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GeorgiaSB 2762025-2026 Regular SessionSenateWALLET

Recovery of Medical Assistance from Third Party; certain provisions to comply with federal law; revise

Sponsored By: Timothy Bearden (Republican), Drew Echols (Republican), Bo Hatchett (Republican), Chuck Hufstetler (Republican), Steven McNeel (Republican), Kay Kirkpatrick (Republican), Shawn Still (Republican), Brian Strickland (Republican), Blake Tillery (Republican), Ben Watson (Republican)

Became Law

InsuranceInsurance and LaborGeneral Bill

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Bill Overview

Analyzed Economic Effects

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

Faster payment on Medicaid third-party claims

Insurers, group health plans, managed care entities, pharmacy benefit managers, and other payors must accept the state’s approval for a Medicaid service as their authorization and cannot refuse payment only for lack of prior authorization. They must follow Georgia’s timely-pay law for claims the state submits and pay interest if they are late. They cannot deny a state-submitted claim only because of the submission date, the claim type or format, or missing documents at the point of sale, when the state sent the claim within three years of the service and starts enforcement within six years of that submission. They must also accept assignment of rights to third-party payments to the Department, the recipient, or another entity. The authorization and timely-pay rules apply to health benefit plans issued or renewed on or after April 28, 2001.

Insurers must help Medicaid verify coverage

The law requires insurers, group health plans, managed care entities, pharmacy benefit managers, and other payors to work with Georgia’s Department of Community Health to check whether a Medicaid recipient has other insurance and is eligible. They must provide eligibility and claims payment data to the state every quarter. They must respond when the state asks about claims the state submitted within three years of the date of service. When the state asks about a claim’s status, they must answer within 60 days. The 60-day rule applies to health benefit plans issued or renewed on or after April 28, 2001.

Sponsors & Cosponsors

Sponsors

  • Timothy Bearden

    Republican • Senate

  • Drew Echols

    Republican • Senate

  • Bo Hatchett

    Republican • Senate

  • Chuck Hufstetler

    Republican • Senate

  • Steven McNeel

    Republican • Senate

  • Kay Kirkpatrick

    Republican • Senate

  • Shawn Still

    Republican • Senate

  • Brian Strickland

    Republican • Senate

  • Blake Tillery

    Republican • Senate

  • Ben Watson

    Republican • Senate

Cosponsors

  • Matthew Gambill

    Republican • House

Roll Call Votes

All Roll Calls

Yes: 222 • No: 3

House vote • 3/18/2025

PASSAGE

Yes: 168 • No: 2

Senate vote • 3/6/2025

PASSAGE

Yes: 54 • No: 1

Actions Timeline

  1. Effective Date

    7/1/2025

  2. Senate Date Signed by Governor

    5/14/2025Senate

  3. Act 297

    5/14/2025

  4. Senate Sent to Governor

    4/7/2025Senate

  5. House Third Readers

    3/18/2025House

  6. House Passed/Adopted

    3/18/2025House

  7. House Committee Favorably Reported

    3/13/2025House

  8. House Second Readers

    3/11/2025House

  9. House First Readers

    3/10/2025House

  10. Senate Third Read

    3/6/2025Senate

  11. Senate Passed/Adopted

    3/6/2025Senate

  12. Senate Read Second Time

    3/4/2025Senate

  13. Senate Committee Favorably Reported

    3/3/2025Senate

  14. Senate Read and Referred

    2/27/2025Senate

  15. Senate Hopper

    2/26/2025Senate

Bill Text

  • SB 276/AP* (v5)

    PDF

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