Selective Application of Reductions in Prior Authorization Requirements

If this bill is passed, it will change part of the Code of Georgia about giving official approval to people or companies that check if medical treatments and services are necessary before insurance pays for them.

• Code of Georgia: These are the rules or laws for the state of Georgia that say what people in Georgia can and cannot do.

This bill:

• Allows health insurance companies to set up and keep a program that makes it easier to get medical treatments approved if certain rules are followed.

• Includes a rule for turning in paperwork every year.

• Helps make new rules.

• Sets a start date of January 1, 2026 and explains what happens then.

• Gets rid of any other laws that stop this one from working.

• Adds a new section to the Code of Georgia that says:

  • Insurance companies that use prior authorization must set up and keep a program that makes it easier to get medical care if certain rules are followed.

    • Prior authorization: When a health plan has to say “yes” or “no” before a person can get the care they need

  • Insurance companies need to turn paperwork in that has details about the program, who can take part, a list of processes and services that are affected, number of healthcare professionals who are taking part, and any other necessary info.

  • Paperwork must be turned in by July 1, 2026, and then every year after that.

The changes in this bill apply to all policies or contracts issued, delivered, or renewed on or after the effective date.