The Georgia Association of Pathologists (GAP) and the CAP together scored several legislative victories that protect patients and pathologists in the state. To strengthen the profession of pathology nationwide, the CAP partners with state pathology societies to bolster advocacy efforts.

Improving Health Insurance Plan Network Adequacy

The GAP- and CAP-backed legislation, Senate Bill 20, was enacted by Gov. Brian Kemp to expressly require state oversight over health plan network adequacy, including clinical laboratory services, to ensure covered persons can access in-network “the full scope of benefits and services covered under the plan.” In addition, the state insurance commissioner must assess “the availability of participating providers that are within a reasonable time and distance to covered persons.”

The GAP and CAP worked in partnership with the Medical Association of Georgia (MAG) to advance the legislation to provide proper insurance department oversight mechanisms for adequate health care contracting of pathology and clinical laboratory services for Georgia patients.

Strengthening Biomarker Testing Access

On May 2, Gov. Kemp enacted the GAP- and CAP-backed legislation, House Bill 85, to mandate Medicaid and private insurance coverage of biomarker testing when supported by robust medical and scientific evidence.

The GAP and the CAP partnered with the American Cancer Society Action Network (ACS-CAN) and the biomarker coalition of medical and public health stakeholders to advance biomarker testing coverage for Georgia patients. Private and Medicaid plans will be mandated to provide biomarker testing beginning on or after July 1, 2023, to Georgia patients.

Deterring Out-of-Network Written Estimates

Furthermore, the GAP and the CAP successfully deterred the advancement of House Bill 70 in the 2023 legislative session. With such efforts, legal constraints were successfully thwarted by removing written estimates for health care services exceeding $100 and protecting patient access to non-emergency and emergency services.

With MAG’s support, the GAP and CAP provided opposition comments to the sponsor and received receptive acknowledgment of these concerns. As a result, the legislation failed to advance and will be carried over to the 2024 legislative session. The CAP will continue to oppose any bill advancement.

1st CAP-Amended Physician Title Protection Legislation Enacted

Lastly, Gov. Kemp enacted the first CAP and state pathology society-amended physician title protection legislation, Senate Bill 197, to protect against nonphysician use of physician nomenclature.

The GAP and CAP closely worked with the American Society of Anesthesiologists (ASA) on the legislation to include an explicit exemption for health care practitioners such as speech-language pathologists to ensure their current title use under title protection laws, to avoid any conflicts with physician nomenclature. This inclusion will remove regulatory barriers in the future and enhance the new statutory protections for pathologists from inappropriate non-physician title use and deceptive advertising. The law will take effect on July 1, 2023.