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Hill: Hospitals balk at fee
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Medicaid currently relies on around $90 million from a 5.5 percent CMO “Quality Assessment Fee” that provides funds to the Medicaid population. These fees are used to “draw down” enhanced federal funds and do not have a negative impact on the CMOs.  

The Federal Agency with Medicaid responsibility has ruled that states like Georgia cannot assess a fee on one Medicaid provider without assessing the same fee on all health care providers. You can’t treat a Medicaid provider differently from other providers like insurance companies.

So Georgia is faced with a choice that must be made and implemented by Oct. 1 — either stop taxing the care management companies and create a $90 million hole in the 2010 budget or start assessing insurance companies the same amount.

Gov. Sonny Perdue has proposed to lower the assessment fee from 5.5 percent to 1.6 percent but to apply the fee to insurance companies and to the net revenue of hospitals. In other words, all health care providers will be subject to this fee.

The total produced by the fee would continue the $90 million presently collected as well as plug a Medicaid shortfall created by the prior use of one-time reserve funds. This amount is $204.9 million. The total of $217 million would also pay for increased Medicaid demand and fund $60 million toward a trauma fund for hospitals.

The hospital piece of the funding, $259 million, has been met with strong objections by hospitals around the state. Rural hospitals particularly say they would be hard hit and that the fee has the potential to put some out of business.  
This is one of the crucial issues before this General Assembly. The governor’s proposal does not appear to have widespread legislative support.

Senate action last week
• SB 1:  The “Waste Reduction Act,” introduced by Sen. David Shafer, would implement a system of zero-based budgeting for state government. Georgia currently prepares its budget on a “continuation” basis, which assumes that all current spending will be carried forward.  His legislation would require that one-fourth of the budget be zero based each year, so that over a four-year term, the entire budget is scrutinized by the General Assembly. SB 1 passed the Senate on Jan. 29.

Legislation introduced

Bills of interest that have recently been introduced in the Senate:
• SB 16: Would allow local communities the option of allowing Sunday retail alcohol sales by referendum.    

• SB 39: The “Senate Transportation Bill” would permit a regional sales tax option, subject to voter approval. Next week we will expand on the Senate and House transportation proposals.  

• SB 23: Failure to comply with the current seatbelt laws may be admitted into evidence in court as a contributing factor when determining medical damages.  

• SB 12: Would require coding of handgun ammunition.   

• SB 9:  Seeks to repeal the requirement that a concealed weapon must be kept in a holster.  

• SB 29: Requires 10 percent of all Department of Transportation contracts be awarded to employers of 50 or fewer individuals.   

• SB 36: Would require each school board to adopt a code of ethics.      

• SB 67: Would require that license examinations only be in English.  

• SB 65: Would allow jail time to count toward sentence for probation violators.  

• SB 60: Changes mandatory school attendance for all children from the present age 16 to 18.  

• SR 84: Urges the Georgia Board of Regents to merge Savannah State University with Armstrong Atlantic State University and Albany State University with Darton College.  

• SR 90: Would increase state sales tax by 1 percent to fund various transportative needs and the Homeowner Tax Relief Grants.  

• SB 52:  Would tighten punishment for metal thieves and track their location upon release from prison.  

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