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

25 LC 52 0766 House Bill 830 By: Representatives Beckles of the 96th, Flournoy of the 74th, Frye of the 122nd, Williams of the 168th, Dawson of the 65th, and others A BILL TO BE ENTITLED AN ACT To amend Title 33 of the Official Code of Georgia Annotated, relating to insurance, so as to1 establish the State Oversight Board within the office of the Commissioner of Insurance; to2 provide for the membership, duties, and powers of such board; t o provide for rules and3 regulations; to provide for insurer liability for certain delay s or denials in healthcare4 coverage; to provide for a private cause of action; to provide for related matters; to provide5 for an effective date; to repeal conflicting laws; and for other purposes.6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7 SECTION 1.8 Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended in9 Chapter 2, relating to department and Commissioner, by adding a new Code section to read10 as follows:11 "33-2-35.12 (a) There is established within the office of the Commissioner the State Oversight Board. 13 The board shall be composed of nine members, as follows:14 (1) Three healthcare professionals, including physicians and nurses, to be appointed by15 the Speaker of the House of Representatives;16 H. B. 830 - 1 - 25 LC 52 0766 (2) Three hospital administration officials, to be appointed b y the President of the17 Senate;18 (3) Two members with experience in the public sector, to be appointed by the Governor;19 and20 (4) One member representing the office of the Commissioner as designated by the21 Commissioner; provided that such member shall not be the Commissioner.22 (b) Appointed members shall serve for a period of three years. The members shall elect23 a chairperson and vice chairperson from among their membership whose duties shall be24 established by the board.25 (c) The board shall fix a time and place for regular meetings, provided that the board shall26 meet at least quarterly.27 (d) Board members shall receive no compensation for their services but shall be allowed28 actual and necessary expenses in the performance of their duties. Any legislative members29 of the board shall receive the allowances provided for in Code Section 28-1-8. Citizen30 members shall receive a daily expense allowance in the amount specified in subsection (b)31 of Code Section 45-7-21 as well as the mileage or transportation allowance authorized for32 state employees. If any members selected to serve on the board are state officials, other33 than legislative members, or are state employees, they shall receive no compensation for34 their services on the board but shall be reimbursed for expense s incurred in the35 performance of their duties as members of the board in the same manner as reimbursements36 are made in their capacity as state officials or state employees. The funds necessary for the37 reimbursement of the expenses of state officials, other than legislative members, and state38 employees shall come from funds appropriated to or otherwise available to their respective39 departments.40 (e) The board shall advise the office of the Commissioner on m atters related to health41 insurers' denials and delays in healthcare coverage in this state. The board shall:42 H. B. 830 - 2 - 25 LC 52 0766 (1) Develop and promulgate rules and regulations to govern health insurance practices43 within this state;44 (2) Have access to any and all information, including, but not limited to, documents,45 materials, forms, rate filings, and data, submitted by health insurers to the office of the46 Commissioner; provided, however, that confidential treatment of such submissions shall47 be preserved;48 (3) Review data and identify any trends, issues, and concerns regarding health insurance49 premiums, healthcare coverage, prior authorization practices, a nd patient access to50 healthcare services;51 (4) Investigate health insurer denials or delays in healthcare coverage, compensation to52 healthcare providers, and patient access to healthcare services; and53 (5) Take action, including imposing fines or other penalties, against health insurers that54 violate federal or state law, state regulations, or otherwise c ommit practices that are55 harmful to consumers.56 (f) The board, no later than June 30, 2026, and annually there after, shall submit to the57 Commissioner a report of its activities and recommendations for further action by the58 Commissioner.59 (g) Every health insurer shall submit to the board such data as required and requested by60 the board so that the board can perform its duties as provided in subsection (e) of this Code61 section.62 (h) Any meetings held by the board shall be open to the public and subject to Chapter 1463 of Title 50, relating to open meetings. Any rules and regulati ons shall be adopted,64 established, promulgated, amended, repealed, filed, and publish ed by the board in65 accordance with the applicable provisions and procedures set forth in Chapter 13 of Title66 50, the 'Georgia Administrative Procedure Act.'67 (i) The Commissioner shall promulgate any rules and regulations necessary to implement68 the provisions of this Code section."69 H. B. 830 - 3 - 25 LC 52 0766 SECTION 2.70 Said title is further amended in Article 2 of Chapter 46, relating to prior authorizations, by71 adding a new Code section to read as follows:72 "33-46-29.1.73 (a) An insurer shall be liable for harm caused to a covered pe rson for the unnecessary74 delay in or wrongful denial of healthcare coverage caused by th e act or inaction of the75 insurer or the insurer's private review agent or utilization review entity.76 (b) Any covered person who suffers harm as provided in subsect ion (a) of this Code77 section may bring an action against the insurer and may recover or obtain against such78 insurer:79 (1) Actual damages;80 (2) Equitable relief;81 (3) Punitive damages;82 (4) Reasonable attorney fees and costs; and83 (5) Any other relief that the court deems proper.84 (c) An insurer shall notify the office of the Commissioner and the State Oversight Board85 of any actions filed against it pursuant to this Code section."86 SECTION 3.87 This Act shall become effective on July 1, 2025.88 SECTION 4.89 All laws and parts of laws in conflict with this Act are repealed.90 H. 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