edge here may ha- have an answer for that. [0:23:09] I may be able to. [0:23:09] Okay. Thank you. [0:23:10] Sure, yeah. [0:23:12] Uh, Skin Edge, representing Ponia Therapeutics, and, uh, I, I, just, just right before this meeting, I was approached by some folks from Emory who are, who are doing some research, uh, with animals and, and also, uh, some federally funded research in this area. And, uh, we advised them in terms of putting in an amendment, uh, which I think they're gonna discuss when they present, uh, to, to clarify that this bill will not impede that. Number one, it's limited to humans, and number two, that it will not impede, uh, what I think you're getting at with your question. [0:23:45] Mm. [0:23:45] And we certainly have no objection to that. [0:23:48] Okay. [0:23:48] All right. Thank you. [0:23:48] So there, there are, there are producers in Georgia- [0:23:51] Yes [0:23:51] ... that can meet the need. Okay. [0:23:53] Right. [0:23:53] Thank you. [0:23:55] Representative Schofield. [0:23:56] Uh, that... Thank you, Mr. Chair. That was one of my questions. The other question I wanted to ask the author, uh, or, or Skin, you might be able to add. How many, uh, companies are currently, like, in the space right now in Georgia? [0:24:08] Well, there, there are none in this state. [0:24:09] There are none? Okay. [0:24:10] The purpose of this bill is to allow them to come to Georgia. [0:24:12] Okay. I know he said that there were other- [0:24:14] Physicians use, use these tissues [0:24:17] That they're getting from out of state [0:24:18] ... you said, should be passed in from, from the state. [0:24:21] Okay. [0:24:21] So this just puts us on par with Florida and some other states- [0:24:24] All right [0:24:24] ... so we can compete. [0:24:26] Thank you. [0:24:29] All right. Representative Jaspers. [0:24:31] Thank you. [0:24:32] Chairman Jasperse. [0:24:33] Thank you, Chairman Newton. [0:24:35] Yes, sir. [0:24:36] Question. I mean, you know, I'll read through this, and I just don't, I just got a, just a how it works question. So does the OB contract with the patient who's having the child, baby to acquire the s- [0:24:51] The, the, this- [0:24:52] How does that work? [0:24:53] It's a good question. The, um, the, the therapies and the tissues that are being, uh, processed, manufactured and stored here that are being allowed by line 66 and beyond, um, uh, 63 and beyond, that is, uh, there's already a system in place to acquire this tissue. Usually the, there are entities that go out and, um, uh... Well, I know my son's an OBGYN, and I know when he was in St. Mary's, Georgia, uh, the, the donation people would, would ask the mother if, if she was willing to donate the tissue. [0:25:23] I believe if the physician had kind of a unique... They can't buy the tissue. Like, just like any other organ or any other tissue, I don't believe it's legal to sell. But, um, so they, they do offer to make a donation to charity i- if, if, um, if a physician's willing to cooperate with them. So there's no money that changes hand, both to the donor, uh, mother or the physician involved as well. But they do know it's going for a good cause, either for research or for treatment of others. [0:25:52] Okay. Good. Thank you. [0:25:53] Thank you. [0:25:54] Representative Davis. [0:25:56] Thank you, Chairman. An amendment was mentioned. Is that forthcoming? You s- you stated about- [0:26:02] Is somebody from Emory gonna speak, um- [0:26:05] We got a number of people signed up. I'm not sure. There's a Dr. Mark, and I can't read your last name. Uh, are you from Emory? [0:26:14] No, sir. [0:26:14] No, these are, those were not r- related to Emory. I don't know if anyone is here from- [0:26:19] I don't know. We'll get, we'll, we'll get to them. [0:26:21] There's a, there's a hand. Okay. Good. [0:26:22] We'll get to them when we can. We've, we've got committee members asking, still asking questions. [0:26:27] So, so I don't, I don't have- [0:26:28] Mr. Chairman [0:26:28] ... the amendment language that they would like yet, and I'm glad to listen to it when they bring it. [0:26:32] Okay. [0:26:35] Representative Clark. [0:26:37] Thank you, Mr. Chair. My apologies for being late. I'm running from another committee meeting. Um, and so I apologize if this question's already been asked, but what is the impact on stem cell, uh, research and research for therapies, or for individuals who are getting some of the, um, uh, experimental, um... Like, they're in clinical trials, for example, for, um, stem cell therapies, uh, right now? [0:27:05] Well, two things about that. I believe lines 66 through 74 are all the different organizations that, that are, um, described as, uh, the, uh, the, the categories to, to make sure that this is being done in a, in a proper way, either the FDA or by one of the other four organizations that are listed there. I, I would imagine most of the research related individuals are, are s- affiliated with those kind of, uh, uh, guidelines for retrieval, manufacture, storage, and use of stem cells, like line 63 says. [0:27:41] Um, uh, once again, if there is a organization we left out that, that wouldn't be covered by line, um, um, line 74, any other such entity that Department of Public Health may determine is appropriate, I, I certainly would be glad to add it if it needs to be added as specific language to make sure there is no conflict with ongoing research. [0:28:01] All right. And, and, and that would include clinical trials as well? [0:28:05] Right. [0:28:05] Okay. Thank you. [0:28:06] Thank you. [0:28:07] Okay. Seeing no oth- other questions, let's go ahead and, and, uh, call some folks up who came to speak. Di- Diana Bing. DeAnn Bing? Okay. [0:28:21] Hi. Um, I'm Dr. DeAnn Bing. I'm a board-certified internal medicine physician. Been practicing in the state of Georgia for about 15 years. I have a, a specialty in, uh, functional medicine, also regenerative therapy em- emphasis. So I've had a number of patients that I've encountered over the past few years who've asked me about stem cell therapies and know, they know the benefits of reduction of pain, improvement of range of motion from these therapies, but they're having to seek these options out of state, especially in Florida and now Utah, and also out of the country. [0:28:55] So I feel like this bill would give us an opportunity here in Georgia to provide these services at home b- and increase, you know, revenue for these services here in the state of Georgia, and I think it's just important for us to have these options for our patients because they're aware of them and they're seeking them out. [0:29:10] Okay. Thank you. Uh, up next is Dr. Mark, and I'm sorry, I, I... Come to mic. I, I just can't read your handwriting. [0:29:19] It's okay. It's a doctor's handwriting. [0:29:21] Yeah. [0:29:23] Excuse me. So I'm Dr. G- Mark Guerdin. I'm an anesthesiologist, uh, a member of the ASA, the American, uh, Board of Anesthesiologists. Uh, I practice pain management in my current job, and I do, uh, in- interventional injections in joints and also in the spine, uh, epidurals for people that have disc problems and injections into the facet joints in the s- in the neck and in the spine. And I feel that, uh, when in comparison to anything else, these stem cells, when I've used them and inject them, have worked much, have a much more superior long-term outcome than anything else that I can inject, okay? [0:30:05] Uh, if you use something like, like a steroid, that gives a great immediate pain relief. But four months, six months, a year out, tho- that relief usually dissipates. And with the stem cells, I've found that it's much more superior 'cause the cells are actually doing a regenerative thing. They're not just decreasing inflammation in the area. So, uh- to have that for patients who have really, really bad disease, it's something that offers them hope when steroid injections have not been able to, to affect the area and, and given them any kind of relief. [0:30:41] And when you have 10 out of 10 pain in your spine, you, you, you know, you need something, and that's something we can offer without having to do a major surgery to help these people. Many times I've injected knees and hips on people that n- that normally would need a total hip or total knee re- replacement, and by being able to do this, I've brought them to the years in their 60s when if they get a hip or knee replacement, it will last them a lifetime. Instead of doing it on somebody that's 40 years old and then what are they gonna do in 15 years when their replacement wears out? [0:31:15] So it, it's, it's really, uh, been a great benefit to my patients and something that I, I laud as a, a great breakthrough in medical science. [0:31:25] Thank you. Uh, Representative Schofield, you have a question? [0:31:28] I do. Uh, thank you, Mr. Chair. Uh, so does this actually help with sciatica? [0:31:34] Well, sciatica usually is a condition that occurs from injuries to discs pressing on the nerves that make up the sciatic nerve plexus, okay? Um, in layman's terms, it's a herniated disc that's pressing on the nerve. [0:31:49] Okay. [0:31:49] And when we inject it in the epidural space, yes, it does. It, in, in fact, I think it works better than the standard steroid approach and lasts much longer, perhaps sometimes what I would say would be a lifetime. I've seen in my own practice for the last eight years I've used it that it's lasted more than eight years. [0:32:08] Okay. Follow-up, just point of personal privilege, you have any samples with you today? I'll be glad to have them. [0:32:14] The line forms in the b- basement there. [0:32:15] But, but I do have one question. [0:32:16] When are you doctors today? [0:32:17] What is the cost of this, w- this procedure? What is the cost? [0:32:20] Well, well, it depends on... What I do a lot of is personal injury cases, okay? [0:32:26] Mm-hmm. [0:32:26] But in my own practice, when I do it, it kinda depends on what the patient can afford. [0:32:31] Yeah. [0:32:31] I've done professional MLB, NFL, uh, NBA players who can afford to pay top price for this kind of injection, and then I get to a person who's very needy and, and, and needs this injection, I, I lower the price down to just sometimes cost. And I, I've done injections for free for those kind of people that have, you know, a situation that they couldn't