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HB654 • 2025

Insurance; prohibit insurers from conditioning the payment of any medical test or procedure or prescription drug benefit on prior authorization

Insurance; prohibit insurers from conditioning the payment of any medical test or procedure or prescription drug benefit on prior authorization

Healthcare Labor
Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor
Campbell, Lisa
Last action
2025-02-28
Official status
House Second Readers
Effective date
Not listed

Plain English Breakdown

The provided bill text excerpt is a raw PDF stream and contains no readable content; all facts were derived solely from the metadata and summary fields.

HB654: Prohibiting Prior Authorization for Medical Tests, Procedures, and Drugs

This bill changes state laws to stop insurance companies from requiring prior approval before paying for medical tests, procedures, or prescription drugs.

What This Bill Does

  • Amends general provisions regarding insurance in the Official Code of Georgia Annotated (O.C.G.A.).
  • Updates regulations and licensure rules for pharmacy benefit managers.
  • Changes laws related to medical practice.
  • Modifies the state employees' health insurance plan so payment is not conditioned on prior authorization.
  • Provides definitions, an effective date, and repeals conflicting laws.

Who It Names or Affects

  • Insurance companies operating under Georgia law
  • Pharmacy benefit managers regulated in Georgia
  • Medical practitioners providing tests or procedures
  • Participants in the state employees' health insurance plan

Limits and Unknowns

  • The official text excerpt does not list specific exceptions to the ban on prior authorization.
  • The exact effective date is mentioned as a provision of the bill but is not specified in the provided summary or metadata.
  • Details about how existing contracts or pending authorizations are handled are not included in the source material.

Bill History

  1. 2025-02-28 Georgia General Assembly

    House Second Readers

Official Summary Text

Insurance; prohibit insurers from conditioning the payment of any medical test or procedure or prescription drug benefit on prior authorization