Governor Signs New Healthcare Bills into Law

Recently, Gov. Kemp signed two new healthcare bills into law.

HB 733 (Part II) requires insurers that cover diagnostic examinations for breast cancer to treat cost-sharing requirements the same as annual mammograms. Such diagnostic examinations include medically necessary and clinically appropriate examinations using breast MRI or ultrasound to evaluate an abnormality detected by a breast cancer screening or other examination.

For HSA qualified HDHPs, these cost-sharing requirements shall only apply after the enrollee has satisfied the minimum statutory deductible, except with respect to items or services that are preventive care as defined by the IRS (in which case the cost-sharing requirements shall apply regardless of whether the minimum statutory deductible has been met).

SB 341 allows enrollees to receive prior authorization for prescribed medications to treat chronic conditions requiring ongoing medication therapy under certain circumstances.

Under this law, if a healthcare provider receives a prior authorization for a medication prescribed to a covered person with a chronic condition that requires ongoing medication therapy and continues to prescribe the medication, the prior authorization shall be valid for the lesser of one year or the last day of the plan coverage. Additionally, the authorization shall cover any change in dosage prescribed by the healthcare provider during the authorization period.

These provisions shall become effective on January 1, 2023, and shall apply to policies or contracts issued, delivered, issued for delivery or renewed in the state on or after such date.

Employers should be aware of these upcoming changes and review the legislation and/or contact their carrier for further information.

HB 733 »
SB 341 »