get care like this. [0:32:56] Mm-hmm. [0:32:56] So that's hard to, to really say. But I would say in general- [0:33:00] There's a range [0:33:01] ... the, the, the cells cost anywhere usually between 500 and $1,000 for the cells, okay? Depending on which place you get these stem cells from. [0:33:12] Okay. Thank you. [0:33:12] If that answers your question. [0:33:14] Yeah. [0:33:15] Thank you. Okay. Um- [0:33:16] Did you bring any samples? [0:33:18] Dewey, one more time. [0:33:18] Did you bring samples? [0:33:21] Thank you, sir. [0:33:21] Yes, sir. [0:33:24] Oh, okay. [0:33:25] Sorry. [0:33:27] Representative Gisler. [0:33:29] Uh, yeah, I, I'm sorry I let you get away. Uh, I, I'm just curious, how would this bill help you in your practice? Would it reduce your costs? Would it make it more available? [0:33:40] What it does is really it, it helps my patients more than anything. [0:33:44] Mm-hmm. [0:33:45] Um, because of the fact that, like, as I was talking about, how, how much longevity do you get. Normally steroid epidurals, for instance, only last about six months, okay? [0:33:56] Okay. [0:33:56] And then they need to come back in for more, or they have to go to surgery. And so that's one of the big things it does. It, it basically, it can bring the s- the situation out where they can deal with their problems with their spine or their joints- [0:34:10] Mm-hmm [0:34:10] ... uh, for several more years and then not have to have that knee replacement, have that back surgery. Um, and a lot of the back surgeries, even though they're very successful- [0:34:19] Mm-hmm [0:34:19] ... you end up having to have more and more surgeries done down the line. [0:34:23] Yeah. [0:34:23] With, with these stem cells that kind of basically repair the area, uh, to me, that's what we're looking to do. I- In, in the end, we, we love to help the body heal itself, and that's- [0:34:36] Sure [0:34:36] ... what the stem cells do. [0:34:37] I, I, I get that. I understand that the stem cells are, are powerful. [0:34:41] Yeah. [0:34:41] Um, but you're doing this today. [0:34:42] Yes. [0:34:43] Presumably your practice is in Georgia- [0:34:44] Yes [0:34:44] ... without this bill. So what does this bill provide for you that- [0:34:48] Well- [0:34:48] ... you don't get today? [0:34:49] What does it provide for me? [0:34:50] Mm-hmm. [0:34:51] Is that what you're saying, sir? It- [0:34:52] Well, what, what's the benefit? Why, why should it matter? [0:34:53] The benefit is, is that we don't have to go to Florida. That's where I get my stem cells a lot of the time- [0:34:58] Okay [0:34:59] ... is out of Florida. Uh, I would name the laboratory, but I don't think we need to do that. But that's how I get my stem cells. They ship them to me on dry ice, uh, at negative 70 degrees. [0:35:09] Yeah. [0:35:10] And I'm able to get them out, uh, heat, warm them up, and then put them back in the body at that point so that they're all alive. And then I don't have to go all the way to Florida to get these cells and hope that I have enough that I can do my injections. [0:35:24] Yeah. [0:35:25] Because you have to coordinate it really well outside a day, and those cells may not be any good anymore. [0:35:31] Okay. [0:35:32] Okay. [0:35:32] That, that helps. I, I guess it kind of brings it back to the other point, though, that if you have to get them from Florida today, do we have enough of an industry here in Georgia today- [0:35:41] Yes [0:35:41] ... to implement those steps? [0:35:41] I, that's where I came, uh, to testify for Pawnee. They asked me to come 'cause I, that's where I get some of my cells here from now. [0:35:48] Okay. [0:35:49] 'Cause I used to get all, all from Florida, now I've started to get them from them. [0:35:52] Okay. [0:35:53] And they asked me, can I come and let people know what a good j- and they do a great job here. [0:35:57] Okay. Okay, thank you. [0:35:59] Representative Davis. [0:36:00] I was just gonna ask, is this covered by insurance? [0:36:03] It, it's not covered by insurance. The, yeah, it's just, it's not, it's not Medicare and Medicaid approved, okay? And so that's where you run into that. If it's not Medicare and Medicaid approved, then insurances are not gonna approve it. [0:36:18] Okay. [0:36:19] It's always looked upon as it's research. Now, I do tell people in my consent that th- there's no guarantees from this, and it is not a standard way of doing things. And I tell them, give them alternatives. But- [0:36:32] In the end, this is what I've seen in my practice, and I haven't seen one failure of those stem cells in the last eight years that I've been using them. So that tells me they're working really well. Thank you very much. Yep. Appreciate that. Uh, Joey Martinet. [0:36:52] Hi. Thank you. I represent the Catholic Bishops of Georgia and the Archdiocese of Atlanta, Roman Catholic Archdiocese of Atlanta, and, uh, Roman Catholic Diocese of Savannah. Uh, we're happy to support this bill. We, uh, we wanna help as many people with, uh, with great science, with adult stem cell research. Uh, where we have, uh, issues is when that comes at the expense of innocent human life. And as I understand it, that this bill does not cross over into that territory. So this is, this is ethical adult stem cell research that we're happy to support. Thank you. [0:37:23] Okay. Mike Griffin. [0:37:32] Thank you, Mr. Chairman. I am Mike Griffin. I'm the Public Affairs Representative with the Georgia Baptist Mission Board, and we do, uh, support Representative Newton on this legislation. We do feel that some great ethical legislation is needed. We like the statement that's made here that says that it's to ensure that stem cell therapies are used to advance medical treatments and improve patient outcomes to an ethical manner that does not involve stem cells derived from aborted fetuses. I think that's tremendous. I think he's... We're looking in the right direction from the ethical standpoint and, uh, the sanctity of human life. [0:38:07] But, you know, we're trying to advance and help people, uh, to, to take care of their medical needs, and I believe this is the proper way to do that. So we do support it and we appreciate it. Thank you. Thank you very much. Thank you. Thank you. Sydney Wilkins [0:38:23] from Emory. [0:38:29] Hello, I'm Sydney Wilkins with Emory. Um, we do not have an issue with the intention of this bill. We do have some ongoing research that is, um, regulated by the Institutional Review Board and our Escrow Committee, and we just wanna make sure that's not impacted. Um, in particular, we have a lot of research that goes on with animal stem cells, um, that helps us research birth defects and pregnancy complications. So again, um, we got some of the feedback from our general counsel yesterday, um, to protect that. So would love to work with the bill sponsor, um, to just make sure that that's protected. [0:39:03] But no issue with the underlining intent of the bill. Do you want to speak to that? Um, just is there... Uh, that is certainly not the intent. Correct. And most of everything in here refers to human stem cell, and then does... There are the, uh, the organizations that which, which oversee, uh, at least the, um, uh, accrediting organizations- Okay ... or approving organizations. Nothing in this is intended- No ... or not, and I don't believe affects any animal stem cell research. There's a couple of sections where the, uh, the human part is left out before the stem cells, so we were just hoping to maybe get the human piece in. [0:39:40] Would you like us to add that on a couple of... Do you know where, or can you tell us before? I have it on my computer, and I can send it to you right now. Oh, do we want it now? Do you... Well, before we pass the legislation, I- I'd like to have it before- If we pass it the way it is- It is the way it is ... it'll hit the rules- Well- ... and then it'll have to b- be bounced back. Right. Re-committed to, to this committee. Can you tell us the locations? Oh, thank you. Yes. Okay. So on line 12, "significant potential of clinical human stem cell therapies." Is it everywhere where it says stem cell, you just wanna put human in front of it? [0:40:19] Yes. Yes. To- Obviously over at the definition- ... 16- ... on line 50. [0:40:38] I, I mean, I'm, uh, I'm, I'm glad to, to specify in front of- Okay ... stem cell therapy. Sure. In particular, line 50. Okay. Which we'd be, we'd just change to human stem cell therapy. That's what this is all meant. And but really every other place the stem cells are referenced. Um, Vince, was that, um... Can we just- I guess if I could have, uh, the authority from the committee just to do a, a universal change to these locations as well. Yes. If somebody'll offer that amendment, that'd be great. In case we miss something, that way we don't have to redo this again. [0:41:11] I appreciate it. I- Thank you. Yes. Thank you. You good with that? Yes. Thank you. All right. All right. Okay, I see no other questions. No one else is, uh, set to speak. Do I hear a motion? So moved. Second? Second. Okay. Now we have an amendment before us adding human before stem cells throughout the bill per the Legislative Council. Do I hear a motion on that? Motion. Second on that? Second. Okay. Let's vote on the amendment first. All those in favor say aye. [0:41:41] Aye. All those against say nay. Okay, now to the main body of the bill as amended, 46-14-20, House Bill 1275. Do I hear a motion? Well, we already had a motion. Okay, all those in favor... Uh, well, no. I need a motion as amended now. Do I hear a motion? So moved. Second? Second. All those in favor say aye. Aye. All those against say nay. Congratulations, you got your bill. Thank you, Chairman. Thank you, committee. As amended. I'm sorry, what? [0:42:12] You had two nays. Two nays. Oh, two no's? Oh, I didn't hear you. I apologize. Okay. Now Representative Frye. You're on deck. [0:42:47] What's the LC on- [0:42:48] My friend from Athens, Georgia. [0:42:57] Representative Parsons, Chairman Parsons, do you need a, a packet? I do. Okay. Mark. Nevaeh, we need one for Representative- [0:43:08] Yes, sir [0:43:08] ... Parsons, please. Okay. Excuse me, Representative Frye. Go ahead. [0:43:16] Thank you, Mr. Chair. Um, I do not have a copy of the bill in my folder. [0:43:21] Oh. You need an extra one. [0:43:23] Yeah. [0:43:25] Think you need another copy. [0:43:25] And