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GeorgiaSB 52025-2026 Regular SessionSenateWALLET

Private Review Agents; health insurers to implement and maintain a program that allows for the selective application of reductions in prior authorization requirements; provide

Sponsored By: Ed Harbison (Democrat), Chuck Hufstetler (Republican), Kay Kirkpatrick (Republican), Michael 'Doc' Rhett (Democrat), Larry Walker (Republican), Ben Watson (Republican)

Became Law

InsuranceInsurance and LaborGeneral Bill

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

State employee plan covers PANDAS and PANS

Starting January 1, 2026, the state health benefit plan covers diagnosis, treatment, management, and monitoring of PANDAS and PANS. Care must follow nationally recognized clinical guidelines. The plan must use the same deductibles, copays, coinsurance, and limits it uses for other covered services. It cannot add special extra costs or limits for this care. This applies to state and public employees, their dependents, and retirees.

State-regulated plans cover PANDAS and PANS

For policies issued or renewed on or after July 1, 2025, state-regulated health plans must cover diagnosis, treatment, management, and monitoring of PANDAS and PANS. Care must follow nationally recognized clinical guidelines. The plan must use the same deductibles, copays, and coinsurance it uses for other covered services. It cannot add special extra costs or limits for this care. This state rule does not apply to self-insured employer plans governed by ERISA.

Insurers must ease prior authorization burdens

Beginning July 1, 2025, any insurer that uses prior authorization runs a program to reduce it for qualifying providers. Providers are ranked on performance and use of evidence-based care. If your provider qualifies and the service is on the insurer’s list, you face fewer prior authorization steps. Insurers must file program details with the Insurance Department by July 1, 2026, and update them every year.

Sponsors & Cosponsors

Sponsors

  • Ed Harbison

    Democrat • Senate

  • Chuck Hufstetler

    Republican • Senate

  • Kay Kirkpatrick

    Republican • Senate

  • Michael 'Doc' Rhett

    Democrat • Senate

  • Larry Walker

    Republican • Senate

  • Ben Watson

    Republican • Senate

Cosponsors

  • Lee Hawkins

    Republican • House

Roll Call Votes

All Roll Calls

Yes: 272 • No: 3

Senate vote • 4/4/2025

AGREE TO HOUSE SUBSTITUTE

Yes: 52 • No: 0

House vote • 4/2/2025

PASSAGE

Yes: 169 • No: 2

Senate vote • 2/12/2025

PASSAGE

Yes: 51 • No: 1

Actions Timeline

  1. Effective Date

    7/1/2025

  2. Senate Date Signed by Governor

    5/14/2025Senate

  3. Act 299

    5/14/2025

  4. Senate Sent to Governor

    4/10/2025Senate

  5. Senate Agreed House Amend or Sub

    4/4/2025Senate

  6. House Third Readers

    4/2/2025House

  7. House Passed/Adopted By Substitute

    4/2/2025House

  8. House Committee Favorably Reported By Substitute

    3/31/2025House

  9. House Withdrawn, Recommitted

    3/27/2025House

  10. House Committee Favorably Reported

    2/26/2025House

  11. House Second Readers

    2/18/2025House

  12. House First Readers

    2/13/2025House

  13. Senate Third Read

    2/12/2025Senate

  14. Senate Passed/Adopted

    2/12/2025Senate

  15. Senate Read Second Time

    2/3/2025Senate

  16. Senate Committee Favorably Reported

    1/30/2025Senate

  17. Senate Read and Referred

    1/14/2025Senate

  18. Senate Hopper

    1/13/2025Senate

Bill Text

  • SB 5/AP* (v9)

    PDF

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