Georgia CommonsHouse · Engrossed · 2025-2026 Regular Session
HB 1263: Insurance; premiums made within three years of payment to the Commissioner; provide for a claim for a refund of certain fees and taxes
Last action March 31, 2026 · Senate Passed/Adopted By Substitute
A Senate substitute for HB 1263 would exempt cancer treatment facilities, equipment, and services from Georgia's certificate of need process, with conditions on reporting, location, and charity care.
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 Comm Sub version, the latest the General Assembly's website lists.
In plain language
Georgia's certificate of need law (O.C.G.A. § 31-6-47) requires state approval before many new health care facilities, services, or major equipment purchases can move forward. This bill, offered as a Senate committee substitute to HB 1263, adds a new exemption to that law for anything primarily or exclusively dedicated to treating cancer, including hospitals, clinics, surgical centers, radiation and proton therapy equipment, outpatient chemotherapy and infusion programs, oncology clinical trial sites, and hospice or rehab care for cancer patients. Facilities using the exemption must follow federal and state oncology regulations, report patient volume and treatment data to the Department of Community Health, and file annual reports like other regulated facilities. The exemption applies no matter who owns the facility or where in the state it is located, except it does not apply within 35 miles of an existing nonprofit sole community hospital that already offers chemotherapy or radiation therapy. Facilities using the exemption must also provide charity care worth at least 3 percent of their prior year's adjusted gross revenue. Note: the bill's title referencing insurance premiums and fees does not match this substitute's actual text, which addresses certificate of need exemptions for cancer care.
What the bill does
- Adds a new exemption to Georgia's certificate of need law (O.C.G.A. § 31-6-47) for facilities, equipment, and services dedicated primarily or exclusively to cancer treatment.
- Covers a wide range of cancer-related items, including hospitals, surgical centers, radiation and proton therapy machines, outpatient chemotherapy programs, oncology clinical trial sites, and hospice care for cancer patients.
- Requires exempt facilities to follow federal and state oncology rules, report patient data to the state, and file annual reports.
- Blocks the exemption for any facility within 35 miles of an existing nonprofit sole community hospital that already offers chemotherapy or radiation therapy.
- Requires facilities using the exemption to provide charity care for the poor equal to at least 3 percent of their prior year's adjusted gross revenue.
Who it affects
Hospitals, cancer treatment centers, ambulatory surgical centers, and companies seeking to build or expand oncology facilities or equipment in Georgia; existing sole community hospitals near proposed new cancer facilities; cancer patients seeking treatment; and the Department of Community Health, which oversees certificate of need reviews and reporting.
Why it matters
New cancer treatment facilities and equipment could open in Georgia without going through the state's certificate of need approval process, potentially speeding access to care, while existing rural sole community hospitals within 35 miles that already offer cancer treatment would keep some protection from new competing facilities.
Key provisions
- Section 1 amends O.C.G.A. § 31-6-47(a) by adding paragraph (36), creating the cancer care exemption from certificate of need requirements.
- Subparagraph (A) lists covered items: hospitals, clinics, surgical centers, specific cancer equipment, outpatient cancer services, clinical trial facilities, and hospice or supportive care for cancer patients.
- Subparagraph (B) requires exempt facilities to follow oncology regulations, submit patient data to the department, and file annual reports under O.C.G.A. § 31-6-70.
- Subparagraph (C) states the exemption applies regardless of ownership, hospital affiliation, or location in the state.
- Subparagraph (D) excludes facilities within 35 miles of an existing nonprofit sole community hospital already offering chemotherapy or radiation therapy.
- Subparagraph (E) requires facilities using the exemption to provide charity care worth at least 3 percent of the prior year's adjusted gross revenue.
- Section 2 repeals conflicting laws.
From the bill
“The development, expansion, acquisition, relocation, or operation of any health care facility, service, or equipment that is primarily or exclusively dedicated to the treatment of cancer”
“The exemption provided for in this paragraph shall not apply to any facility within 35 miles of an existing nonprofit hospital designated as a sole community hospital”
“provide uncompensated indigent and charity care in an amount equal to or greater than 3 percent of its adjusted gross revenue from the previous calendar year.”
Discussed in meetings (13)
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 Insurance Committee, February 19, 2026
From 0:15:01 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 1263 would establish a three-year limit for insurers seeking refunds through changes to prior premium tax filings. According to the sponsor, current law has no statutory look-back limit, allowing insurers to revisit filings from any number of years. The sponsor said one company reviewed seven years of filings and sought more than $142 million in refunds in fiscal year 2025, disrupting state budgeting and financial planning. The sponsor described the proposed limit as consistent with the three-year amendment window for individual income taxes and said it would preserve legitimate refunds while making state revenue more predictable. No members asked questions or offered amendments. The committee approved the bill by voice vote and sent it to Rules.
House Rules Committee, February 23, 2026
From 1:27:29 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 1263, another Department of Insurance proposal, would establish a three-year period for insurance companies to amend prior premium-tax filings. The sponsor said current law did not specify how far back companies could amend those filings. There were no questions.
