GA SB5

Health insurers using prior authorization must implement programs to reduce prior authorization requirements for healthcare providers who demonstrate strong performance and adherence to evidence-based medicine, with annual filings to the department required by July 1, 2026.

Mandates insurance coverage for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) treatment in accordance with nationally recognized clinical practice guidelines.

Coverage requirements apply to all health benefit policies issued or renewed on or after July 1, 2025, including HMOs, PPOs, and other insurers, but exclude self-insured ERISA plans.

State health benefit plan for public employees must include PANDAS/PANS coverage beginning January 1, 2026.

Prohibits insurers from imposing special deductibles, coinsurance, or copayments on PANDAS/PANS services that differ from limitations applied to other covered healthcare services.