Georgia 2025-2026 Regular Session

Georgia House Bill HB102 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	25 LC 57 0172
2	2	House Bill 102
3	3	By: Representatives Cooper of the 45
4	4	th
5	5	, Newton of the 127
6	6	th
7	7	, Silcox of the 53
8	8	rd
9	9	, Hawkins of
10	10	the 27
11	11	th
12	12	, and Au of the 50
13	13	th
14	14
15	15	A BILL TO BE ENTITLED
16	16	AN ACT
17	17	To amend Chapter 2 of Title 31 of the Official Code of Georgia Annotated, relating to the
18	18	1
19	19	Department of Community Health, so as to provide for the establishment of the Georgia2
20	20	Quality Reporting Project; to provide for definitions; to provide for the purposes of the3
21	21	project; to provide for a working group; to provide for submission of clinical data; to provide4
22	22	for processing of clinical data with claims data; to provide for penalties; to amend Code5
23	23	Section 33-6-4 of the Official Code of Georgia Annotated, relating to enumeration of unfair6
24	24	methods of competition and unfair or deceptive acts or practices and penalty, so as to provide7
25	25	for conforming changes; to provide for related matters; to repeal conflicting laws; and for8
26	26	other purposes.9
27	27	BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:10
28	28	SECTION 1.11
29	29	Chapter 2 of Title 31 of the Official Code of Georgia Annotated, relating to the Department12
30	30	of Community Health, is amended by adding a new Code section to read as follows:13
31	31	"31-2-20.
32	32	14
33	33	(a) As used in this Code section, the term:15
34	34	H. B. 102
35	35	- 1 - 25 LC 57 0172
36	36	(1) 'Direct personal identifiers' means information relating to a covered individual that16
37	37	contains primary or obvious identifiers, such as the individual's name, street address,17
38	38	email address, telephone number, and social security number, but shall not include18
39	39	geographic or demographic information that would prohibit the identification of a19
40	40	covered individual.20
41	41	(2) 'GQRP' means the Georgia Quality Reporting Project established pursuant to this21
42	42	Code section.22
43	43	(3) 'HEDIS' means the Healthcare Effectiveness Data and Information Set.23
44	44	(4) 'Qualified Health Information Network' or 'QHIN' means a network certified by the24
45	45	secretary of the United States Department of Health and Human Services and the25
46	46	assistant secretary for technology policy/office of the National Coordinator for Health26
47	47	Information Technology that meets all of the Trusted Exchange Framework and Common27
48	48	Agreement requirements established by the federal 21st Century Cures Act, P.L. 114-255,28
49	49	and utilizes a quality measure calculation product certified by the National Committee29
50	50	for Quality Assurance for HEDIS reporting.30
51	51	(5) 'Submitting entity' means a Medicaid care management organization that contracts31
52	52	with the department to arrange healthcare services for Medicaid recipients.32
53	53	(b)(1) The department shall facilitate the establishment of the Georgia Quality Reporting33
54	54	Project. The purpose of the GQRP shall be to:34
55	55	(A) Gauge the quality of treatment for opioid use disorder and healthcare overall;35
56	56	(B) Improve the quality of care to Georgia residents;36
57	57	(C) Reduce the overall cost of medical treatment and care in this state; and37
58	58	(D) Foster clinical research in this state.38
59	59	(2) The department may enter into agreements with the administrator of the Georgia39
60	60	All-Payer Claims Database established pursuant to Article 3 of Chapter 53 of this title40
61	61	and the Georgia Data Analytic Center established pursuant to Part 3 of Article 4 of41
62	62	H. B. 102
63	63	- 2 - 25 LC 57 0172
64	64	Chapter 12 of Title 45 for purposes of establishing the GQRP and accomplishing its42
65	65	purposes.43
66	66	(c) The department shall facilitate the establishment of a GQRP use case working group44
67	67	for the purpose of creating a framework and implementation plan for the GQRP.45
68	68	(d) Beginning January 1, 2028, and every month thereafter, all submitting entities shall be46
69	69	required to transmit clinical data collected through the methods and formats established by47