I apologize for that, I thought I did. [0:43:27] That's okay. It was a long nap at lunch, right? [0:43:33] I sort of- [0:43:33] I know- [0:43:33] I sort of did well [0:43:34] ... he just drove in from Athens, so that, he's got a reason. And I called him this morning about this bill, so. [0:43:42] Okay. I've, I've got a copy now. Um, members, uh, Mr. Chair, I thank you for the opportunity to present this bill. I'm looking at LC600270. [0:43:56] Thank you. [0:43:58] It's a very simple bill. [0:44:03] Basically, um, in Georgia, we have two skilled nursing veterans nursing homes, and we heard testimony from the commissioner that we could use six more. Um, some estimates have actually said that we could use eight more. Um, the two homes that we have that are state-run were established, first one was, um, right after World War II, and the second one was during Vietnam. [0:44:37] Now, we had a pretty high population of veterans at the time, but that has waned and then picked back up to where we do need, um, a number of facilities for these folks that have served our country to go to, especially with the onset of the retirement of the baby boomer generation coming on board in Georgia, as well as all of the incentives that we provided veterans to, uh, wanna move here, and the different tax liabilities that we have, uh, res- rescinded for their income. [0:45:13] So basically, this would remove the requirement for a certificate of need, but only for skilled nursing homes that serve veterans. And the idea that potentially we could entice the private sector to come in and try to partner with the state, uh, which probably w- would be the angle. I'm not gonna say that the, uh, government is gonna be paying full bore for our veterans care, but the federal government, but potentially we could entice the private sector to do a public-private partnership into this. [0:45:51] Um, Florida is going through a similar situation, although they have, um, six veterans care facilities at the time, and but they passed this bill, a similar bill, in '25, and they're already seeing another home being built this year. Um, I can't necessarily guarantee that was because of the, that legislation. We couldn't figure out the timelines, but, um, certainly something we need to look at in order to give our veterans a place to go when they need the care they need without having folks go through a bunch of red tape, um, going through a CON, which we all know is, is a little difficult sometimes. [0:46:34] I can appreciate this. Both my parents were veterans of World War II. My mother was WAVE and my father was in the Navy Air. They both died of strokes. There was no opportunity for them, but I appreciate it. [0:46:46] Same here. I was the son of a Vietnam veteran. I was born during Vietnam, so this is, uh, I may not seem like an Army brat, but this is sorta, um, near and dear to my heart for sure. [0:46:58] Sure. Sure. Are there any questions? [0:47:06] Is that... Does someone have a... Oh, you just... Okay, you hit it. All right. Well, I see no questions. Do I hear a motion? So moved. Do I hear a second? [0:47:17] Second. [0:47:18] All those in favor say, "Aye." [0:47:19] Aye. [0:47:20] All those against say, "Nay." [0:47:24] All right. Congratulations. You- [0:47:26] Thank you, Mr. Chair. [0:47:27] Yeah. [0:47:27] Thank you members of the committee. I appreciate the opportunity to do- [0:47:30] You did your best. Thank you [0:47:30] ... pass the bill out of here. [0:47:33] All right. [0:47:34] Appreciate y'all. [0:47:35] Appreciate you. All right. Representative Au. Uh, 326, HB 326. [0:47:45] Uh, thank you, Mr. Chairman. Dr. Hawkins asked if I could do this in five minutes. I can do it in three. Watch me. So we already talked about this bill already. This is HB 326, the Non-Opioid Coverage Parity Act, and basically what it aims to do is ensure that non-opioid-based pain medications are covered for state health benefit plan, uh, carriers at rates no less favorable than they cover opioids. And what this aims to do is to prevent a prescription bias towards opioid-based pain medications just because they're older and more often to be covered by insurance, um, because biasing prescription patterns towards opioids increases patient risk for dependence and addiction in the future, and we know that very well now. [0:48:28] Um, you should still have the packets that I handed out. That was from last time. We don't have to walk through it, but the top sheet is the most important. It is the final study report from the, uh, committee that looked at, um- Alternatives to opioids for pain management. And one of the recommendations of that study committee headed by Chair Lady Dempsey recommended exactly this. Last time we spoke, we had a, a number of people come testify in favor of this bill, including the Medical Association of Georgia, Georgia Society of Anesthesiologists, Georgia Dental Association, um, Jeff Breedlove from the American Addiction Recovery Association, and a family member who lost her son to opioid addiction after receiving short-term opioid prescriptions for, um, a sports injury. [0:49:11] So, um, if you have any questions, I'm happy to take them. Otherwise, I ask for your favorable support for this bill. [0:49:15] You do have a question. [0:49:16] Yes, sir. [0:49:16] Representative Parsons. [0:49:19] Thank you, Chairman. I just wanted to ask you, uh, it sounds like it makes sense. It sounds like it does, but I, my question would be, is there any likelihood that, uh, that patients would get a less effective pain medication because of this if they were also covered? [0:49:37] That's a great question. I think that, um, Representative Davis asked a, a similar type question last time. Nothing in this bill dictates clinical practice or judgment, right? So sometimes, like I said in my first presentation, sometimes opioids are the correct prescription for a patient, especially for things like cancer pain, um, some types of chronic pain, right? So nothing in this indicates that you should not prescribe opioids. What we're trying to do, however, is prevent people from prescribing a medication that they feel may be more appropriate for a patient simply because of insurance coverage issues, right? [0:50:07] So the physician or medical provider's judgment would still be at the top with respect to if opioids are appropriate. They can still provide them, and there's no detriment to that judgment. [0:50:18] Thank you. [0:50:19] You're welcome. [0:50:20] Who do we have? Clark. Okay. Representative Clark. [0:50:24] Um, thank you, Mr. Chair. Uh, so, um, Chairman Parsons stole my first question. But, uh, my second question has to do with line 66. Um, it says that this shall become effective, um, about two months ago. So do we need to change that? [0:50:48] We do. [0:50:48] Or is this just like, because if it becomes effective two months ago, then we are good to go? [0:50:56] I like how she thinks. [0:50:57] Very good to point that out, and I- [0:50:58] She's smart [0:50:59] ... I think she did have an amendment. [0:51:00] Yes, I do have an amendment. Thank you for reminding me that, uh, one amendment to change in line 66, 2026, to change it to 2027. Obviously, you can tell from the bill number that I dropped this last year immediately after the conclusion of the study committee I cited. [0:51:14] Right. [0:51:14] So. [0:51:15] Okay. Thank you. That was a good- [0:51:17] Good one [0:51:17] ... pickup. [0:51:18] See, she reads the bills. I like this. [0:51:20] All right. Um, I see no other questions. Do I hear a motion? Okay. Uh, now we have the, uh, amendment before us. Uh, that is on line 66, changing 2026 to 2027. Do I hear a motion on the amendment? [0:51:39] So moved. [0:51:40] Do I hear a second? [0:51:41] Second. [0:51:42] All those against, say aye. I mean nay. [0:51:44] Yes. [0:51:45] All those for. Excuse me. All those for say aye. [0:51:48] Aye. [0:51:49] All those against say nay. Okay, now we're back to the, uh, main bill as amended. This is House Bill 326 as amended. All those in favor say aye. [0:51:59] Aye. [0:52:00] All those against say nay. Congratulations, you have your bill. [0:52:05] Thank you, everyone. [0:52:06] Thank you. Okay, let's see. [0:52:12] How about Representative Camp, 1138? [0:52:21] Thank you, Mr. Chairman. Um, today I bring to you House Bill 1138, and it is a substitute. It's LC461461S, as in Sam. And this is the bill we heard last time. Um, thank you for allowing it a second hearing. Um, this bill increasing access to contraceptive acts, allows pharmacists to dispense self-administered hormonal contraceptives like the pill or administer, um, injectable hormonal contraceptives like progesterone shots. Um, it amends the state insurance code that requires insurance to provide coverage for extended supplies on certain contraceptives. [0:52:57] Um, it, uh, also amends the me- uh, the state's medical board to waive liability, allowing pharmacists acting under this bill not to face malpractice or discipline for following expanded provisions. And it changes Georgia's Medical Assistance Program by amending a previous law, allowing Medicaid and state-funded programs to cover certain contraceptives and extended supplies of those contraceptives. [0:53:19] Bad news. [0:53:20] Uh-oh. [0:53:20] We don't have the correct bill. We don't have your substitute. [0:53:23] Oh. [0:53:24] Yeah. Uh- [0:53:24] Well, you know what? I'm okay acting off the first one, if that would be better. We, you know what? [0:53:35] I'm gonna dive, I'm gonna back up. [0:53:37] Okay. [0:53:37] I don't believe I ever gave you the substitute. [0:53:39] Can you rewind this? [0:53:40] Y- may I rewind? It does the same thing. [0:53:42] Rewind, rewind, rewind, rewind. [0:53:42] Um, let me rewind. All right, so I believe, and I do, I do apologize. [0:53:46] That's okay. [0:53:46] This has been a very hectic day. [0:53:48] Yeah. [0:53:48] But, uh, for all of us, right? We've all been running around a lot. I apologize. Um, I believe that it was decided not to move forward with a sub, if memory serves, and, um, there was a reason for that, and there's a reason why you did not get copies of that, sir. [0:54:02] Oh, that's a real rewind. [0:54:03] Yes, it is. It's a very big rewind. So I am working off of LC461351. Is that the one on your end? [0:54:10] We have that. [0:54:11] Well, hey- [0:54:12] We can do