Georgia 2025-2026 Regular Session

Georgia House Bill HB326 Compare Versions

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

Old	New	Differences
1	1	25 LC 46 1006
2	2	House Bill 326
3	3	By: Representatives Au of the 50
4	4	th
5	5	, Stephens of the 164
6	6	th
7	7	, Cooper of the 45
8	8	th
9	9	, Oliver of the
10	10	84
11	11	th
12	12	, and Hawkins of the 27
13	13	th
14	14
15	15	A BILL TO BE ENTITLED
16	16	AN ACT
17	17	To amend Article 1 of Chapter 18 of Title 45 of the Official Code of Georgia Annotated,
18	18	1
19	19	relating to state employees' health insurance and benefit plans, so as to mandate that the state2
20	20	health benefit plan provide coverage for qualifying nonopioid pain management drugs that3
21	21	is in parity with its coverage for opioid pain management drugs; to provide for definitions;4
22	22	to provide for parity with regard to annual deductibles, coinsurance, copayments, exclusions,5
23	23	reductions, other limitations, or utilization review; to provide for legislative construction; to6
24	24	provide for related matters; to provide for a short title; to provide for legislative findings; to7
25	25	provide for an effective date; to repeal conflicting laws; and for other purposes.8
26	26	BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9
27	27	SECTION 1.10
28	28	This Act shall be known and may be cited as the "State Health Benefit Plan Nonopioid11
29	29	Coverage Parity Act."12
30	30	SECTION 2.13
31	31	The General Assembly finds and declares that:14
32	32	H. B. 326
33	33	- 1 - 25 LC 46 1006
34	34	(1) An opioid epidemic has cost the state millions of dollars in medical treatment, lost
35	35	15
36	36	economic productivity, and increased overdose deaths, among other costs; and16
37	37	(2) Requiring coverage for nonopioid pain management drugs in the state health benefit17
38	38	plan that is at least as good as its coverage for opioid pain management drugs will reduce18
39	39	the costs borne by this state. 19
40	40	SECTION 3.20
41	41	Article 1 of Chapter 18 of Title 45 of the Official Code of Georgia Annotated, relating to21
42	42	state employees' health insurance and benefit plans, is amended by adding a new Code22
43	43	section to read as follows:23
44	44	"45-18-4.2.
45	45	24
46	46	(a) As used in this Code section, the term:25
47	47	(1) 'Healthcare provider' means the pharmacy, attending physician, or any other person26
48	48	or entity administering healthcare to a member of the state health benefit plan at the time27
49	49	of reference that is licensed, certified, or otherwise authorized or permitted by law to28
50	50	administer healthcare in the ordinary course of business or practice of a profession,29
51	51	including any person employed by or acting for any such authorized person or entity.30
52	52	(2) 'Prior authorization' means any requirement for the healthcare provider to obtain31
53	53	approval from the state health benefit plan prior to the furnishing of a drug.32
54	54	(3) 'Qualifying nonopioid pain management drugs' means a drug or biological product33
55	55	that:34
56	56	(A) Has a label indication approved by the federal Food and Drug Administration to35
57	57	reduce postoperative pain or any other form of acute pain;36
58	58	(B) Does not act upon the body's opioid receptors;37
59	59	(C) Is not a Schedule I or II controlled substance;38
60	60	(D) Has been selected by the Department of Community Health for inclusion in its39
61	61	formulary; and40
62	62	H. B. 326
63	63	- 2 - 25 LC 46 1006
64	64	(E) Is sold or marketed in the United States.41
65	65	(4) 'State health benefit plan' means the health insurance plan established pursuant to this42
66	66	article.43
67	67	(5) 'Step therapy' means a drug therapy utilization management protocol or program that44
68	68	requires use of an alternative, preferred prescription drug or drugs before the state health45
69	69	benefit plan approves coverage for the nonpreferred drug therapy prescribed.46
70	70	(b) The state health benefit plan shall cover qualifying nonopioid pain management drugs47
71	71	and such drugs shall be subject to the same annual deductible, coinsurance, copayment,48
72	72	exclusions, reductions, or other limitations as to coverage, or utilization review applicable49
73	73	to similar covered opioid pain management drugs.50
74	74	(c) Notwithstanding subsection (b) of this Code section, nothing in this Code section shall51
75	75	be construed to prohibit the state health benefit plan from contracting to provide qualifying52
76	76	nonopioid pain management drug coverage for the state health benefit plan that is greater53
77	77	than the coverage provided for opioid pain management drugs.54
78	78	(d) The state health benefit plan shall, with respect to a qualifying nonopioid pain55
79	79	management drug for which coverage is provided under such plan, neither impose any step56
80	80	therapy requirement under which an individual enrolled under such plan is required to use57
81	81	an opioid pain management drug prior to receiving the prescribed qualifying nonopioid58
82	82	pain management drug nor require prior authorization for qualifying nonopioid pain59
83	83	management drugs unless similar prior authorization is required for opioid pain60
84	84	management drugs.61
85	85	(e) Nothing in this Code section should be construed to interfere with the ability of a62
86	86	healthcare provider to prescribe or administer a course of treatment that is medically63
87	87	appropriate."64
88	88	SECTION 4.65
89	89	This Act shall become effective on January 1, 2026.66
90	90	H. B. 326
91	91	- 3 - 25 LC 46 1006
92	92	SECTION 5.
93	93	67
94	94	All laws and parts of laws in conflict with this Act are repealed.68
95	95	H. B. 326
96	96	- 4 -