25 LC 52 0731
House Bill 420
By: Representatives Taylor of the 173
rd
, Hawkins of the 27
th
, Dempsey of the 13
th
, Mathiak
of the 82
nd
, Stinson of the 150
th
, and others
A BILL TO BE ENTITLED
AN ACT
To amend Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated,
1
relating to general provisions regarding insurance, so as to require certain health benefit2
policies to cover genetic testing for an inherited mutation and cancer imaging under certain3
conditions; to provide for definitions; to exclude such coverage from any cost-sharing4
requirements; to protect the eligibility of health savings accounts; to provide for rules and5
regulations; to provide for related matters; to repeal conflicting laws; and for other purposes.6
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7
SECTION 1.8
Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to9
general provisions regarding insurance, is amended by adding a new Code section to read as10
follows:11
"33-24-59.34.
12
(a) As used in this Code section, the term:13
(1) 'Cancer imaging' means imaging modalities available to healthcare providers who14
diagnose, stage, and treat human cancer in accordance with nationally recognized clinical15
practice guidelines. Such term includes but is not limited to x-ray, computed16
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tomography, ultrasound, magnetic resonance imaging, single photon emission computed17
tomography, positron emission tomography, and optical imaging.18
(2) 'Clinical utility' means any test or imaging result that provides information that is19
used in the formulation of a treatment or monitoring strategy that informs a patient's20
outcome and impacts a clinical decision. Such term includes the most appropriate test21
that may include information that is actionable and information that cannot be22
immediately used in the formulation of a clinical decision.23
(3) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any24
maximum limitation on the application of such deductible, coinsurance, copayment, or25
similar out-of-pocket expense.26
(4) 'Genetic testing for an inherited mutation' means germline multi-gene testing for an27
inherited mutation or pathogenic variants in an individual's genes that are associated with28
an increased risk of cancer.29
(5) 'Health benefit policy' shall have the same meaning as set forth in Code30
Section 33-24-59.21.31
(6) 'Nationally recognized clinical practice guidelines' means evidence based clinical32
practice guidelines developed by independent organizations or medical professional33
societies utilizing a transparent methodology and reporting structure and with a34
conflict-of-interest policy. Such guidelines establish standards of care informed by a35
systematic review of evidence and an assessment of the benefits and risks of any36
alternative care options and include recommendations intended to optimize patient care.37
(b) All health benefit policies renewed or issued on or after July 1, 2025, shall include38
coverage for:39
(1) Genetic testing for an inherited mutation for a covered person with a personal or40
family history of cancer when such testing provides clinical utility, is recommended by41
a healthcare provider, and is in accordance with nationally recognized clinical practice42
guidelines; and43
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(2) Cancer imaging for a covered person with an increased risk of cancer when such44
imaging provides clinical utility, is recommended by a healthcare provider, and is in45
accordance with nationally recognized clinical practice guidelines.46
(c) The coverage provided for in subsection (b) of this Code section shall not be subject47
to any cost-sharing requirement of the covered person's health benefit policy and shall not48
diminish or limit any other benefits provided under such policy.49
(d) If application of the provisions of this Code section would result in health savings50
account ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then51
such provisions shall apply only to health savings accounts with qualified high deductible52
health plans with respect to the deductibles of such plans after an individual has satisfied53
the minimum deductibles; provided, however, that the provisions of this Code section shall54
apply to items or services that are preventive care.55
(e) The Commissioner shall promulgate rules and regulations necessary to implement the56
provisions of this Code section in accordance with current guidelines established by57
professional medical organizations such as the National Comprehensive Cancer Network."58
SECTION 2.59
All laws and parts of laws in conflict with this Act are repealed.60
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