Don’t let Georgia make the mistake of being the first state in the country to use Medicare as a benchmark for payment for out of network (OON) emergency care. (California uses Medicare, but even California excluded emergency services.) This proposal simply would make Georgia the worst state in the country for OON reimbursement for emergency care.  

Last week, in House Insurance subcommittee model bill SB 56 was hijacked and stripped. Chairman Smith’s HB 84 was inserted along with 150% of Medicare or the average contracted rate as the payment model for OON emergency care. 

  • Medicare doesn’t work for physicians providing emergency care for many reasons, including that inflation has severely outpaced Medicare adjustments over the past 25 years so Medicare is substantially lower than current rates paid to physicians by health plans.
  • It is also noteworthy that President Trump has proposed billions of dollars in cuts to Medicare - what happens to physicians in that case if this law were to pass? 

In a positive development, SB 56, as originally passed unanimously by the Senate, was inserted into HB 540 in Senate Finance Committee.  HB 540 was a tax credit bill brought forward by Rep. Trey Rhodes. He is willing to ask for an agreement in the House when the Senate passes HB 540 and sends it back over. 

  • Once HB 540 passes the Senate, it will ultimately be the Speaker’s decision on whether to bring HB 540 to the floor for a vote or not.
  • HB 540 must be given a floor vote!

The House Insurance Committee meets this Wednesday, March 27 at 8:00 am to vote on a stripped-down version of SB 56, which would make Georgia the worst state in the country for OON reimbursement for emergency care.  

We urge you to contact the House Insurance Committee Members and tell them HB 540 must be given a floor vote using the originally passed SB 56. Do NOT use Medicare as payment for out of network (OON) emergency service - making Georgia the WORST state for physicians, providing emergency services, to practice in - ultimately contributing to a physician shortage in Georgia, and endangering our communities.

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