HB830: HB830 Insurance; establish State Oversight Board within office of the Commissioner of Insurance

Georgia currently has no dedicated board focused specifically on how health insurers handle coverage denials and delays, or prior authorization practices. This bill would add a new State Oversight Board within the office of the Commissioner of Insurance (O.C.G.A. § 33-2-35), made up of healthcare professionals, hospital administrators, public sector appointees, and one office representative. The board would review data from health insurers, investigate denials and delays in coverage, write new rules for health insurance practices, and could fine insurers that break the law or harm consumers. It must report to the Commissioner by June 30, 2026, and every year after that. The bill also creates a new legal right (O.C.G.A. § 33-46-29.1): patients harmed by an insurer's unnecessary delay or wrongful denial of coverage could sue for actual damages, punitive damages, equitable relief, and attorney fees. Insurers would have to report any such lawsuits to the Commissioner and the new board. The law would take effect July 1, 2025.

• Creates a nine-member State Oversight Board inside the Insurance Commissioner's office to oversee health insurer denials and delays in coverage.
• Gives the board power to write binding rules for health insurance practices in Georgia and to fine insurers that violate the law or harm consumers.
• Requires health insurers to submit data to the board on request and requires the board to report to the Commissioner every year starting June 30, 2026.
• Creates a new private right for patients to sue insurers for wrongful denial or unnecessary delay of healthcare coverage, allowing actual damages, punitive damages, and attorney fees.
• Requires insurers to notify the Commissioner and the new board whenever such a lawsuit is filed against them.
• Sets board meetings and rulemaking under Georgia's open meetings law and Administrative Procedure Act, and takes effect July 1, 2025.

Health insurers operating in Georgia, patients and policyholders seeking healthcare coverage, physicians, nurses, and hospital administrators who could serve on the board, the Insurance Commissioner's office, and the Governor, House Speaker, and Senate President, who would make board appointments.

Patients denied or delayed coverage would gain a state board dedicated to investigating those practices and a new legal avenue to sue insurers for damages. Insurers would face new reporting duties, potential fines, and lawsuits, changing the stakes around denying or delaying claims.

• Section 1 adds O.C.G.A. § 33-2-35, creating the State Oversight Board with three healthcare professionals (appointed by the House Speaker), three hospital administrators (appointed by the Senate President), two public sector members (appointed by the Governor), and one Commissioner's office representative.
• Board members serve three-year terms, receive no salary but get expense reimbursement, and the board must meet at least quarterly and elect its own chair and vice chair.
• The board can access confidential insurer data submitted to the Commissioner, investigate denials and delays, and impose fines or penalties on insurers that violate the law or harm consumers.
• The board must submit an annual report to the Commissioner starting no later than June 30, 2026, and its meetings and rulemaking follow Georgia's open meetings law and Administrative Procedure Act.
• Section 2 adds O.C.G.A. § 33-46-29.1, making insurers liable for harm from unnecessary delay or wrongful denial of coverage and allowing patients to sue for actual damages, equitable relief, punitive damages, and attorney fees.
• Insurers must notify the Commissioner and the board whenever a lawsuit under this new section is filed against them.
• Section 3 sets the effective date as July 1, 2025.

1. 2025-03-28House Second Readers (House)
2. 2025-03-27House First Readers (House)
3. 2025-03-25House Hopper (House)

• Arlene Beckles (D, HD-096)Primary sponsor
• Robert Flournoy (D, HD-074)
• Spencer Frye (D, HD-122)
• Al Williams (D, HD-168)
• Robert Dawson (D, HD-065)
• Segun Adeyina (D, HD-110)

• health insurance
• insurance regulation
• prior authorization
• patient rights
• insurance oversight