25 LC 52 0772
Senate Bill 323
By: Senators James of the 28th, Jones II of the 22nd, Harrell of the 40th, Wicks of the 34th,
Davenport of the 17th and others
A BILL TO BE ENTITLED
AN ACT
To amend Titles 31, 33, and 43 of the Official Code of Georgia Annotated, relating to health,
1
insurance, and professions and businesses, respectively, so as to provide for medically2
necessary tests for metal allergies and metal sensitivities to be administered prior to any3
cardiovascular, dental, or orthopedic surgery involving the insertion of a metal implant; to4
provide for definitions; to provide for health benefit policies to cover such tests; to provide5
for cost-sharing requirements; to provide for rules and regulations; to provide for continuing6
education requirements for dental surgeons and surgeons; to provide for requirements for7
certain healthcare providers; to provide for a private cause of action; to provide for related8
matters; to repeal conflicting laws; and for other purposes.9
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:10
SECTION 1.11
Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in Chapter12
1, relating to general provisions, by adding a new Code section to read as follows:13
"31-1-26.
14
(a) The department, in consultation with the Georgia Board of Dentistry and the Georgia15
Composite Medical Board, shall identify and compile information on metal allergies and16
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metal sensitivities to identify medically necessary and recommended tests to protect17
individuals prior to any cardiovascular, dental, or orthopedic surgery involving the18
insertion of a metal implant into a human body. Such information shall be reviewed19
annually and updated, if necessary.20
(b) The information identified and compiled pursuant to subsection (a) of this Code section21
shall be posted in a prominent location on the department's website for the purpose of22
providing information to healthcare providers and the general public. Such information23
shall be annually distributed by the Georgia Board of Dentistry to all dental surgeons24
licensed to practice dentistry in this state and by the Georgia Composite Medical Board to25
all surgeons licensed to practice medicine in this state."26
SECTION 2.27
Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended in28
Chapter 24, relating to insurance generally, by adding a new Code section to read as follows:29
"33-24-59.34.30
(a) As used in this Code section, the term:31
(1) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any32
maximum limitation on the application of such deductible, coinsurance, copayment, or33
similar out-of-pocket expense.34
(2) 'Health benefit policy' means any individual or group plan, policy, or contract for35
healthcare services issued, delivered, issued for delivery, or renewed in this state which36
provides major medical benefits, including those contracts executed by the State of37
Georgia on behalf of indigents and on behalf of state employees under Article 1 of38
Chapter 18 of Title 45, by a healthcare corporation, health maintenance organization,39
preferred provider organization, accident and sickness insurer, fraternal benefit society,40
hospital service corporation, medical service corporation, or any similar entity and any41
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self-insured healthcare plan not subject to the exclusive jurisdiction of the Employee42
Retirement Income Security Act of 1974, 29 U.S.C. Section 1001, et seq.43
(3) 'Medically necessary' shall have the same meaning as set forth in Code Section44
33-46-4 and shall be in accordance with guidelines established pursuant to Code Section45
31-1-26; provided, however, that, if a patient informs a healthcare provider that he or she46
has a metal allergy or metal sensitivity, a lymphocyte transformation test or other more47
advanced test shall be considered medically necessary.48
(4) 'Metal implant' means any medical device made of metal that is used to support or49
replace any human body part, including but not limited to any bone, joint, or tooth. Such50
term shall not include any medical injection, surgical tool, or dental filling.51
(b) All health benefit policies issued, delivered, issued for delivery, or renewed on or after52
July 1, 2025, shall include coverage for medically necessary tests for metal allergies and53
metal sensitivities prior to any cardiovascular, dental, or orthopedic surgery involving the54
insertion of a metal implant into the human body.55
(c) The coverage provided for in subsection (b) of this Code section shall be subject to any56
cost-sharing requirement of the covered person's health benefit policy and shall not57
diminish or limit any other benefits provided under such policy.58
(d) If application of the provisions of this Code section would result in health savings59
account ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then60
such provisions shall apply only to health savings accounts with qualified high deductible61
health plans with respect to the deductibles of such plans after an individual has satisfied62
the minimum deductibles; provided, however, that the provisions of this Code section shall63
apply to items or services that are preventive care.64
(e) The Commissioner shall promulgate rules and regulations necessary to implement the65
provisions of this Code section."66
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SECTION 3.
67
Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,68
is amended in Chapter 11, relating to dentists, dental hygienists, and dental assistants, by69
adding a new subsection to Code Section 43-11-46.1, relating to continuing education70
requirements and waiver, to read as follows:71
"(f) On and after January 1, 2025, continuing education requirements for dental surgeons
72
shall include one hour of education and training on metal allergies and metal sensitivities73
and any medically necessary and recommended tests to be administered prior to any dental74
surgery involving the insertion of a metal implant into a human body."75
SECTION 4.76
Said title is further amended in Chapter 34, relating to physicians, acupuncture, physician77
assistants, cancer and glaucoma treatment, respiratory care, clinical perfusionists, and78
orthotics and prosthetics practice, by adding a new paragraph to subsection (a) of Code79
Section 43-34-11, relating to continuing education requirement and required training for80
physicians, to read as follows:81
"(7) On and after January 1, 2025, all surgeons shall be required to receive one hour of82
education and training on metal allergies and metal sensitivities and any medically83
necessary and recommended tests to be administered prior to any surgery involving the84
insertion of a metal implant into a human body."85
SECTION 5.86
Said title is further amended in said chapter by adding a new Code section to read as follows:87
"43-34-16.88
(a) As used in this Code section, the term:89
(1) 'Healthcare provider' means a physician or other person licensed or otherwise90
authorized to perform surgical services in this state.91
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(2) 'Medically necessary' shall have the same meaning as set forth in Code Section92
33-46-4 and shall be in accordance with clinical practice guidelines established pursuant93
to Code Section 31-1-26; provided, however, that, if a patient informs a healthcare94
provider that he or she has a metal allergy or metal sensitivity, a lymphocyte95
transformation test or other more advanced test shall be considered medically necessary.96
(3) 'Metal implant' means any medical device made of metal that is used to support or97
replace any human body part, including but not limited to any bone, joint, or tooth. Such98
term shall not include any medical injection, surgical tool, or dental filling.99
(b) Prior to performing any cardiovascular, dental, or orthopedic surgery involving the100
insertion of a metal implant into a human body, a healthcare provider shall:101
(1) Ask a patient if he or she has any metal allergy or metal sensitivity; and102
(2) Perform any medically necessary tests for metal allergies and metal sensitivities.103
(c) A patient aggrieved by a healthcare provider's failure to satisfy the requirements104
provided for in subsection (b) of this Code section may bring a private cause of action105
against such provider for damages and any other relief a court of competent jurisdiction106
deems appropriate."107
SECTION 6.108
All laws and parts of laws in conflict with this Act are repealed.109
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