HB170: HB170 Insurance; benefit provider to disclose certain payments to a treating healthcare provider; provide

When someone is injured and receives medical treatment, insurers or other benefit providers sometimes pay the injured person directly for healthcare costs rather than paying the healthcare provider. This can leave the provider unsure whether they have been paid or reimbursed for their services. This bill addresses that gap by adding a new section to Georgia's insurance code (O.C.G.A. Title 33, Chapter 3). The bill defines key terms such as 'benefit provider' (insurers, health maintenance organizations, health benefit plans, and similar entities), 'injured party' (someone injured by another party's acts who received payments from a benefit provider), and 'treating healthcare provider' (a licensed provider who treated the injured party). It requires a benefit provider to give a treating healthcare provider a written accounting of all payments and reimbursements made to the injured party for that provider's services, within 30 days of a written request. The law would take effect as soon as the Governor signs it or it otherwise becomes law without his signature.

• Adds a new Code section (O.C.G.A. § 33-3-28.1) requiring benefit providers to disclose certain payments to treating healthcare providers upon request.
• Defines 'benefit provider' broadly to include insurers, health maintenance organizations, preferred provider organizations, and employee benefit plans.
• Defines 'injured party' as someone claiming injury by another's acts who has received payments from a benefit provider, including their estate's representative.
• Sets a firm 30-day deadline for benefit providers to respond in writing to a treating healthcare provider's request for a payment accounting.
• Takes effect immediately upon the Governor's signature or upon becoming law without his signature.

Health insurers, health maintenance organizations, employee benefit plans, and other benefit providers that pay claims; treating healthcare providers such as doctors, hospitals, and clinics who treat injured patients; and injured patients whose payment records would be disclosed to their providers.

Healthcare providers treating injured patients often cannot tell whether an insurer already paid the patient for their care, making it harder to bill correctly or avoid double payment. This bill would give providers a clear right to request that payment information and a firm 30-day deadline for benefit providers to respond.

• Section 1 creates new Code section 33-3-28.1, defining 'benefit provider,' 'injured party,' and 'treating healthcare provider' for purposes of the disclosure requirement.
• Section 1(b) requires a benefit provider to give a written accounting of payments and reimbursements made to an injured party within 30 days of a treating healthcare provider's written request.
• Section 2 sets the effective date as the date the Governor signs the bill or it otherwise becomes law without his signature.
• Section 3 repeals any existing laws that conflict with this Act.

1. 2026-02-19House Committee Favorably Reported (House)
2. 2025-04-04House Withdrawn, Recommitted (House)
3. 2025-02-26House Committee Favorably Reported (House)
4. 2025-02-03House Second Readers (House)
5. 2025-01-30House First Readers (House)
6. 2025-01-29House Hopper (House)

• Karen Mathiak (R, HD-082)Primary sponsor
• Lee Hawkins (R, HD-027)
• Gerald Greene (R, HD-154)
• Anissa Jones (D, HD-143)
• Darlene Taylor (R, HD-173)

• health insurance
• medical billing
• insurance regulation
• healthcare providers