Georgia CommonsHB 326: State Health Benefit Plan Nonopioid Coverage Parity Act; enact
Comm Sub version, the latest LegiScan holds · Last action February 24, 2026 · Introduced
The text as LegiScan holds it, read from the PDF the legislature publishes with its margin line numbers, running heads, and page footers removed. Line breaks are joined into paragraphs here; no word is changed.
Underlined words are what the bill adds to current law and struck-through words are what it removes, as the printed bill shows them.
The House Committee on Health offers the following substitute to HB 326:
A BILL TO BE ENTITLED
AN ACT
To amend Article 1 of Chapter 18 of Title 45 of the Official Code of Georgia Annotated, relating to state employees' health insurance plan and post-employment health benefit fund, so as to mandate that the state health benefit plan provide coverage for qualifying nonopioid pain management drugs in parity with its coverage for opioid pain management drugs; to provide for definitions; to provide for parity with regard to annual deductibles, coinsurance, copayments, exclusions, reductions, other limitations, or utilization review; to provide for legislative construction; to provide for related matters; to provide for a short title; to provide for legislative findings and declarations; to provide for an effective date; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
This Act shall be known and may be cited as the "State Health Benefit Plan Nonopioid Coverage Parity Act."
SECTION 2.
The General Assembly finds and declares that:
(1) An opioid epidemic has cost the state millions of dollars in medical treatment, lost economic productivity, and increased overdose deaths, among other costs; and
(2) Requiring coverage for nonopioid pain management drugs in the state health benefit plan that is at least as good as its coverage for opioid pain management drugs will reduce the costs borne by this state.
SECTION 3.
Article 1 of Chapter 18 of Title 45 of the Official Code of Georgia Annotated, relating to state employees' health insurance plan and post-employment health benefit fund, is amended by adding a new Code section to read as follows:
"45-18-4.3.
(a) As used in this Code section, the term:
(1) 'Healthcare provider' means the pharmacy, attending physician, or any other person or entity administering healthcare to a member of the state health benefit plan at the time of reference that is licensed, certified, or otherwise authorized or permitted by law to administer healthcare in the ordinary course of business or practice of a profession, including any person employed by or acting for any such authorized person or entity.
(2) 'Prior authorization' means any requirement for the healthcare provider to obtain approval from the state health benefit plan prior to the furnishing of a drug.
(3) 'Qualifying nonopioid pain management drugs' means a drug or biological product that:
(A) Has a label indication approved by the federal Food and Drug Administration to reduce postoperative pain or any other form of acute pain;
(B) Does not act upon the body's opioid receptors;
(C) Is not a Schedule I or II controlled substance;
(D) Has been selected by the Department of Community Health for inclusion in its formulary; and
(E) Is sold or marketed in the United States.
(4) 'State health benefit plan' means the health insurance plan established pursuant to this article.
(5) 'Step therapy' means a drug therapy utilization management protocol or program that requires use of an alternative, preferred prescription drug or drugs before the state health benefit plan approves coverage for the nonpreferred drug therapy prescribed.
(b) The state health benefit plan shall cover qualifying nonopioid pain management drugs and such drugs shall be subject to the same annual deductible, coinsurance, copayment, exclusions, reductions, or other limitations as to coverage, or utilization review applicable to similar covered opioid pain management drugs.
(c) Notwithstanding subsection (b) of this Code section, nothing in this Code section shall be construed to prohibit the state health benefit plan from contracting to provide qualifying nonopioid pain management drug coverage for the state health benefit plan that is greater than the coverage provided for opioid pain management drugs.
(d) The state health benefit plan shall, with respect to a qualifying nonopioid pain management drug for which coverage is provided under such plan, neither impose any step therapy requirement under which an individual enrolled under such plan is required to use an opioid pain management drug prior to receiving the prescribed qualifying nonopioid pain management drug nor require prior authorization for qualifying nonopioid pain management drugs unless similar prior authorization is required for opioid pain management drugs.
(e) Nothing in this Code section should be construed to interfere with the ability of a healthcare provider to prescribe or administer a course of treatment that is medically appropriate."
SECTION 4.
This Act shall become effective on January 1, 2027.
SECTION 5.
All laws and parts of laws in conflict with this Act are repealed.