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GA HB1519
Bill
Status
Introduced
3/3/2022
Primary Sponsor
David Knight
Click for details
AI Summary
- Prohibits insurers from making unilateral changes to network participation contracts or health benefit plan policies that would substantially alter coverage, authorization, or site of delivery of ancillary services such as laboratory, pharmacy, infusion, radiology, diagnostic testing, and durable medical equipment services
- Bars insurers from precluding or limiting access to ancillary services from healthcare facilities or providers that were participating in the network at the start of the contract term
- Prevents insurers from imposing changes that result in materially adverse reimbursement or administrative cost impacts on providers, or higher cost-sharing requirements on covered persons for ancillary services delivered by the provider performing the primary healthcare service
- Exempts changes required by law, regulation, or government agency fee schedule updates, as well as changes expressly provided for in the contract through specific fee schedules or payment policy indexing mechanisms
- Effective January 1, 2023, applying to all policies issued, delivered, or renewed on or after that date, with noncompliance subject to penalties under Georgia Code Section 33-2-24
Legislative Description
Insurance; prohibit insurers from unilaterally changing network participation contracts impacting coverage, access to, or costs of ancillary services
Last Action
House Committee Favorably Reported By Substitute
3/11/2022
Committee Referrals
Special Committee On Access to Quality Health Care3/4/2022
Full Bill Text
No bill text available