Medical Loss Ratio Waiver: On Monday, the Senate Health Care Delivery Subcommittee of the Insurance Committee voted DO PASS out of subcommittee by a vote of 2-1 on SB 22 (Judson Hill, Dist. 32), which authorizes the state Insurance Commissioner to apply for a waiver from the federal government to meet Medical Loss Ratio (MLR) requirements set into law by the Affordable Care Act. MLR sets standards for what percentage of a consumer’s premium must go toward medical care, as opposed to administrative costs or amounts retained for profit by the insurance company.  This legislation does not afford the Insurance Commissioner any new authority, as the Insurance Commissioner already has the authority to apply for this waiver.

Medicaid/PeachCare Fingerprinting: SB 63 (Albers, Dist. 56) would require all individuals enrolled in Medicaid and PeachCare, including children and infants, to be fingerprinted when first enrolled within the program and at the point of receiving medical care as a means to decrease fraud.  The Senate Health Care Delivery Subcommittee of the Insurance Committee by majority chose not to bring this bill to a vote but decided to wait for a fiscal note to be completed first.  Some issues raised were about access to data to inform at which points Medicaid fraud occurs, what the costs to implement would be, whether requiring fingerprints would violate federal maintenance of effort (MOE) provisions and put federal Medicaid dollars to Georgia at risk, what if any additional administrative functions would be needed, and whether implementation would negatively impact access to care.

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