that [0:54:12] ... now we're cooking with gas. [0:54:13] Yeah. [0:54:13] All right. So it does all the same things as I told you it did. [0:54:17] Save us. [0:54:18] Save us. Yes, please. Um, but the purpose being that, and we had individuals come in last time and testify in favor of, this is allowing pharmacists to prescribe and dispense birth control to individuals throughout our state. This is done in 36 other states. Um, I wish I had reinvented the wheel and I was coming with some groundbreaking information. But there are- Two-thirds of our country already successfully doing this. And in many areas, um, we heard the president of the, um, Georgia Association of OBGYNs last time testify there are 82 counties out of 159 that do not have an OBGYN in their county. [0:54:56] Right. [0:54:57] Oftentimes, a pharmacist is going to be the medical professional they're gonna see most often, and pharmacists are, you know, you know their hours, um, it's posted on the door. [0:55:07] Mm-hmm. [0:55:08] Uh, I was startled by a statistic that 10% of the pregnancies that happen in the state are not intended or were intended to happen later, and most of those are because of birth control failures or access to contraception in general. Um, and I'm open for any questions. [0:55:24] Okay, a- and I will remind the committee we held this bill last time, had a hearing only because we were not sure of the fiscal note. Uh, DCH has advised me that th- this would be minimal and a fiscal note was not necessary. We have a question, uh, Representative Clark, yes? [0:55:41] Yes. Thank you, Mr. Chair. [0:55:42] Oh, I tell you what, try that other mic so you don't break your neck. See- [0:55:44] Oh [0:55:44] ... see if that one- [0:55:45] That works today [0:55:46] See if, see if that works. [0:55:46] Yay. That works. [0:55:48] Okay, good. [0:55:49] Perfect. Thank you, Mr. Chair. I'm so used to it not working that I didn't even try. [0:55:54] That's part of my job. [0:55:55] Um, so my question is about, uh, lines, uh, 120 through 124, the disclaimer that is required, um, about the effectiveness of abstinence. Is this something that, um, or I guess, like, what is the rationale for having that there? [0:56:13] Well, uh, I mean, in quite honesty, I told this to my daughter, and I mean, this was told to me, and this has been told to me by multiple physicians, the only way you can 100% guarantee you don't get pregnant is not to do anything to get pregnant. And although birth control methods are highly effective, the only 100% effective birth control metho- method is abstinence. Um, even there are still unintended pregnancies, um, with IUDs, with, with the pill, with Depo shots. [0:56:45] Um, human body is an amazing thing, and that is the only 100% way. And also, it also goes as far as, um, infections. Um, the only 100% way to make sure that you do not encounter a, a sexually transmitted disease is not to have sexual activity. And just letting someone know that, um, uh, we want everyone to make good decisions. I'm not trying to legislate morality by any means- [0:57:10] Yeah [0:57:10] ... but letting someone know the reality of the situation's important. [0:57:15] Um, thank you. A follow-up to that, because I agree with you that information is wealth, um, do we require physicians to also, um, hand out written materials, um, for, with this similar disclaimer when prescribing? Like, if they were to go to the doctor, do they have to also get this type of mater- written material? [0:57:34] That's a good question. Um- [0:57:35] They would get that from the pharmacist if they were to- [0:57:37] I was gonna say it would be in, it would probably be in the pharmacy leaflet with the pills they get. [0:57:41] Yep. [0:57:41] Um, and we have someone who might be able to speak to that. Could you speak to that? [0:57:45] Sure. [0:57:46] All right. I've got Dr. Rebecca Stone here, Mr. Chairman, if you'll indulge me. [0:57:50] Sure. [0:57:50] She actually teaches pharmacy school at the University of Georgia. [0:57:55] Go Dawgs. [0:57:55] Go Dawgs, exactly. And we are honored that she took the long drive from Athens. She could've ridden with, um, Representative Spencer Frye- [0:58:02] That's right [0:58:03] ... but he didn't offer. [0:58:04] He didn't. No. [0:58:06] He leaves really early. [0:58:07] Hi. Thanks for allowing me to be here today. My name's Rebecca Stone. I'm a clinical professor at the University of Georgia. Uh, I have to start off by saying I don't speak on behalf of the university, and everything that I say today are my own personal thoughts and opinions. Um, so I prepared a brief statement. I think if it's okay, I'll go through some of this. [0:58:25] Well, if, if- [0:58:27] What would you prefer? [0:58:28] Would you ans- answer her question- [0:58:29] Absolutely [0:58:29] ... about the leaflet? Yeah, I mean... [0:58:30] Yeah, so OBGYNs and other primary care physicians are not compelled to give specific statements about abstinence to patients. Um, that would... I would advocate that pharmacists should be given the same latitude as some of those other providers in providing clinical, um, counseling as needed by the patient. Um, that is something you could include in materials to go with the medication regardless of what prescriber it came from. [0:58:58] Okay. Thank you. [0:59:01] Okay. You had something else you wanted to say, or was that it? [0:59:02] Yeah. I just wanted to say, um, you know, I started at UGA in 2016, couple years after Oregon and California first started to allow pharmacists to prescribe birth control, and we immediately started to overhaul our curriculum to make sure our graduates would be ready to do this if and when Georgia decided to allow pharmacists to prescribe. We teach contraception in six courses in our core curriculum covering all three years of our didactic classroom, including over-the-counter progesterone-only pills, condoms, and emergency contraceptives, and then all of the self-administered pill, patch, ring, and long-acting removable contraceptives, IUDs, and arm implants. [0:59:40] They undergo a simulation where we use other states' pharmacist-prescribed protocol to practice pharmacist prescribing, and we've been doing this for just shy of the last decade, since 2017. Um, I wanted to just go on and say this is a structured, progressive, and clinically rigorous education that has prepared our graduates to provide this service. In addition to teaching, I've conducted research in this area. In 2021, we, um, surveyed students at UGA, Mercer, and South. [1:00:13] 97% of the students, the 400 students we surveyed, said they were interested in prescribing contraception, and 92% agreed that they felt well prepared to provide this service. We also did a survey of Georgia pharmacists who had boots on the ground in practice. Uh, 74% agreed that providing hormonal contraception was within their scope. 65% of pharmacists said they were already well-educated and trained to prescribe it. And keep in mind, many of these pharmacists had not already gone through our updated curriculum or received some of the additional training proposed in the bill. [1:00:49] 85% believe that pharmacists prescribed contraceptives with improved patient access. And to me, uh, this statistic is the critical one. So as, um, we, we mentioned earlier, pharmacists are the most accessible. We work nights, evenings, weekends, and holidays, right? No, um, no appointments are required. And for people who face transportation challenges, childcare challenges, time constraints, or other provider shortages, this is another way. So this is particularly important in rural Georgia, where primary care shortages are significant and 83 counties lack OBGYN prescribers. [1:01:23] Practice... Pharmacists already practice in almost every county in Georgia. In our urban counties, there's tw- an average of 21 pharmacies per county. In our rural counties, there's an average of six pharmacists per county. So allowing pharmacists, who are a highly trained workforce, to expand access in this way leverages existing infrastructure and geography. I don't believe this bill replaces physicians. It doesn't eliminate the importance of comprehensive reproductive care. It gives another access point within a collaborative healthcare system. [1:01:56] Pharmacists are trained medication experts, and it aligns directly with our education and contraindications, interactions, and pharmacology. So- [1:02:06] Okay. Thank you. You have a question. Representative, uh, Chairman Parsons. [1:02:11] Thank you, Chair. Thank you, Chair. My question is actually for the author, but- [1:02:15] Okay. Go ahead. [1:02:17] I know that it's been discussed in here before, apparently, and I know we, we discussed it, uh, some conversation about this before, I think, it was introduced. But my question's about line 32 to 34. I'm just wondering, uh, under 18 years of age, but there's no, there's no, uh, minimum a- minimum age, uh, what exactly, evidence, what is the evidence? Like, presenting a, presenting a prescription? [1:02:47] I've got- [1:02:47] A copy of a prescription. And then I guess, too, and my question would be, and this may be way off the chart here, but, I mean, wouldn't that be, under 18, wouldn't that be, uh, a signal maybe that there's, that, that, that person, the, the young lady could be a victim of trafficking to be under? I mean, that could be 14, 15, 13. [1:03:06] Uh, without a doubt. And thank you for that question, Chairman Parsons. Um, it, it's only in accordance with a, with a patient who is 18 years or older, or 18 years, or the person has evidence of a previous prescription. Um, that most assuredly could be evidenced, um, unfortunately, that someone could be in a situation where they were, um, being mistreated and possibly trafficked. [1:03:28] Yeah. [1:03:29] Um, but there again, there would be seeing a, they would be seeing a pharmacist face-to-face. And, um- [1:03:36] I don't know [1:03:36] ... I don't know if, if perhaps we need to put some language in here that, um, the pharmacist could make sure that they were okay. But, but most assuredly, seeing that individual face-to-face would be pretty important to me. Um, if they were under 18, they would have to pres- pr- provide a prescription. Um, and maybe, um, Dr. Stone can help us on this, but when you're filling a prescription or, or seeing a patient, um, you'd