Legal Update

The 2024 Georgia Legislative Session ended on March 28. Governor Kemp has 40 days to decide whether to sign or veto each bill. If Governor Kemp signs a bill or fails to veto a bill, the bill becomes law, which will become effective July 1 unless the act provides a different date. If the governor vetoes a bill, it requires a two-thirds majority of members of each house to override.

This legal update highlights healthcare-related legislation that passed the General Assembly during the 2024 session.

No Patient Left Alone Act (HB 663)

This bill gives minors and adults admitted to a hospital or long-term care facility the right to have a parent, guardian, or other designated caregiver to be always physically present. These visitors must abide by all policies, rules of conduct, and reasonable safety protocols. Hospitals and long-term care facilities may establish visitation restrictions to ensure the safety of patients and staff that do not conflict with the law and are not required to allow such visitors to enter operating rooms, isolation rooms or units, behavioral health settings, or other typically restricted area or to remain present during the administration of emergency care.

Mid-Level Providers May Prescribe Certain Schedule II Controlled Substances (HB 557)

This bill allows physicians to delegate to advanced practice registered nurses and physicians assistants who have at least one year of post-licensure experience and are in good standing with their respective board to issue prescriptions for hydrocodone, oxycodone, and compounds thereof in emergency situations. The following requirements must also be met: the authorization is specifically included in the nurse protocol agreement or job description, the mid-level provider has directly evaluated the patient, the prescription is limited to a 5-day supply, and the patient is at least 18 years or older.

Mid-Level Providers May Sign Death Certificates; Supervision Changes (HB 1046)

This bill allows advanced practice registered nurses and licensed physician assistants to complete and sign death certificates for patients under their care. Authorized individuals who complete and sign a death certificate in good faith are immune from civil liability for any acts or omissions relating to the certification, except for wanton misconduct or intentional wrongdoing.

In addition, the bill limits the number of advanced practice registered nurses and license physician assistants that a physician may supervise to a combined total of eight mid-level providers.

Increase Public's Access to Prescription Drugs (HB 1072)

This bill increases the number of pharmacy technicians that are authorized to be supervised by a pharmacist in certain situations and increase the maximum ratio of pharmacists to pharmacy technicians in closed-door pharmacies, which are specialty pharmacies that are not open to the public. Also, the bill requires that hospitals licensed in Georgia to provide patients with referral information for the drug repository program, which is a donation program for unused over the counter and prescription drugs.

Increase Access to Glucose Monitoring (SB 109)

This bill requires the Department of Community Health to include continuous glucose monitors as a pharmacy benefit for those with Medicaid. This means that patients in Georgia who have diabetes will be allowed to go through their primary physicians to obtain their crucial monitoring equipment instead of being required to see a separate endocrinologist.

Staffing Requirements for Certain Institutions (HB 1335)

This bill revises the staffing requirements for personal care homes, assisted living communities, and memory care centers, including adding provisions that require that for personal care homes and assisted living communities, there are no fewer than two on-site administrators or on-site direct care staff individuals are always present on the premises. There must also be at least one staff member on each occupied floor who is required to remain posted on that floor at all times unless a medical alert system is in place. A medical alert system is a wearable device provided to every resident that can detect or immediately communicate that the resident is experiencing a medical emergency.

Certificate of Need Revision; Establish the Comprehensive Health Coverage Commission (HB 1339)

This bill changes some Certificate of Need (CON) requirements for certain types of health care facilities. These changes include the following: General acute care hospitals in rural counties now do not have to go through the CON permitting process, as long as they will provide a certain level of charity care, attain teaching hospital status within 3 years of opening, join the statewide trauma system and provide psychiatric services. It also removes the capital expenditure threshold on how much existing healthcare facilities can spend on buildings or new equipment, as long as there are no new clinical health services being offered. The bill also permits physicians who are not owners or employees of a group practice that holds an LNR to provide surgical services at such ASCs.

The bill also expands exemptions for physician groups to own and operate diagnostic imaging equipment so long as a physician is present at the location for 75 percent of the time. The bill also makes clear that physician groups may enter into management and administrative relationships with third parties such as practice management companies or health systems without negating their exemption to operate single specialty physician owned ambulatory surgical centers.

Additionally, the bill creates new exemptions from the CON requirements for the following: certain psychiatric or substance abuse inpatient programs that provide a certain level of charity care; basic perinatal services provided by hospitals in rural counties; and outpatient birthing centers.

The bill also requires the Department of Community Health to review the state health plan (i.e. the CON rules and regulations) every 5 years to ensure that the regulations meet the evolving needs of the state, and it changes the CON review and appeal process in small ways.

Finally, the bill creates the Comprehensive Health Coverage Commission, which will be comprised of 9 members appointed by state leaders, to advise state leaders and the DCH on issues related to access and quality of healthcare for low income and uninsured patients in Georgia.

Authorize and Regulate Teledentistry (HB 441)

This bill adds a new Code section relating to the licenses of dentists, dental hygienists, and dental assistants. Under this law, licensed dentists are authorized to deliver dental care through the use of synchronous, real-time communication with a patient physically located at a separation location from the dentist within the state. Specifically, licensed dentists may authorize a dental hygienist to perform dental hygiene functions permitted under general supervision, prescribe medications that are not controlled substances, authorize performance of digital scans by a dentist or dental hygienist, and allows the dentist to evaluate a patient's oral health condition and authorize performance of dental care via transmission of patient records, images, dental scans, X-rays, and other relevant health information. The bill further requires that health insurers cover dental care provided through teledentistry.

Dentists who intend to provide dental care through teledentistry must notify the Georgia Board of Dentistry of their intent to do so and must provide evidence of a referral relationship with a referral dentist in a 50-mile radius of the setting where the teledentistry visit will occur.

Changes to Certain Licensure Requirements (SB 449)

This bill allows certain military medical personnel to provisionally operate within their scope of practice and training for a period of up to 12 months without meeting the examination requirements for their license, including working as a certified nursing aide, certified emergency medical technicians, paramedics, and licensed practical nurses. Additionally, the bill makes it a misdemeanor to practice advanced nursing practice without a license.

Grace Period Extension for Adult Residential Mental Health Programs (HB 1083)

The DCH shall now have until January 1, 2025, to create and promulgate rules and regulations for licensing of adult residential mental health services, and adult residential mental health programs may obtain a one-time provisional license now through June 30, 2025.

Extend Sunset Provision of Hospital Medicaid Financing Program (HB 991)

This bill extends the sunset provision for the Georgia Hospital Medicaid Financing Program to June 30, 2030.

Financial Transparency (SB 505)

Provides that the State will develop a uniform reporting form for financial transparency documents, which hospitals must implement no later than July 1, 2025.

Bills That Did Not Pass:

• Limits to "White Bagging" (HB 924) - This bill would have limited so-called "white bagging," which is a practice where insurance companies send drugs to hospitals and doctor's offices rather than allowing the providers supply the drugs themselves. Under this law, insurance companies would have been banned from denying payment or refusing to permit hospitals and physicians from using their own supply of medication.
• Medicaid Expansion (SB 17, SB 24, HB 38, HB 62)
• Amend licensure and licensure renewal requirements for APRNS (HB 215)

Updates from Our 2023 Recap:

Anesthesiology Assistant Act (SB 164) - This bill was vetoed by Gov. Kemp "at the request of the sponsor."

If you have any questions about this legal update, please contact a member of the healthcare team.

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