GA HB197

Private review agents and utilization review entities must attempt to contact treating healthcare providers during normal working hours before making adverse determinations on medical necessity, including through direct contact, callback systems, or public websites for scheduling communications

Health insurers using prior authorization must implement programs that reduce prior authorization requirements for healthcare providers based on their performance and adherence to evidence-based medicine

Insurers must file annual reports with the Georgia Department of Insurance detailing their prior authorization reduction programs, including participation criteria, covered procedures, and number of participating providers

Initial filings for the prior authorization reduction programs are due by July 1, 2026

Effective January 1, 2026, applying to all insurance policies issued, delivered, or renewed on or after that date