GA HB991

Creates the Healthcare Transparency and Accountability Oversight Committee, composed of 9 members (3 Governor-appointed professionals including a physician, pharmacist, and consumer, plus 6 General Assembly members appointed by the Governor, Lieutenant Governor, and Speaker of the House), to review the performance of all state healthcare plan contractors and subcontractors.

Requires contractors to submit an Annual Transparency Report by November 1 each year detailing state payments, Medical Loss Ratios, unmet performance benchmarks, dividends paid to shareholders, financial reports, corporate structure, affiliate subcontractor payments, and health care exchange participation.

Requires contractors or their pharmacy benefits managers to submit an Annual Prescription Drug Transparency Report by November 1 each year disclosing aggregated rebate and fee data, pharmacy claim totals, spread pricing differences, prior authorization statistics, and the names of the 25 drugs with the most prior authorizations and 50 most frequently prescribed drugs.

Mandates that contractor payment amounts, including capitated per member per month rates, are subject to open records disclosure and cannot be classified as confidential or trade secrets, while other records submitted to the committee remain confidential unless included in public reports.

Authorizes the Insurance Commissioner to impose monetary penalties of up to $2,000 per violation on noncompliant contractors or pharmacy benefits managers, increasing to up to $5,000 per violation if the entity knew or reasonably should have known it was in violation.