Georgia 2025-2026 Regular Session

Georgia House Bill HB420 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	25 LC 52 ~~0769S~~
	1	+	25 LC 52 0756S
2	2		The House Committee on Insurance offers the following substitute to HB 420:
3	3		A BILL TO BE ENTITLED
4	4		AN ACT
5	5		To amend Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated,1
6	6		relating to general provisions regarding insurance, so as to require certain health benefit2
7	7		policies to cover genetic testing for an inherited mutation and cancer imaging under certain3
8		-	conditions; to provide for definitions; to ~~provide for~~ cost-~~sharing requirements; to protect the4~~
9		-	eligibility of health savings accounts; to provide for rules ~~and regulations; to provide for5~~
10		-	related matters; to repeal conflicting laws; and for other purposes.6
	8	+	conditions; to provide for definitions; to exclude such coverage from any cost-sharing4
	9	+	requirements; to protect the eligibility of health savings accounts; to provide for rules and5
	10	+	regulations; to provide for related matters; to repeal conflicting laws; and for other purposes.6
11	11		BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7
12	12		SECTION 1.8
13	13		Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to9
14	14		general provisions regarding insurance, is amended by adding a new Code section to read as10
15	15		follows:11
16	16		"33-24-59.34.12
17	17		(a) As used in this Code section, the term:13
18	18		(1) 'Cancer imaging' means imaging modalities available to healthcare providers who14
19	19		diagnose, stage, and treat human cancer in accordance with nationally recognized clinical15
20	20		practice guidelines.16
21	21		H. B. 420 (SUB)
22		-	- 1 - 25 LC 52 ~~0769S~~
	22	+	- 1 - 25 LC 52 0756S
23	23		(2) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any17
24	24		maximum limitation on the application of such deductible, coinsurance, copayment, or18
25	25		similar out-of-pocket expense.19
26	26		(3) 'Genetic testing for an inherited mutation' means germline multi-gene testing for an20
27	27		inherited mutation or pathogenic variants in an individual's genes that are associated with21
28	28		an increased risk of cancer.22
29	29		(4) 'Health benefit policy' means any individual or group plan, policy, or contract for23
30	30		healthcare services issued, delivered, issued for delivery, executed, or renewed in this24
31	31		state which provides major medical benefits, including those contracts executed by this25
32	32		state on behalf of indigents and on behalf of state employees under Article 1 of Chapter26
33	33		18 of Title 45, public school teachers and employees under Part 6 of Article 17 of27
34	34		Chapter 2 of Title 20, and members and employees of the board of regents under Code28
35	35		Section 31-2-4, by a healthcare corporation, health maintenance organization, preferred29
36	36		provider organization, accident and sickness insurer, fraternal benefit society, hospital30
37	37		service corporation, medical service corporation, or any similar entity and any31
38	38		self-insured healthcare plan not subject to the exclusive jurisdiction of the Employee32
39	39		Retirement Income Security Act of 1974, 29 U.S.C. Section 1001, et seq.33
40	40		(5) 'Nationally recognized clinical practice guidelines' means evidence based clinical34
41	41		practice guidelines developed by independent organizations or medical professional35
42	42		societies utilizing a transparent methodology and reporting structure and with a36
43	43		conflict-of-interest policy. Such guidelines establish standards of care informed by a37
44	44		systematic review of evidence and an assessment of the benefits and risks of any38
45	45		alternative care options and include recommendations intended to optimize patient care.39
46	46		(b) All health benefit policies renewed or issued on or after July 1, 2025, shall include40
47	47		coverage for:41
48	48		H. B. 420 (SUB)
49		-	- 2 - 25 LC 52 ~~0769S~~
	49	+	- 2 - 25 LC 52 0756S
50	50		(1) Genetic testing for an inherited mutation for a covered person with a personal or42
51	51		family history of cancer when such testing is recommended by a healthcare provider and43
52	52		is in accordance with nationally recognized clinical practice guidelines; and44
53	53		(2) Cancer imaging for a covered person with an increased risk of cancer when such45
54	54		imaging is recommended by a healthcare provider and is in accordance with nationally46
55	55		recognized clinical practice guidelines.47
56		-	(c) The coverage provided for in subsection (b) of this Code section shall be subject to any48
57		-	cost-sharing requirement of a covered person's health benefit policy.49
58		-	(d) If application of the provisions of this Code section would result in health savings50
59		-	account ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then51
60		-	such provisions shall apply only to health savings accounts with qualified high deductible52
61		-	health plans with respect to the deductibles of such plans after an individual has satisfied53
62		-	the minimum deductibles; provided, however, that the provisions of this Code section shall54
63		-	apply to items or services that are preventive care pursuant to Section 223(c)(2)(C) of the55
64		-	Internal Revenue Code.56
65		-	(e) The Commissioner shall promulgate rules and regulations necessary to implement the57
66		-	provisions of this Code section in accordance with current guidelines established by58
67		-	professional medical organizations such as the National Comprehensive Cancer Network."59
68		-	SECTION 2.60
69		-	All laws and parts of laws in conflict with this Act are repealed.61
	56	+	(c) The coverage provided for in subsection (b) of this Code section shall not be subject48
	57	+	to any cost-sharing requirement of a covered person's health benefit policy and shall not49
	58	+	diminish or limit any other benefits provided under such policy.50
	59	+	(d) If application of the provisions of this Code section would result in health savings51
	60	+	account ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then52
	61	+	such provisions shall apply only to health savings accounts with qualified high deductible53
	62	+	health plans with respect to the deductibles of such plans after an individual has satisfied54
	63	+	the minimum deductibles; provided, however, that the provisions of this Code section shall55
	64	+	apply to items or services that are preventive care pursuant to Section 223(c)(2)(C) of the56
	65	+	Internal Revenue Code.57
	66	+	(e) The Commissioner shall promulgate rules and regulations necessary to implement the58
	67	+	provisions of this Code section in accordance with current guidelines established by59
	68	+	professional medical organizations such as the National Comprehensive Cancer Network."60
	69	+	SECTION 2.61
	70	+	All laws and parts of laws in conflict with this Act are repealed.62
70	71		H. B. 420 (SUB)
71	72		- 3 -