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GA SB276
Bill
Status
5/14/2025
Primary Sponsor
Drew Echols
Click for details
AI Summary
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Prohibits third-party payers (insurers, managed care entities, pharmacy benefits managers) from refusing to pay for healthcare items or services solely because the payer did not provide prior authorization
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Requires third-party payers to respond to Department of Community Health inquiries about healthcare claim status within 60 days
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Mandates third-party payers accept the Department of Community Health's payment authorization for healthcare items or services as equivalent to the payer's own authorization for Medicaid recipients
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Applies to all insurers, group health plans under ERISA, managed care entities, pharmacy benefits managers, and any other parties legally responsible for healthcare claims
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Amends Code Section 49-4-148 regarding recovery of medical assistance from third parties liable for sickness, injury, disease, or disability
Legislative Description
Recovery of Medical Assistance from Third Party; certain provisions to comply with federal law; revise
Last Action
Effective Date 2025-07-01
5/14/2025