Bill > SB5

This bill introduces two main provisions aimed at improving healthcare coverage and reducing administrative burdens. First, it requires health insurers to develop a program for selectively reducing prior authorization requirements based on healthcare providers' performance and adherence to evidence-based medicine, with insurers submitting an annual detailed filing to the department describing their program by July 1, 2026. Second, the bill mandates that all health benefit policies issued or renewed after July 1, 2025, must provide coverage for healthcare services related to Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS), which are conditions causing sudden neuropsychiatric symptoms in children and adolescents. This coverage must be based on nationally recognized clinical practice guidelines and be subject to the same deductibles and payment provisions as other healthcare services, without imposing special or additional limitations. The bill applies to both private health insurance plans and the state health benefit plan for employees, with the goal of ensuring comprehensive and standardized care for these specific pediatric neurological conditions.

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https://www.legis.ga.gov/legislation/69280