get information just like a doctor would, like an, an ID and that type of thing to, to prescribe. Is that typically the case? [1:04:06] When you enter someone in the system, you're putting in basic information, their address, their health insurance, their contact information. So for them to receive medicines from your pharmacy, you are collecting basic demographic information. [1:04:19] Well, I'm not, I'm not suggesting that anything else goes in there. I'm just, just ex- mayha- just out of curiosity, s- so asking a question, how, how young can, uh, a child really get, um, uh, get a prescription for, uh- [1:04:34] So in the over-the-counter setting, we don't have laws limiting, like, m- minimum age requirements. If a child walked up to buy Tylenol, the, we would probably give you pause and ask questions, 'cause if you take too much Tylenol, it would poison you and die. In the same way, if a child walked up with a prescription that didn't seem appropriate, you'd probably ask additional questions about the, um, source and the need for the prescription. [1:04:56] Well, I'm talking about a doctor, though, that actually prescribes a pres- prescript- uh- [1:05:00] If it's pre- [1:05:00] ... got a prescription. How young can he pr- for a, uh, a girl, can he prescribe a prescription for? I mean, how young? [1:05:07] There are no limitations. [1:05:08] Is there no limit to that? [1:05:09] Mm-mm. Well, but not everyone is on contras- not everyone takes contraceptives for contraceptive purposes. [1:05:16] Mm-hmm. [1:05:16] Um, some people are on birth controls- [1:05:18] Okay [1:05:18] ... or other methods because of, um, hormone irregularities, um, severe acne. There's a whole litany of reasons why young women- [1:05:26] Okay [1:05:26] ... are on birth control that have nothing to do with sex. [1:05:29] You've answered my questions. [1:05:30] Okay. [1:05:30] Thank you very much. [1:05:30] All right. Thank you. Representative Kelley. [1:05:34] Thank you, Mr. Chairman. Um, apologize for running late. Been down in the judiciary committee since a little before lunch, and don't mean to bring any of that up here, but- [1:05:45] Yeah [1:05:45] ... uh, Chair Lady Camp, um, I appreciate what you're trying to do in this bill. I'm looking at lines 157, starting there section four. Is this creating blanket immunity, uh, for a prescribing practitioner in this legislation? [1:06:04] It is not. That's a wonderful question. I spent a great deal of time on the phone, um, on a conference call with, um, a number of individuals from the Medical Composite Board, and all this is doing is as long as they follow the protocol, which is going to be established, which is you do A, B, C, D, E, F, G, then there would not be liability. If they veer from that protocol, which is my understanding in the medical field anyway, if, um, if you don't follow protocol, then there could be a liability issue. [1:06:37] But right now, there's no liability coverage for pharmacists prescribing these medications. They are under the Medical Composite Board, and that's why that terminology is there. [1:06:49] Mm. A follow-up, Mr. Chairman. [1:06:53] Go ahead. [1:06:53] So if a practitioner follows the protocol from the Georgia Medical Composite Board, are they immune from full civil liability under just the regular justice system in the state? [1:07:05] They are not. That is- that's my understanding, they are not. [1:07:10] Now l- let me back up here just- [1:07:13] Yes [1:07:13] ... a second for clarity. Did you say the pharmacists were under the Medical Composite Board? [1:07:17] In, in the prescribing, because that's where the protocol comes for this particular... Am I misspeaking here? [1:07:23] I think they'd be under the Board of Pharmacy. [1:07:26] Well- [1:07:26] Under the ACA [1:07:26] ... they're working in conjunction. Um- [1:07:28] Yeah, they're- [1:07:28] But the ability, it says here, um, "Civil liability, criminal liability, professional discipline, uh, for acts of omission resulting from dispensing or administering the hormonal contraceptive or administering of the injectable hormonal contraceptive." [1:07:43] I guess, could I get clarification from legislative counsel- [1:07:46] Yeah, yeah [1:07:46] ... Mr. Chairman, 'cause that looks like blank immunity. [1:07:49] Right. This does, this does indicate that as long as it's in accordance with basically the, the regulations, they would be immune. [1:07:59] Can he get that? [1:08:00] Um, they would be immune from civil liability, criminal culpability, or professional discipline as long as they're in compliance with 26-4. [1:08:11] Could you come to a mi- I'm sorry. [1:08:14] Is there some- [1:08:14] It sounds like a pretty detailed answer. [1:08:17] And I was gonna say, is there some way to resolve this? We certainly don't... If, [1:08:24] if they do something wrong, we certainly don't want to- [1:08:27] Th- that's what I'm just trying to get to [1:08:29] ... protect them [1:08:29] ... is, is right now in, in our civil justice system, we have at least some form of if there's negligence or gross negligence, there's still an ability to seek redress. And this though says is not subject to civil liability. [1:08:44] That's correct. [1:08:45] And that is- [1:08:46] Regardless of what, what they do. [1:08:48] Well, as long as what they do, the... My understanding, if this is not the intent of the author, then obviously we'll change it, but my understanding is that, y- you know, this, I mean, this reads that if, um, the individual acts in compliance with 26-4-53, then they're not subject to civil liability, criminal culpability, or professional discipline. So it is, it is, it is broad, uh, protection. [1:09:15] Is that, is that something that would be in accordance with other... [1:09:23] Is, is that in accordance with other- [1:09:25] Um- [1:09:25] ... medical professionals who provide prescriptions? [1:09:28] Well, I mean, I think, I mean, the point is, is, is as long as they're following the kind of, it's like as long as they're following the rules that they're required to follow, that they're not gonna be, you know, they wouldn't be subject to civil liability, but that is very broad protection, there's no doubt. [1:09:41] That's- [1:09:42] J- [1:09:42] I don't know of many places in the code where that does exist, where we say we're gonna give a group of unelected people an opportunity to dictate a group of rules governing their own industry, and if you follow that, then you're s- you're immune from civil liability. [1:09:57] I think you're accurate in that. [1:09:59] Okay. Thank you. [1:10:00] Yeah. Well, thank you. [1:10:02] But- [1:10:02] It, well, Legislative Counsel, Vance? [1:10:04] Do you want to- [1:10:04] Is there a remedy to this? [1:10:06] Well, sure. [1:10:06] I can- [1:10:07] Will [1:10:07] ... draft an amendment. [1:10:09] Strike it. [1:10:09] Okay. Why, why don't we do this then? Okay, then why don't we do this? It sounds like we're at an impasse right now. We're not gonna write a bill during committee. [1:10:18] No. [1:10:18] So why don't we, um, table this bill for this time and give you a chance to come back next week, a third run at this thing. All right? [1:10:28] That works for me. [1:10:29] Okay. [1:10:29] Thank you so much, Mr. Chairman. [1:10:30] I got a bunch of slides to go through. Is that- [1:10:33] Thank you. [1:10:33] I, I, I Googled the, uh, Georgia Medical Composite, and the pharmacists are not under that. They are- [1:10:42] No, they're not [1:10:42] ... not. [1:10:42] They have their own board. And so I have a little bit of question about how this is gonna be regulated. The Composite Medical Board, if they took action, couldn't take the license, my understanding of the law. Is that correct, Counselor? [1:10:55] Well, and I, I think, Mr. Chairman, when we're looking at it, it may be when it talks... Because it's a little un- un- unclear to, to me, is it, if it, it references a practitioner who issues a standing prescription drug order. So to me- [1:11:10] Well- [1:11:10] ... it looks like we're going back to the definition which is in 22, because it's almost there. And I don't know if on 162 we mean a practitioner, it means a prescribing practitioner- [1:11:24] Okay [1:11:24] ... who issues a standing order- [1:11:27] All right [1:11:27] ... which would reference back to the doctor, which would be under the Composite Board. [1:11:31] Okay, it's tabled, and, and we'll work on this, on this a little bit more. [1:11:35] We will work on this. Thank you very much. [1:11:37] Yeah. Okay. All right. [1:11:40] I didn't mean to, to- [1:11:41] No, no, no, no, that was a good question. That's a good question. Okay, let's see. Who do we have up next? How about Demet- uh, Representative Douglas? [1:11:55] Oh, that sounds like a good idea. Thank you. [1:11:58] Uh, you can speak from there. [1:11:59] I can? [1:12:00] Are you three or four? [1:12:01] Uh, five. [1:12:04] Oh, you're five? [1:12:06] Yes, sir. [1:12:08] Okay, go ahead. [1:12:10] All right. Thank you, Mr. Chair. Thank you for allowing me to speak- [1:12:15] Yeah [1:12:15] ... in support of this legisl- legislation today. [1:12:18] Just do a- [1:12:18] I have- [1:12:19] ... test on that mic. I'm not sure if you're- [1:12:21] Testing, one, two, three. Testing. [1:12:23] Go ahead. You did... No, we all- [1:12:25] You have a big crowd. [1:12:26] Okay, now. [1:12:27] Hello? [1:12:28] Yeah. [1:12:28] You got it. [1:12:28] All right. Thank you, Ms., Mr. Chairman. I am excited to have the opportunity to bring forth with you, um... First of all, let me say we're working off a sub. If I can pull that out and give you the correct numbers. [1:12:46] Yeah, it's LC461395S. Does that help you? [1:12:51] 95S? [1:12:52] Mm-hmm. [1:12:53] That is correct, sir. [1:12:54] I think everyone has a copy of that. [1:12:56] Everybody has a copy of that? [1:12:57] You good? [1:12:58] Okay, good. It's basically I bring forth to you, it's, it's basically a, um, peripheral, uh, artery disease. It's called PAD for short, and basically it's a one-time test, uh, for arteries that have shrink, shrunk, shrunk over time. Uh, it's a, a one-time test. Um, it's mainly done for, uh, people over 50 or around that age or older, and it is done pretty much like a blood, a blood pressure test. [1:13:32] Put something around your ankle and it's done in two minutes. And that's the gist of the bill. I don't