70	70	the federal Department of Health and Human Services' Electronic Clinical Quality48
71	71	Measures Fast Health Information Resources standards to the department. Such data shall49
72	72	be transmitted either directly or through QHIN connections implemented by such50
73	73	submitting entities. Such data shall include:51
74	74	(1) Clinical data from electronic health records for all Georgia healthcare organizations52
75	75	who provide substance use disorder care to Medicaid patients to evaluate opioid care in53
76	76	this state; and54
77	77	(2) Clinical data from electronic health records to report relevant state level quality55
78	78	measures to evaluate the quality of care and improve clinical outcomes for in-state56
79	79	patients.57
80	80	(e) Beginning January 1, 2029, and every month thereafter, the clinical data collected58
81	81	pursuant to subsection (d) of this Code section shall be converted and combined with all59
82	82	claims data to calculate state level opioid statistics and relevant state level quality measures60
83	83	available in the HEDIS data sets. A nationally recognized and standardized National61
84	84	Committee for Quality Assurance accredited process shall be used for the calculation of62
85	85	relevant HEDIS quality measures.63
86	86	(f) Direct personal identifiers contained in clinical data transmitted pursuant to this Code64
87	87	section shall not be considered a public record and shall not be subject to Article 4 of65
88	88	Chapter 18 of Title 50, relating to open records.66
89	89	H. B. 102
90	90	- 3 - 25 LC 57 0172
91	91	(g) The collection, storage, and release of healthcare data and other information pursuant67
92	92	to this Code section shall be subject to the federal Health Insurance Portability and68
93	93	Accountability Act (HIPAA) of 1996, P.L. 104-191.69
94	94	(h) Except as otherwise provided in this Code section, any submitting entity that fails to70
95	95	submit clinical data in accordance with this Code section shall be subject to penalty. The71
96	96	department shall adopt a schedule of penalties not to exceed $1,000.00 per day of violation,72
97	97	determined by the severity of the violation. A penalty imposed under this subsection may73
98	98	be remitted or mitigated upon such terms and conditions as the department considers proper74
99	99	and consistent with the public health and safety. Any fines collected pursuant to this75
100	100	subsection shall be deposited into the state treasury.76
101	101	(i) Any submitting entity that is subject to the jurisdiction of the Commissioner of77
102	102	Insurance that fails to submit clinical data in accordance with this Code section shall be78
103	103	subject to violation of paragraph (14.2) of subsection (b) of Code Section 33-6-4, and any79
104	104	other penalties that may be imposed by the Commissioner of Insurance. The department80
105	105	may refer violations by such submitting entities to the Commissioner of Insurance for81
106	106	enforcement action for each instance in which such submitting entity fails to submit clinical82
107	107	data to the department in accordance with this Code section and in accordance with any83
108	108	rules and regulations established for such purpose.84
109	109	(j) No healthcare provider contracting with a submitting entity to provide healthcare85
110	110	services to Medicaid recipients shall be required to incur any direct or indirect expense86
111	111	related to the compliance by a submitting entity with the requirements of this Code section."87
112	112	SECTION 2.88
113	113	Code Section 33-6-4 of the Official Code of Georgia Annotated, relating to enumeration of89
114	114	unfair methods of competition and unfair or deceptive acts or practices and penalty, is90
115	115	amended by revising paragraph (14.2) of subsection (b) as follows:91
116	116	H. B. 102
117	117	- 4 - 25 LC 57 0172
118	118	"(14.2) Failing to submit all claims data to the Georgia All-Payer Claims Database as
119	119	92
120	120	required in Article 3 of Chapter 53 of Title 31 or failing to submit all clinical data to the
121	121	93
122	122	department as required in Code Section 31-2-20;"94
123	123	SECTION 3.95
124	124	All laws and parts of laws in conflict with this Act are repealed.96
125	125	H. B. 102
126	126	- 5 -