Legislation Signed into Law

2022

Primary Focus Mental Health Parity
Title/Description Mental Health Parity Act
Citation GA Code § 33-1-27 (2022)
Summary

A bill to be entitled an Act to amend Titles 15, 20, 31, 33, 37, 45, and 49 of the O.C.G.A., relating to courts, education, health, insurance, mental health, public officers and employees, and social services, respectively, so as to implement the recommendations of the Georgia Behavioral Health Reform and Innovation Commission; to provide for related matters; to repeal conflicting laws; and for other purposes.

This legislation aims to ensure compliance with federal laws related to mental health parity, requiring annual reports and data calls on mental health care parity by private insurers, establishing information repositories, defining treatment limitations, addressing consumer complaints, revising provisions for independent review panels, and implementing various measures to enhance mental health care, substance use disorder treatment, workforce data collection, and accountability within the state of Georgia.

Effective Date July 1, 2022
Notes HB 1013

2021

Primary Focus Updating and promoting transparency in utilization management
Title/Description Certification of Private Review Agents: Ensuring Transparency in Prior Authorization Act
Citation

GA 33-46-1 et.al., including GA 33-46-20 (New provisions not codified yet; see Title 33 Insurance, Chapter 46 – Certification of Private Review Agents)

Summary

The new law focuses on transparency and disclosure requirements associated with current prior authorization requirements.  Insurers must disclose the criteria in a timely fashion when making adverse decisions along with publishing aggregate statistics on their websites.  The statistics shall cover trends associated with approval/denial rates; reasons for the denials, whether the denial was appealed, the outcome of the appeal, and time between submission and response.

Effective Date January 1, 2021
Notes

Adopted through SB 80; signed by the Governor on May 10, 2021.

2019

Primary Focus Access to Services, Compliance
Title/Description Coverage for Autism
Citation O.C.G.A. § 33-24-59.10
Summary

Outlines coverage requirements for autism, including accident and sickness contract, policy, and benefit plans. Defines autism spectrum disorder and qualifying treatment services.
Section (b) updates coverage for autism by changing the age limit for an individual covered under a policy or contract from 6 years and under, to 20 years and under.
Does not create obligations under individualized family service plan, an individualized education plan as required by the federal Individuals with Disabilities Education Act, or an individualized service plan.
Provides how an insurer, corporation, or health maintenance organization, or a governmental entity providing coverage for treatment pursuant to the Code can be exempt from providing coverage for behavioral health treatment.
Also provides discussion of relationship to Affordable Care Act and reporting requirements.

Effective Date 1/1/2016 (subsection (b) effective 1/1/ 2019)
Notes

GA SB118

2017

Primary Focus Controlled Substances
Title/Description Review of PDMP data when filling certain prescriptions
Citation GA CODE § 16–13–63
Summary

On and after July 1, 2018, when a prescriber is prescribing a controlled substance listed in paragraph (1) or (2) of Code Section 16–13–26 or benzodiazepines, the prescriber shall seek and review information from the Prescription Drug Monitoring Program (PDMP) the first time the prescriber issues such prescription to a patient and thereafter at least once every 90 days, unless the:
(i) Prescription is for no more than a three-day supply of such substance and no more than 26 pills;
(ii) Patient is in a hospital or health care facility, including but not limited to, a nursing home, an intermediate care home, a personal care home, or hospice program, which provides patient care and prescriptions to be administered and used by a patient on the premises of the facility;
(iii) Patient has had outpatient surgery at a hospital or ambulatory surgical center and the prescription is for no more than a ten-day supply of such substance and no more than 40 pills;
(iv) Patient is terminally ill or under the supervised care of an outpatient hospice program; or
(v) Patient is receiving treatment for cancer

Effective Date 7/1/2017
Notes

Enacted by The General Assembly of Georgia through House Bill 249.

2015-2016

HB 429
Introduced 2/2015
Sponsor Many (click link to see sponsors)
Status Signed into Law 4/2015
Summary

This bill changed the section of the state insurance law about autism coverage to what it is currently (that section is summarized at the bottom of this page under “Georgia Parity Law,” “Autism Coverage”).

2011-2012

Primary Focus Access to Service
Title/Description Interstate Compact on Mental Health
Citation O.C.G.A. § 37-10-2
Summary

Provides for the care and treatment of mentally retarded persons regardless of residence requirements and authorizes supplementary agreements for joint or cooperative use of mental health resources. Compact eligibility is on a nationwide basis.
This compact’s goals include setting the legal basis for higher quality and faster responses to mental health issues in the states. The compact identifies public safety and humanitarianism as key motivations for providing such services.

Effective Date 5/1/2012
Notes

HB 942

2009-2010

Primary Focus Access to Services
Title/Description “Drug” defined; Right of minor to obtain treatment of drug abuse on his consent alone; binding effect of consent; informing minor’s parent, spouse, custodian, or guardian of treatment
Citation O.C.G.A. § 37-7-8
Summary

Defines “drug,” what qualifies as consent for minor seeking drug abuse treatment, and when providers can provide information to a spouse, parent, custodian, or guardian of a minor.

Effective Date 2010

Primary Focus Access to Services
Title/Description Coverage of Treatment of Mental Disorders
Citation O.C.G.A. § 33-24-28.1
Summary

Every insurer authorized that issues accident and sickness insurance benefit plans, policies, or contracts is required to make coverage for the treatment of mental disorders, that is at least as extensive as coverage for the treatment of other types of physical illnesses available.
Plans must also cover the spouse and the dependents of the insured if the insured’s spouse and dependents are covered under such benefit plan, policy, or contract.
Optional endorsements cannot contain any exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance provisions which apply to the treatment of mental disorders unless such provisions apply generally to other similar benefits in the plan.

Effective Date 2010

Primary Focus Access to Services
Title/Description Coverage for Treatment of Mental Disorders Under Accident and Sickness Insurance Benefit Plans Providing Major Medical Benefits Covering Small Groups; Federal Law
Citation O.C.G.A. § 33-24-29
Summary

Defines covered plans and limitations.
Creates coverage for the treatment of mental disorders that is at least as extensive and has the same annual and lifetime dollar limits as that provided by the respective plan, policy, or contract for the treatment of other types of physical illnesses.
Plans may provide for different limits on the number of inpatient treatment days and outpatient treatment visits.
Coverage must also cover the spouse and the dependents of the insured if the insured’s spouse and dependents are covered under such benefit plan, policy, or contract.
Cannot contain any exclusions, reductions, or other limitations as to coverages which apply to the treatment of mental disorders unless such provisions apply generally to other similar benefits provided or paid for under the accident and sickness insurance benefit plan, policy, or contract.

Effective Date 2010

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Common Violations

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