wanna get into the weeds. It's pretty much like, um, um, Representative Kelly's bill with doing research and trying to find a remedy for, for, um, this cancer stuff before it gets started. [1:13:52] Right. [1:13:54] It's on the same, same- [1:13:55] The shrinking of the arteries. [1:13:56] Yes. [1:13:57] Should we have a headband for legislators on this thing too, you think? [1:14:00] You will have one if it go, gets across the finish line. Yes, sir. [1:14:05] Okay. Are there no questions? [1:14:09] No, it's good. [1:14:10] You gotta be kidding me. One, two, three, four, five, six, seven, eight, nine, 10. Good, we're still. Okay, do I hear a motion? [1:14:17] Motion to pass. [1:14:18] Motion to pass. [1:14:19] Do I have a second? [1:14:21] Second. [1:14:21] All those in favor say, "Ah." [1:14:23] Ah. [1:14:23] Ah. [1:14:23] All those against say, "Nay." Congratulations. [1:14:26] Thank you. [1:14:27] LC 461395S has passed. Okay, I see that, uh, Representative Kelly has stepped out, so we'll, uh, hold on his for right now. How about, uh, 1278, Representative Hawkins? Is he here? [1:14:48] We're not sure. [1:14:49] Yeah. I, no, we're good. [1:14:54] Uh, I think Jasper can do it. Would you mind chairing? [1:15:04] Oh, we got buttons. [1:15:04] Yeah. [1:15:07] Which bill? [1:15:08] 1278. [1:15:10] Chairman Hawkins, we look forward to hearing your bill, 1278. [1:15:16] Okay. Uh, this was actually... Making sure I got the right one 'cause I got two. [1:15:23] Can you tell us what number you're working off of? [1:15:26] Yeah. Uh, LC 521018. [1:15:31] Thank you. [1:15:32] Looking for my copy. I've got underlined here. I don't, I don't have it. Okay. I apologize. I had a highlighted copy that's gotten lost in all this paperwork. It was supposed to be in there. Um, this, this bill speaks to, um, sedation, and it says, also says general anesthesia in the bill. This does not affect general anesthesia. What this bill does, and this bill was actually brought to me by the Board of Dentistry, and the reason it was brought is because we have had a difficult time getting, uh, dentist conscious sedation permits in especially southwest Georgia. [1:16:18] It is a long trek to go down there. In the law, previous law and rules, it required a site visit. That's where they're having problems. So they have come back and want to change each section in the bill where it says site visit, and I apologize again because I don't know where my copy is, but I had the lines on here. But, but there's a couple lines in here where it says on site. That's been changed to, um, let me see. [1:16:53] The board approved. [1:16:55] Good. Board or designee there. Uh, that means they can do this by tele-dentistry, uh, whichever way they decide to go or, or which way would work for them. Again, the, the objective of this is to get more permits out there, uh, but also these pa- these, uh, docs will have to be fully qualified and fully vetted. It only changes that site, uh, visit. I see a question. Oh, you see a question. [1:17:26] I see a question. That's over here. Yes, ma'am. Go ahead. [1:17:30] Can we get Whit too? [1:17:31] It's in your binder. [1:17:33] You do what? [1:17:34] Her button doesn't work, so I'm pressing his button for her. [1:17:37] Thank you. [1:17:38] Oh. [1:17:38] We're, we're getting there. [1:17:41] It wasn't me, I promise. [1:17:43] There you go. [1:17:44] Thank you. [1:17:44] You're welcome. [1:17:44] Thank you, Mr. Chair. I appreciate it. So, um, currently right now they do have to physically, uh, show up, and so the members of the board, have they ever done an on-site examination and maybe they just haven't done it in a while? Or, like, I just wanna make sure that the quality is still there. [1:18:06] They do on-site visits. In fact, the, uh, past president of the board, Michael Knight, was going to come and testify today. Unfortunately, his mother passed away- [1:18:16] Oh, condolences [1:18:17] ... a couple weeks, but he is one of the few conscious sedation dentists in South Georgia. He is asking for help. [1:18:24] Mm-hmm. [1:18:24] And so, yes, th- by law they have to do a site visit. [1:18:28] Okay. But in this law, they, they won't have to do a site visit anymore? [1:18:33] That's the only thing that's changed is the site visit. [1:18:33] Okay. [1:18:34] That's right. [1:18:34] Thank you. [1:18:35] Yep. [1:18:35] Mr. Chairman, just for my, uh, knowledge, could you tell me what conscious sedation actually is? [1:18:41] Like IVs. They may use Sublimaze, something like that. It's an IV, so, uh- [1:18:47] Oh, okay [1:18:48] ... like when you had your third molars out- [1:18:49] Yes, sir [1:18:50] ... they probably did that for you on the oral surgery. [1:18:52] That was tough. [1:18:56] Yeah. Well, maybe the, maybe the vet doesn't use that, but- ... dentists do. Yeah, but- Okay. [1:19:06] Couldn't res- couldn't resist. [1:19:08] Thank you. Thank you. [1:19:08] Any other members have questions for the bill sponsor? Then I hear none. What's the pleasure of the committee? [1:19:15] Motion to pass. [1:19:16] Motion to do pass. There a second? [1:19:18] Second. [1:19:19] Got a second. All those in favor, aye. [1:19:20] Aye. [1:19:21] Any opposed, same. Mr. Chairman, your bill passes. [1:19:24] Thank you. Since you're at the mic, why don't we go ahead and do 1374 next? [1:19:30] You're a busy little bee. [1:19:31] Well, this, this is it, I hope. [1:19:34] Okay. [1:19:36] That is LC461434. House Bill 1374. [1:19:41] Floor is yours. [1:19:42] Okay. Uh, years ago, I carried some legislation for, uh, virtual credit cards. A virtual credit card is actually a piece of paper that's mailed to a provider's office with a n- set of numbers on there that they c- you can type into your credit card machine and get paid. So the provider is being ch- and they charge anywhere from four to five, six percent. [1:20:14] So the provider was getting paid, was being charged to get paid. [1:20:19] Mm-hmm. [1:20:19] Net result is your bills go up because overhead goes up. [1:20:23] Mm-hmm. [1:20:23] So in this bill, it said that on- it simply said that, uh, there must be other methods offered to the provider that could be, that could not only be the method being paid. Well, it was brought to me that they're still having problems with this. So this is a simple correction to that or an addition to that. And, um, it says, I, I won't go through every line here, but, but the gist of this thing says that they will, it, it will be an opt-in in, in plain English. [1:20:58] The provider will sign a, a document saying that, uh, this, that, that he opts into this and accepts that type of payment. It doesn't take the right, uh, away from the provider to, to choose that method. It only says that they must sign a document now. That's the gist of the bill. [1:21:28] The members heard the chairman's bill. Do they have any questions? I see none. What's the pleasure of our committee? [1:21:37] Motion to do pass. [1:21:38] Get a motion to do pass. Do I have a second? [1:21:40] Second. [1:21:41] Second. Get all those in favor of passing House Bill 13- [1:21:45] 74 [1:21:46] ... 74, aye. [1:21:48] Aye. [1:21:48] Any opposed? [1:21:50] Okay. [1:21:50] You're two for two. You got another one, Mr. Chairman? [1:21:52] No. [1:21:53] Oh. [1:21:53] That's it. That's it. [1:21:55] I call Mr. Chairman on the floor. [1:21:55] We do have- [1:21:57] What, we got... Uh, Mr. Chairman, you- [1:21:58] Oh. [1:21:59] Yeah. Hi. [1:22:00] Yeah. [1:22:00] Yeah. [1:22:00] Mr. Chairman, thank you so much. Lauren Powell representing the Georgia OBGYN Society. [1:22:04] Oh, okay. [1:22:05] Um, we just had a little caucus with, uh, Chairman Kelly in the hallway and the Medical Association of Georgia, and we believe that we may be able to satisfactorily address his concerns. If it were to be possible to bring up the Contraceptive Act again, I think there's a, a few lines that could be- [1:22:21] You talking about 1138? [1:22:22] Um, Trey, is that the number? [1:22:24] Oh. [1:22:24] Sorry, Chairman. [1:22:25] Are you talking about Representative Camp's bill? [1:22:27] 1138. [1:22:27] Yes. I think we figured it out to maybe not delay it, if you're open to that, but of course it's your committee. I just wanted to offer it as an option. [1:22:33] Thank you. I'm gonna do his bill next- [1:22:35] Okay [1:22:35] ... and then we'll, we'll see. Okay. Representative Kelly, you're, you're up. [1:22:40] Mr. Chairman. [1:22:40] Yes, sir. And that is HB 1236. [1:22:46] Mr. Chairman, uh, members of the committee, thank you for giving me the opportunity to come before you today with House Bill 1236, working off LC600237. And, and, uh, this is a piece of legislation that has came to me, um, after just hearing frustration from both medical providers and patients in our state. And the gist of the bill is simple. It says that when a patient goes to get medical treatment in Georgia, uh, that if their licensed medical practitioner in Georgia feels that the procedure is necessary, that should a health plan, uh, decide that the treatment is not necessary, that that decision has to be made by a medical professional licensed to practice in our state. [1:23:46] Basically, the providing or denial of care for an individual, I believe, uh, is practicing medicine. And we're seeing over and over again medical providers in our state say that something is necessary for the treatment of patients in Georgia. They go to get authorization from a health plan, and then somebody sitting in a cubicle somewhere who may not even be pra- licensed to practice medicine in our state denies that care. And fundamentally, I have a problem with forcing somebody to buy a product to get treatment from someone who is licensed under our state, for then that license from our doctors in our state who I trust to then be usurped by someone who is just a no button somewhere in a cubicle. [1:24:36] And that's the gist of the legislation I bring before you today. [1:24:40] Oh, this will soon be controversial. Maybe. Uh, let me see. Re- Representative Jones? Karen Clark. Excuse me. [1:24:52] Um, thank you, Mr. Chair. Um, I 100% agree with the frustration that you have. And I am actually curious if the issue is necessarily that the person is licensed in, licensed in the state or not, or whether it has more to do with what you said, which is that they're kind of, they're- What it seems like is their