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GeorgiaHB 1972025-2026 Regular SessionHouseWALLET

Insurance; health care provider to respond to a private review agent or utility review entity's attempt to discuss the patient's care; detail the effort

Sponsored By: Michelle Au (Democrat), Sharon Cooper (Republican), Lee Hawkins (Republican), Trey Kelley (Republican), Mark Newton (Republican), Deborah Silcox (Republican)

Became Law

HealthRulesGeneral Bill

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Reviewers must consult your doctor first

Starting January 1, 2026, a reviewer who questions your care must try to talk to your treating provider first. The talk must be during normal work hours with a clinical peer in a related specialty. The reviewer must try calling, offer a callback system, or let the provider schedule a later talk on a public website. If coverage is denied after these steps, the notice to the provider must state the reasons.

Less prior authorization for high-performing providers

Beginning January 1, 2026, insurers that use prior authorization must run a program that can cut prior authorization for providers who meet performance and evidence-based care standards. Insurers choose the criteria and which services are included. They must file the full program description, criteria, covered services, and number of participating providers with the Department by July 1, 2026. They must file each year after that as the Commissioner requires.

Sponsors & Cosponsors

Sponsors

  • Michelle Au

    Democrat • House

  • Sharon Cooper

    Republican • House

  • Lee Hawkins

    Republican • House

  • Trey Kelley

    Republican • House

  • Mark Newton

    Republican • House

  • Deborah Silcox

    Republican • House

Cosponsors

  • Kay Kirkpatrick

    Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 389 • No: 0

House vote • 4/4/2025

Agree to Senate Substitute

Yes: 162 • No: 0

Senate vote • 4/2/2025

PASSAGE BY SUBSTITUTE

Yes: 53 • No: 0

House vote • 3/4/2025

PASSAGE

Yes: 174 • No: 0

Actions Timeline

  1. Effective Date

    1/1/2026

  2. House Date Signed by Governor

    5/14/2025House

  3. Act 303

    5/14/2025

  4. House Sent to Governor

    4/9/2025House

  5. House Agreed Senate Amend or Sub

    4/4/2025House

  6. Senate Tabled

    4/2/2025Senate

  7. Senate Taken from Table

    4/2/2025Senate

  8. Senate Third Read

    4/2/2025Senate

  9. Senate Passed/Adopted By Substitute

    4/2/2025Senate

  10. Senate Committee Favorably Reported By Substitute

    3/31/2025Senate

  11. Senate Recommitted

    3/28/2025Senate

  12. Senate Read Second Time

    3/20/2025Senate

  13. Senate Committee Favorably Reported

    3/18/2025Senate

  14. Senate Read and Referred

    3/6/2025Senate

  15. House Third Readers

    3/4/2025House

  16. House Passed/Adopted

    3/4/2025House

  17. House Committee Favorably Reported

    2/11/2025House

  18. House Second Readers

    2/4/2025House

  19. House First Readers

    2/3/2025House

  20. House Hopper

    1/30/2025House

Bill Text

  • HB 197/AP* (v5)

    PDF

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