House Rules Committee, February 25, 2026
From 1:45:58 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 1621
Summary by Georgia Commons: The committee placed HB 1263 on Thursday's floor calendar after a motion and second. The chair asked for opposition and declared it added. No substantive discussion was shown.
House floor session, February 26, 2026 (legislative day 25, AM)
From 2:33:34 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 1647
Summary by Georgia Commons: The sponsor said HB 1263 would establish a three-year deadline for insurers to amend premium tax filings and seek refunds. The sponsor explained that insurers sometimes defer claiming credits and deductions until amended filings and said current law allows refunds reaching back an unlimited number of years. The sponsor said the change would align the deadline with the standard three-year period for individual income tax filers. No members asked questions. The House passed the bill, 169 to 0.
Senate Insurance and Labor Committee, March 17, 2026
From 0:37:14 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The chair announced that a subcommittee would handle HB 1263. The committee did not discuss its provisions or vote on it.
House Insurance Committee, March 20, 2026
From 0:28:16 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor of SB 462 described HB 1263 as an added measure concerning premium-tax look-back limitations. No further explanation of those provisions was given. One committee member expressed concern that members needed more time to review the added bills, while another said the four House measures had already received about 170 votes in the House. The committee approved the package within SB 462, including a later local-government reporting amendment. A committee member subsequently identified HB 1263 as part of the same package added to SB 503, which the committee also approved with that reporting amendment. There was no separate vote on HB 1263.
Senate Insurance and Labor Committee, March 26, 2026
From 0:35:57 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The presenter said the substitute would exempt facilities, services and equipment primarily or exclusively serving cancer patients from certificate-of-need requirements, the state approval process for certain health care projects. The presenter said it included previously passed Senate language, a floor amendment, and indigent and charity care requirements mirroring existing exemptions. The presenter argued that additional facilities would help patients who travel three or four hours for care and allow treatment closer to family. Asked how the exemption would affect existing facilities, the presenter emphasized access to complex cancer treatment beyond basic chemotherapy and radiation. One member described a restriction barring the exemption within 30 miles of a community hospital offering chemotherapy oncology services, and the presenter agreed. Another member warned that loosening approval requirements could favor wealthier patients and allow private facilities to draw well-insured patients away from community hospitals serving Medicaid patients. The presenter disputed that characterization and said the proposal would expand access regardless of income. The opposing member also objected to receiving the substitute that day. The committee approved the substitute by a show of hands, without an announced vote count.
Senate Rules Committee, March 30, 2026
From 1:07:03 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: A member selected HB 1263 for the floor calendar. No substantive explanation or debate followed. The committee unanimously approved the calendar containing it.
Senate floor session, March 31, 2026 (legislative day 39, part 2)
From 2:50:18 · Watch on the General Assembly's Vimeo channel · Confirmed by the bill's status history (Senate Third Read)
Summary by Georgia Commons: The sponsor presented a substitute exempting qualifying cancer facilities, services and equipment from the state approval process for health-facility investments. The sponsor said this would expand access and reduce costs, while protecting 10 sole community hospitals from nearby competition. Asked about care for patients unable to pay, the sponsor said exempt facilities would have to provide uncompensated indigent and charity care equal to at least 3% of the previous year's adjusted gross revenue, matching the requirement for hospitals using the approval process. One senator said hospitals still had serious concerns and questioned whether opponents had agreed to the changes. The sponsor said Emory Winship and City of Hope supported the proposal and described equipment delays and opportunities to work with rural providers. Another senator questioned whether the 3% requirement meaningfully matched existing hospitals' obligations. The sponsor said it was the standard requirement and could rise through Department of Community Health action. That senator expressed qualified support but remained concerned about Georgia's broader approach to uncompensated care. The Senate adopted the substitute and passed it, 44 to 7.
- Read aloud: House floor session, February 11, 2026 (legislative day 17), 0:31:08
- Read aloud: House floor session, February 12, 2026 (legislative day 18), 0:53:10
- Read aloud: Senate floor session, March 3, 2026 (legislative day 26), 0:28:11
- Read aloud: Senate floor session, March 27, 2026 (legislative day 38), 0:27:53
Status timeline
- Senate Passed/Adopted By Substitute (Senate)
- Senate Third Read (Senate)
- Senate Read Second Time (Senate)
- Senate Committee Favorably Reported By Substitute (Senate)
- Senate Read and Referred (Senate)
- House Passed/Adopted (House)
- House Third Readers (House)
- House Committee Favorably Reported (House)
Show full history (11 actions)
- House Second Readers (House)
- House First Readers (House)
- House Hopper (House)
Sponsors
- Eddie Lumsden (R, HD-12)
- Matt Reeves (R, HD-99)
- Darlene Taylor (R, HD-173)
- Matthew Gambill (R, HD-15)
- Bruce Williamson (R, HD-112)
- Bill Fincher (R, HD-23)
- Jason Anavitarte (R, SD-31)
Votes
- House voteFebruary 26, 2026
169 yea, 0 nay (6 not voting, 2 excused)
- Senate voteMarch 31, 2026
44 yea, 7 nay (0 not voting, 3 excused)
Topics
- cancer treatment
- certificate of need
- hospital regulation
- health care facilities
- rural hospitals