MO is to start with no and then kind of make you work for it. And so my question is timing. [1:25:23] Um, is there a concern that if we have... if they have to be licensed in the state that we create a burden for those who are doing these authorizations in the state, a time burden for them, and it slows down these authorizations? [1:25:41] I think for them to be in compliance, they will have to have someone, um, who is licensed, and I think they would make it a priority to, to do that. Um... [1:25:57] And then, um, my follow-up question to that: is there any contemplation about also... I, I think that's what maybe line 20 is trying to get to, but I'm just gonna ask it. Any contemplation that the person who is doing this authorization has to have, like, for example, um, a person whose expertise is in podiatry and giving a yes or no to a treatment for, uh, cardiovascular. Like, is there a, uh, contemplation that the person needs to at least be somewhat in the same field? [1:26:29] Or- [1:26:29] That's where- [1:26:29] ... is that too, too- [1:26:32] That's where the language came to a clinical peer- [1:26:34] Yeah [1:26:34] ... because a peer being- [1:26:35] That's what I thought. Okay [1:26:36] ... in a li- like practice, so I appreciate that. [1:26:38] Thank you. [1:26:39] To my Georgia State basketball friends. [1:26:42] Yes. [1:26:49] Representative Gisler. [1:26:51] Yeah. Um, I, I, I fully support what the bill's trying to do. I, I do wonder about the, the unintended consequences. I mean, we, we have a physician shortage in the state, so it's not like we have a lot of licensed medical doctors willing to take up these jobs and do these reviews. So are we creating a problem here? [1:27:11] I don't think we're creating a problem. I think, I think we're solving a problem for patients as it relates to getting healthcare. And I know that there's opportunities for our health plans to go out and contract with doctors. [1:27:27] Mm-hmm. [1:27:27] So I think it could be something that could help attract doctors to our state if they know that there's an opportunity to potentially do this. I think part of the frustration for medical practitioners in our state as well is the fact that they recommend the care that they feel their patients need, and they've got somebody sitting in New York telling them no. And I think this will address that problem. [1:27:46] I completely agree. Yeah, I, I completely agree, but I, I do worry about that. [1:27:48] And we're seeing in other states they're doing this already. Um, I can't tell you how many or all the ones there is, but other states are doing this. [1:27:56] Mm-hmm. [1:27:56] And so our health plans, if they want to comply with this, they can comply with it. But I agree, they probably wouldn't want to. [1:28:03] Yeah. Thank you. [1:28:04] Representative Jasperse. Rick Jasperse. [1:28:07] Thank you. Thank you. Representative Kelley, just on the... I think it's great. You know, it's patients first, very pro-patient. But on line 27, you know, we s- and I really like it that they must provide the reasons for the review, their termination. But, so they gotta be precise and be exact, and I ha- I don't know if it's in here, would people normally pass that on to the patient? 'Cause that's the person that m- many times doesn't get that answer they need, that they got turned down because of X. [1:28:38] Mm-hmm. [1:28:38] And I guess that's just on the provider or the, their provider to give it to them, but... [1:28:44] From hearing from providers, one frustration I hear is that they will call and say, um, th- they'll say that their patient gets mad at their treating doctor- [1:28:54] Uh-huh [1:28:54] ... 'cause they feel like that they're not doing enough to get them transferred to the facility or to get them on the surgical table. And the, the, their treating provider is just as frustrated, but the patient can't talk to the person on the other end of the phone. [1:29:08] Right. [1:29:09] And so what I think in practice, Mr. Chairman, is generally, and I, I, I can't tell you it happens all the time, but I would suspect that those providers, as soon as they know that someone's denied, that they relay that to their patient- [1:29:22] Right [1:29:22] ... and that they communicate a don't shoot the messenger protocol. [1:29:27] That's okay. Yeah. [1:29:27] And, and at least that's what, that's what I, what I understand of the, the process. [1:29:32] Thank you. [1:29:34] Representative, who do we have? Schofield. [1:29:38] Yeah. And let me... Thank you, Mr. Chair. I think you said it perfectly, don't shoot the messenger, because that is exactly what happens, where they, we're told that they're gonna deny you first. The doctor's already frustrated. So I just wanted to thank you for making this and keeping the patient first. Thank you very much. It's a great bill. [1:29:54] I appreciate that. Thank you. [1:29:56] Thank you, Chairman. Uh, I wanna thank you for the bill also. As a critical care nurse, there have been several times I've worked not only in critical care, but emergency rooms and other areas, um, and the doctor would spend so much time trying to get approval, uh, only to find out that the people on the other line didn't even have an ounce of the expertise to make that decision. So I think this streamlines that and, and put the patient first. I thank you for it. [1:30:26] I, I appreciate that. [1:30:29] Representative Par- Chairman Parsons. [1:30:31] Thank, thank you, Chairman. Uh, to, uh, this, to the author of the bill, I mean, it's one of those things that sounds really good, but I wanted to ask you about, uh, lines 14 and 15. It says, "In any instances where the private review agent or u- utilization review entity is questioning the medical necessity," blah, blah, blah. I mean, isn't questioning a very open term to use there? Questioning could be anywhere from... I mean, that could be almost anything. [1:31:03] I understand, uh, your question of the questioning- [1:31:06] Okay. [1:31:07] ... uh, Mr. Chairman. Uh, but that is not new language. Uh, that is language- [1:31:12] That's true [1:31:12] ... that's existed under the statute. Um, and I, I, I certainly do seriously, uh, appreciate you raising that point, but that is the existing law that, that they are practicing under. What we're simply adding is on line 17, the real important part, licensed in this state and. [1:31:33] If I may f- follow up. It, it... Yes, you're, you're correct. It is, uh, existing language, but it's in, um, it's in the perspective of what the following language is though. [1:31:45] Mm. [1:31:45] I mean, when you change the following language, then it becomes a, the questioning, the word questioning seems to become more of an issue, it would seem to me. As, as it stands, okay, but with, with what you're trying to do here- [1:31:59] Sorry. Yeah [1:32:00] ... it just seem like a bigger issue to me. [1:32:01] I- [1:32:01] I mean, it must be more specific. I mean, it seem like it would be more specific language that could be used. I'm not against the bill- [1:32:06] No [1:32:06] ... and what it's trying to do, but I'm just very, very open. I mean, you know, the insurance company says, "Well, I don't know about this." And then that, that would... By this bill, I think that would create this, this circumstance where this, this would have to be set up. It, it seems to me, anyway. [1:32:24] Well, it, it is. We are talking about the synonym of questioning, which is reviewing. And, and I think we could, we could use those terms. Um, we could exchange those, but, but that is what we're talking about. We are talking about when a, a patient goes to get medical treatment in Georgia, and he gets recommended by their g- Georgia licensed medical provider, and they send it to the insurance plan for review or questioning or approval. [1:32:53] Right. [1:32:53] It starts as approval, and then it moves on to, we can call it review, or we can call it questioning. Anything short of, uh, approval is some form of, of questioning, uh, or, or review. And so it's just saying, if you're going to do that and lead to a denial, then you need to be doing that with someone- [1:33:14] Mm [1:33:14] ... who is licensed in the state. We, we expect those who are administering the care to be licensed in our state. We ought to expect those who are denying care in our state to be licensed- [1:33:24] Okay [1:33:25] ... in the same fashion. [1:33:25] You're, you're the attorney, and, uh... [1:33:29] For, for whatever that's worth around here. [1:33:33] They're hard to find, aren't they? [1:33:39] Okay. Representative Gisler. [1:33:41] Yeah. Uh, so a- again, I agree with what the bill aims to do. Um, my concern is if, let's say, UnitedHealthcare has a policy that they're gonna say no the first time on 80% of- [1:33:53] Mm [1:33:53] ... claims, and right now that's somebody making, I don't know, 75, $85,000 a year, whatever, now they have to pay a, a licensed physician to make that decision. Is this not gonna directly increase insurance costs? [1:34:08] I can't even focus on the second part of your question if we accept the first premise. [1:34:13] Okay. [1:34:14] And if, and if that's the kind of actions we assume that they're making, I think we need these guardrails that I'm putting in this bill and probably a lot more. [1:34:22] Uh, that's, yeah, I agree. I'd be happy to work with you on something like that. But I, I, I am concerned that if it's, if it's corporate policy that's driving all these denials and not the lack of medical training, i- is this just gonna increase costs for no benefit? [1:34:37] If we, if we have then a Georgia licensed practitioner who is listening to a corporate shareholder doctrine instead of the Hippocratic Oath, then by God, we ought to go get them in Georgia. [1:34:50] I agree. [1:34:52] And this will give us more of an ability to do that. [1:34:56] Uh, just to make a comment. That's, that's not a bad question. But I think present day, there are hopefully physicians and dentists that review these, these, uh, prior approvals. [1:35:07] Mm. [1:35:08] And if not so, they're practicing medicine without a license. [1:35:13] Mm. [1:35:13] So what this bill is signifying is saying they, they should be in the state. [1:35:16] They have to be in Georgia. Yeah. [1:35:17] Mm-hmm. [1:35:17] Right. [1:35:17] Yeah. [1:35:17] So I, I think all the insurance companies have physicians already hired. [1:35:21] Mm. [1:35:21] Okay. [1:35:22] But- [1:35:22] Fair enough. [1:35:23] Uh. [1:35:23] Thank you. [1:35:23] Yeah. Representative Lim. [1:35:26] Yeah. Uh, I, I love the bill. I just had a quick question. Is there... 