Georgia CommonsHouse · Introduced · 2025-2026 Regular Session
HB 102: Community Health, Department of; Georgia Quality Reporting Project; establish
Last action January 28, 2025 · House Second Readers
House Bill 102 would create the Georgia Quality Reporting Project, requiring Medicaid managed care organizations to send patient clinical data to the Department of Community Health to track opioid treatment quality and overall healthcare quality statewide.
The summaries below were written by an AI model (claude-sonnet-5) from the text of the bill and are not part of it. Quote the text, not the summary. The stored text is the Introduced version, the latest the General Assembly's website lists.
In plain language
Georgia currently collects insurance claims data through the All-Payer Claims Database, but not detailed clinical data from electronic health records. This bill directs the Department of Community Health to set up the Georgia Quality Reporting Project (GQRP) to gauge the quality of opioid use disorder treatment and healthcare generally, improve care, lower costs, and support clinical research. Starting January 1, 2028, Medicaid care management organizations (called submitting entities) would have to send monthly clinical data in a standardized federal format, either directly or through certified health information networks. Starting January 1, 2029, the department would combine that clinical data with claims data monthly to calculate statewide quality measures. Direct personal identifiers in the data would be exempt from Georgia's open records law, and all data handling would follow federal HIPAA privacy rules. Entities that fail to submit data face fines of up to $1,000 per day, and insurance-regulated entities could also face penalties under Georgia's unfair trade practices law.
What the bill does
- Creates the Georgia Quality Reporting Project within the Department of Community Health to track opioid treatment and overall healthcare quality statewide.
- Requires Medicaid care management organizations to submit monthly clinical data from electronic health records to the department starting January 1, 2028.
- Directs the department to combine that clinical data with claims data starting January 1, 2029 to calculate statewide opioid and quality statistics.
- Exempts direct personal identifiers in the submitted clinical data from Georgia's open records law (O.C.G.A. Article 4 of Chapter 18 of Title 50).
- Allows the department to fine noncompliant submitting entities up to $1,000 per day, with proceeds going to the state treasury.
- Amends Georgia's unfair trade practices law (O.C.G.A. § 33-6-4) so failing to submit clinical data is also a violation enforceable by the Commissioner of Insurance.
Who it affects
Medicaid care management organizations that contract with the state, the Department of Community Health, healthcare providers who treat Medicaid patients for substance use disorder, the Georgia Commissioner of Insurance, and Medicaid patients whose clinical data would be collected and analyzed.
Why it matters
The bill would give the state a new pipeline of detailed clinical data, beyond insurance claims, to measure how well Georgia is treating opioid use disorder and other health conditions. It creates real financial penalties for insurers who don't comply, while shielding identifying patient details from public records requests.
Key provisions
- Section 1 adds a new Code section, O.C.G.A. § 31-2-20, defining terms like 'submitting entity' (Medicaid care management organizations) and 'QHIN' (certified health data networks).
- Subsection (b) states the GQRP's purposes: gauging opioid treatment and overall care quality, improving care, cutting costs, and fostering clinical research.
- Subsection (c) creates a GQRP use case working group to build a framework and implementation plan.
- Subsection (d) requires monthly clinical data submissions starting January 1, 2028, covering opioid care and other state-level quality measures.
- Subsection (e) requires the department to combine clinical and claims data starting January 1, 2029 using a nationally accredited HEDIS calculation process.
- Subsection (f) exempts direct personal identifiers in the data from Georgia's open records law, and subsection (g) requires compliance with federal HIPAA privacy rules.
- Subsection (h) sets penalties of up to $1,000 per day for noncompliant submitting entities, deposited into the state treasury; subsection (i) extends enforcement to the Commissioner of Insurance.
- Section 2 amends O.C.G.A. § 33-6-4 to add failure to submit clinical data as an unfair trade practice violation.
From the bill
“Beginning January 1, 2028, and every month thereafter, all submitting entities shall be required to transmit clinical data collected through the methods and formats established by the federal Department of Health and Human Services' Electronic Clinical Quality Measures Fast Health Information Resources standards to the department.”
“Direct personal identifiers contained in clinical data transmitted pursuant to this Code section shall not be considered a public record and shall not be subject to Article 4 of Chapter 18 of Title 50, relating to open records.”
“The department shall adopt a schedule of penalties not to exceed $1,000.00 per day of violation, determined by the severity of the violation.”
Discussed in meetings (1)
The House and Senate meetings that took this bill up, from their machine transcripts. Each account was written by Georgia Commons with AI and is not part of the record; the video is what was said.
House Public and Community Health Committee, March 10, 2026
From 1:28:39 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: A Medical Association of Georgia presenter said HB 102 would establish the Georgia Quality Reporting Project, combining clinical records and insurance claims through standardized measures of care quality and opioid treatment. The presenter said separate reporting systems obscure outcomes and create duplicate work. McIntosh Clinic's chief executive said 13 clinical staff supported 18 reporting programs covering more than 4,600 assigned patients, spending 52 additional staff hours weekly on quality measures. The witness described delayed reports and insurers assigning patients the clinic had never treated. A Kansas hospital executive said combining data improved follow-up, screening and finances while allowing longer patient visits. A healthcare data researcher supported standardized information sharing. A statement from the Georgia Medical Group Management Association's president described repeated reporting requests, changing measures and declining financial incentives. Members asked about patient privacy, public records and pricing transparency. The association presenter said personal identifiers would be protected from public disclosure and information handled under privacy requirements. The Department of Community Health's chief operating officer raised significant feasibility concerns, saying Georgia's All-Payer Claims Database is de-identified, governed by federal agreements and not designed for the proposed matching. The official distinguished a hospital's internal system from a statewide project. The chair requested further discussions with the department over the summer. No vote occurred.
Status timeline
- House Second Readers (House)
- House First Readers (House)
- House Hopper (House)
Sponsors
- Sharon Cooper (R, HD-45)
- Mark Newton (R, HD-127)
- Deborah Silcox (R, HD-53)
- Lee Hawkins (R, HD-27)
- Michelle Au (D, HD-50)
Topics
- Medicaid
- opioid treatment
- healthcare data privacy
- health insurance regulation
- public health reporting