Bill > HB1033

This bill, known as the "Georgia Access to Healthcare for Alzheimer's Disease and Dementias Act," mandates that health insurance policies in Georgia must cover diagnostic testing and medically necessary treatments for Alzheimer's disease and related dementias, including conditions like Lewy body dementia and frontotemporal dementia. It expands the definition of "biomarker testing" to include blood-based biomarkers and certain diagnostic imaging services, such as MRI and PET scans, which are crucial for diagnosing these conditions. The bill prohibits insurance companies from using utilization management practices, like "step therapy protocols" (requiring patients to try cheaper treatments first), that could unreasonably delay or deny necessary testing and treatments. While cost-sharing requirements like deductibles and copayments are allowed, at least one diagnostic test per year must be covered without any cost-sharing, and overall cost-sharing cannot exceed federal limits for essential health benefits. Furthermore, insurers must ensure timely access to these services, and if in-network providers are unavailable, they must cover services from out-of-network providers at in-network rates and reimburse reasonable travel costs. The bill also requires annual reporting to the state legislature on the implementation of these coverage requirements.

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https://www.legis.ga.gov/legislation/72363