'Cause I'm seeing that there are other parts of this code section that refer to clinical peer. Like, I pulled up, um, 33-46-21, Insurer Responsibility for Compliance, and it's referring to clinical peer, and the language says, "A clinical peer shall evaluate the clinical appropriateness of adverse determinations." My question is, is there a reason that it's only this part of this code section where we say clinical peer licensed in the state and not some of those other provisions? [1:36:02] When I spoke to legislative counsel about the adverse determination portion that you see- [1:36:09] Mm [1:36:09] ... on line 18, this is what they felt got there. [1:36:14] Okay. [1:36:14] There can be other reviews prior to this, but before you get to that adverse determination, it has to be the Georgia licensed provider. [1:36:26] Gotcha. Thank you. [1:36:27] Thank you for the question and for the love of the bill. [1:36:31] It's a good question. Some of your colleagues here tell me- [1:36:34] It's a start [1:36:34] ... you're one of the sharpest legal minds in, in, uh- [1:36:36] Thank you [1:36:37] ... your side of the aisle. No, they have. Okay, we have someone who wants to speak to the bill. Jesse Wavington. [1:36:48] Good luck. [1:36:53] Uh, good afternoon, Mr. Chairman, uh, members of the committee. Uh, my name is Jesse Weddington. I'm the president of the Georgia Association of Health Plans. Um, appreciate the opportunity to, uh, speak with the committee, uh, today about some of the concerns our members have with the bill before you. I have shared those with the sponsor as well as the chairman, so appreciate the opportunity to share that with the broader committee. And you know, I thought everybody had signed up in favor of everything today, so I might as well sign up to testify- ... against something, um, at the risk of ensuring its swift passage out of the committee, uh- ... in our opposition. So, um, a lot of the members have already, uh, touched on some of the concerns that we have, and so that is the fact that, you know, as you all have heard frequently and from other folks besides myself, uh, Georgia does have a shortage of physicians. [1:37:34] So the concern would be are, are these folks out there and available and licensed in Georgia today to be able to do this work? Um, the number of 80% denials is actually quite the opposite. It's, it's, it's really more the other way around. Almost all prior authorizations are approved. Um, y'all have legislated quite frequently on this issue. Um, as recently as last year we passed the Gold Carding bill and the callback for the peer-to-peer. Um, so Title 33, Chapter 46 is sort of a comprehensive review of what private review agents, so that's what these entities are determined to be under the law, um, can and cannot do as relating to handling utilization management activities. [1:38:14] Um, so again, our concern with this is that while well-intentioned, um, you know, law of unintended consequences may prevail here. Um, I believe it would have the effect of potentially driving up costs, uh, to, uh, try to attract or get some of these folks, um, that are currently not available in the state of Georgia to do this work. Uh, there may be an issue of quality. Um, you know, you want the highest specialist or sub-specialist that you can get ahold of, and while, you know, we love our Georgia doctors and we think we have the best, um, again, there is a shortage and we, there may be somebody with a greater level of expertise that may be able to communicate in that peer-to-peer that may just not be available in the state of Georgia for whatever reason. [1:38:50] Um, a couple of our members, uh, of the association already do this, uh, but we did want to air these concerns with the committee, uh, and just kind of worry about, you know, is this gonna slow things down, lower the quality of the peer-to-peer conversation, and potentially increase the cost. [1:39:04] Thank you. In the interest of no more blood shedding, I appreciate it. [1:39:09] Mr. Chairman? [1:39:10] Yes, go ahead. [1:39:10] He said some of his members are currently doing this. Could you tell us those members, which are and which aren't? [1:39:15] Uh, could I tell you that offline? I generally, my members like for me to blind information that we give so as not to sort of create a competitive issue. [1:39:23] Okay. I was just curious as to which members would be- [1:39:25] It's, they, they're two of the smaller ones, uh- [1:39:27] That are doing it or not doing it? [1:39:28] That are presently doing this now. [1:39:30] Okay, so the smaller guys can do it, the bigger guys are having a problem doing it? [1:39:34] That's the concern that my members shared with me, yes, sir. [1:39:36] Okay. Thank you. [1:39:38] All right, I see no mo- more questions or other questions and no one else is, uh, signed up. Do I hear a motion? [1:39:44] Motion to pass. [1:39:45] Do I hear a second? [1:39:46] Second. [1:39:47] All those in favor say aye. [1:39:48] Aye. [1:39:49] All those against say nay. Congratulations, you have your bill. [1:39:54] Thank you, Mr. Chairman. [1:39:55] All right. [1:39:55] I've never felt so loved. [1:39:58] Well, just don't go anywhere 'cause you, you're in the middle of the next one. We're gonna call 1138 back up. [1:40:05] It's taken off the table. [1:40:08] I feel like I should buy a lottery ticket right now, Mr. Chairman, thank you. Um, all right, so House Bill 1138, and we are looking at LC 13... I'm sorry, 461351. And, um, I appreciate very, very much, um, Representative Kelly and his thoughtfulness, and he, um, he has proposed some amendments. And, uh, I'm not really sure what the posture should be for those. [1:40:39] I'm sorry? [1:40:39] Um, Representative Kelly and I have worked through a couple of amendments. I'm not really sure what the posture needs to be at this point, if, um, I need to speak more on the bill. It's a very, it's very, it's very short. [1:40:50] Uh, uh, well, wait a minute. You've worked through amendments? [1:40:53] No, no. [1:40:53] Of these new amendments? [1:40:54] We... No, no. Just striking- It's striking ... a couple words. [1:40:56] Oh, okay. [1:40:56] It's striking- [1:40:56] Hold on. Wait, I'll, I'm looking for the bill here [1:40:57] ... basically five words from the bill. [1:41:02] And, um, on page- [1:41:04] Getting it all fixed up [1:41:05] ... on page six, line 138. [1:41:07] Hold it. Okay, now go. [1:41:09] Okay. [1:41:09] Can we make the motion do pass, Mr. Chairman? [1:41:11] Yeah. Do I hear a motion do pass? [1:41:14] Motion. [1:41:14] Second? [1:41:15] Second. [1:41:16] All right. Let's hear the amendment. [1:41:18] All right. Um, on line 138, strike civil liability or, and on pa- on 160, line 163, strike civil liability and the comma after civil liability. [1:41:32] And you will need to delete the comma after culpability. [1:41:36] Thank you. [1:41:38] So repeat that one more time. 138, we're striking civil liability or criminal li- [1:41:43] No, just civil liability and the word or. [1:41:45] Okay. [1:41:46] And then on, um, 163, we're striking civil liability- [1:41:52] Comma [1:41:52] ... the comma after liability and the comma after culpability. [1:41:57] I'll make that in the form of a motion, Mr. Chairman. [1:41:59] Okay. Did you actually do this out in the hall? [1:42:03] Yes, sir, we did. [1:42:03] We could've done that while still sitting here, but we, we took, we moved on to another bill. [1:42:10] I'm impressed. You're, you're on your game today. All right. [1:42:15] We have a motion. [1:42:15] Do, do I hear a motion on the amendment? Oh, oh, oh, okay, go ahead. [1:42:20] I, I just had a- [1:42:20] Representative Lim. [1:42:21] I, I had a question. I agree with the amendment. Is there, what is the reasoning we're not also striking out criminal culpability? 'Cause I, as I heard, um, Representative Kelly's concerns, that could still apply to there. So I'm, I'm just curious as to the reasoning why we're not striking that out. [1:42:35] Well, that was one thing we did not discuss in our hall meeting. I'm open for a discussion on that. [1:42:42] Representative Kelly. [1:42:43] I would just say that, that to prosecute someone criminally, you already have to hit a higher, and, and that's where I'm, I'm at there. And I guess I would just ask Vance if, if that answered your question, Representative Lim. Uh, that, Vance, um, in the motion, do we also have to include a change to the caption or will you just do that based on the amendment that we're offering? Because, I mean, I guess we could... We need to include in the amendment strike and get on line nine as well. [1:43:14] Yeah. Yes. Good call. [1:43:15] All right, so on line nine, uh, we would also strike civil liability, comma, as well as a comma on, after culpability. [1:43:36] Excuse me. I'm looking for our sign-up list. Before we go any further, I did skip over someone. Caitlin, somebody wanted to speak to this bill. Is Caitlin here? [1:43:43] I believe, I believe she's gone to another committee, Mr. Chairman. [1:43:46] Okay. Well, I just want to give her a shot. You know, that's, it's only being fair. Okay, so now we're back. Are you good, Representative Lim? [1:43:54] Yeah, no, thank you. [1:43:55] Okay. [1:43:56] Thank you. [1:43:56] Okay. So we're back, uh, to the amendment. Do I hear a motion? [1:44:01] Move. [1:44:02] Second? [1:44:04] Second. [1:44:04] All those in favor say aye. [1:44:06] Aye. [1:44:06] Okay. Now we're back to the m- main body of the bill. We, we... Oh. [1:44:11] There's an amendment. [1:44:11] Any of those against say, say nay. Okay, thank you. Now we're back to the main body of the bill, LC461351 as amended. Do I hear a motion? [1:44:22] Moved. [1:44:23] Do I hear a second? [1:44:24] Second. [1:44:24] All those in favor say aye. [1:44:26] Aye. [1:44:27] All those against say no. All right. Congratulations, you have your bill. [1:44:30] Thank you, committee and Mr. Chairman. [1:44:32] You're welcome. [1:44:32] Certainly appreciate all the hard work. [1:44:33] You're welcome. And that is it. This meeting's concluded. [1:44:39] Why, why he didn't want to do it.