HB 170: Insurance; benefit provider to disclose certain payments to a treating healthcare provider; provide

Under current Georgia law, a healthcare provider who treated an injured patient does not have a clear right to find out what an insurer or other benefit provider paid or reimbursed that patient for the provider's own services. This often matters in situations like car accident injury claims, where a patient may receive a settlement or reimbursement that includes money meant to cover medical bills. This bill adds a new section to Georgia's insurance code (O.C.G.A. § 33-3-28.1) requiring a 'benefit provider,' defined broadly to include insurers, health maintenance organizations, and other entities that pay healthcare or disability benefits, to give a treating healthcare provider a written accounting of any payments or reimbursements made to an injured patient for that provider's services. The benefit provider must respond within 30 days of a written request from the provider. The law would take effect as soon as the Governor signs it or it otherwise becomes law without his signature.

• Creates a new Georgia law (O.C.G.A. § 33-3-28.1) requiring benefit providers to disclose certain payment information to treating healthcare providers.
• Defines 'benefit provider' broadly to cover insurers, health maintenance organizations, preferred provider organizations, employee benefit plans, and similar entities that pay healthcare or disability benefits.
• Defines 'injured party' as someone claiming injury by a third party who has received payments from a benefit provider, including that person's estate representative.
• Requires a benefit provider to give a written accounting of payments or reimbursements made to an injured party within 30 days of a treating provider's written request.
• Sets the law to take effect immediately upon the Governor's signature or upon becoming law without his approval.

Insurance companies, health maintenance organizations, preferred provider organizations, and employee benefit plans that pay healthcare or injury-related benefits; treating healthcare providers such as doctors, hospitals, and clinics; and patients injured by a third party who have filed claims or received benefit payments.

Healthcare providers often struggle to confirm whether an injured patient's settlement or reimbursement already covered their bills, which can affect billing and collection decisions. This bill gives providers a formal, time-limited right to request that payment information directly from the benefit provider.

• Section 1 adds new Code section 33-3-28.1, defining 'benefit provider,' 'injured party,' and 'treating healthcare provider.'
• Section 1(b) requires a benefit provider to respond to a treating healthcare provider's written request with a full accounting of payments or reimbursements to the injured party within 30 days.
• Section 2 sets the effective date as the date the Governor signs the bill or it becomes law without his signature.
• Section 3 repeals any conflicting Georgia laws.

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
• personal injury claims
• insurance regulation