--- title: HB 420. Insurance; require certain health benefit policies to cover genetic testing for an inherited mutation and cancer imaging under certain conditions collection: bills id: 2025-2026/hb420 cite_as: HB 420, 2025-2026 Regular Session (Ga.) canonical_url: https://georgiacommons.org/bills/2025-2026/hb420 md_url: https://georgiacommons.org/bills/2025-2026/hb420.md text_url: https://georgiacommons.org/bills/2025-2026/hb420/text source_url: https://www.legis.ga.gov/legislation/70264 date: 2025-04-04 status: introduced corpus_version: bills-2026-08-28 license: Public record of the Georgia General Assembly, via LegiScan; see about.md publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice. up: https://georgiacommons.org/bills/2025-2026.md previous: https://georgiacommons.org/bills/2025-2026/hb419.md next: https://georgiacommons.org/bills/2025-2026/hb421.md index: https://georgiacommons.org/bills/index.md omitted: votes and history omitted_chars: 369 omitted_url: https://georgiacommons.org/bills/2025-2026/hb420.md?full=1 bill_number: HB 420 session: 2025-2026 Regular Session session_slug: 2025-2026 chamber: House bill_type: bill status_date: 2025-02-12 last_action: House Withdrawn, Recommitted sponsors: - Darlene Taylor - Lee Hawkins - Katie Dempsey - Karen Mathiak - Patty Stinson - Angie O'Steen text_version: Comm Sub has_text: true legiscan_url: https://legiscan.com/GA/bill/HB420/2025 upstream_id: 1968147 summaries_model: claude-sonnet-5 topic_tags: - health insurance coverage - cancer screening - genetic testing - insurance regulation - health savings accounts --- # HB 420. Insurance; require certain health benefit policies to cover genetic testing for an inherited mutation and cancer imaging under certain conditions ## Text 25 LC 52 0769S The House Committee on Insurance offers the following substitute to HB 420: A BILL TO BE ENTITLED AN ACT To amend Article 1 of Chapter 24 of Title 33 of the Official Co de of Georgia Annotated,1 relating to general provisions regarding insurance, so as to re quire certain health benefit2 policies to cover genetic testing for an inherited mutation and cancer imaging under certain3 conditions; to provide for definitions; to provide for cost-sharing requirements; to protect the4 eligibility of hea lth savings accounts; to provide for rules an d regulations; to provide for5 related matters; to repeal conflicting laws; and for other purposes.6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7 SECTION 1.8 Article 1 of Chapter 24 of Title 33 of the Official Code of Geo rgia Annotated, relating to9 general provisions regarding insurance, is amended by adding a new Code section to read as10 follows:11 "33-24-59.34.12 (a) As used in this Code section, the term:13 (1) 'Cancer imaging' means imaging modalities available to hea lthcare providers who14 diagnose, stage, and treat human cancer in accordance with nationally recognized clinical15 practice guidelines.16 H. B. 420 (SUB) - 1 - 25 LC 52 0769S (2) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any17 maximum limitation on the application of such deductible, coinsurance, copayment, or18 similar out-of-pocket expense.19 (3) 'Genetic testing for an inherited mutation' means germline multi-gene testing for an20 inherited mutation or pathogenic variants in an individual's genes that are associated with21 an increased risk of cancer.22 (4) 'Health benefit policy' means any individual or group plan , policy, or contract for23 healthcare services issued, delivered, issued for delivery, exe cuted, or renewed in this24 state which provides major medical benefits, including those contracts executed by this25 state on behalf of indigents and on behalf of state employees under Article 1 of Chapter26 18 of Title 45, public school teachers and employees under Part 6 of Article 17 of27 Chapter 2 of Title 20, and members and employees of the board of regents under Code28 Section 31-2-4, by a healthcare corporation, health maintenance organization, preferred29 provider organization, accident and sickness insurer, fraternal benefit society, hospital30 service corporation, medical service corporation, or any simila r entity and any31 self-insured healthcare plan not subject to the exclusive juris diction of the Employee32 Retirement Income Security Act of 1974, 29 U.S.C. Section 1001, et seq.33 (5) 'Nationally recognized clinical practice guidelines' means evidence based clinical34 practice guidelines developed by independent organizations or m edical professional35 societies utilizing a transparent methodology and reporting str ucture and with a36 conflict-of-interest policy. Such guidelines establish standar ds of care informed by a37 systematic review of evidence and an assessment of the benefits and risks of any38 alternative care options and include recommendations intended to optimize patient care.39 (b) All health benefit policies renewed or issued on or after July 1, 2025, shall include40 coverage for:41 H. B. 420 (SUB) - 2 - 25 LC 52 0769S (1) Genetic testing for an inherited mutation for a covered pe rson with a personal or42 family history of cancer when such testing is recommended by a healthcare provider and43 is in accordance with nationally recognized clinical practice guidelines; and44 (2) Cancer imaging for a covered person with an increased risk of cancer when such45 imaging is recommended by a healthcare provider and is in accordance with nationally46 recognized clinical practice guidelines.47 (c) The coverage provided for in subsection (b) of this Code section shall be subject to any48 cost-sharing requirement of a covered person's health benefit policy.49 (d) If application of the provisions of this Code section woul d result in health savings50 account ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then51 such provisions shall apply only to health savings accounts with qualified high deductible52 health plans with respect to the deductibles of such plans after an individual has satisfied53 the minimum deductibles; provided, however, that the provisions of this Code section shall54 apply to items or services that are preventive care pursuant to Section 223(c)(2)(C) of the55 Internal Revenue Code.56 (e) The Commissioner shall promulgate rules and regulations necessary to implement the57 provisions of this Code section in accordance with current guid elines established by58 professional medical organizations such as the National Comprehensive Cancer Network."59 SECTION 2.60 All laws and parts of laws in conflict with this Act are repealed.61 H. B. 420 (SUB) - 3 - ## Summaries written by Georgia Commons The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary. A House substitute bill would require Georgia health insurance plans to cover genetic testing for inherited cancer-related mutations and cancer imaging when a doctor recommends it, starting July 1, 2025. ### Plain-language summary Currently, Georgia law does not specifically require health insurance plans to cover genetic testing for inherited cancer mutations or certain cancer imaging. This bill adds a new section to Georgia's insurance code (O.C.G.A. ยง 33-24-59.34) requiring most health benefit policies, including individual and group plans, state employee and teacher plans, and university system employee plans, to cover this testing and imaging. Coverage applies to a covered person with a personal or family history of cancer who is recommended for genetic testing by a healthcare provider, or someone at increased risk of cancer recommended for cancer imaging, as long as the recommendation follows nationally recognized clinical practice guidelines. Insurers can still apply normal deductibles, copays, or coinsurance to this coverage. The bill includes a safeguard so people with health savings accounts paired with high-deductible health plans do not lose their tax-advantaged status, and it directs the Insurance Commissioner to write implementing rules. The requirement applies to policies issued or renewed on or after July 1, 2025. ### What it does - Adds a new Georgia insurance code section requiring covered health benefit policies to include genetic testing for inherited cancer mutations when recommended by a healthcare provider. - Requires the same policies to cover cancer imaging for people at increased risk of cancer when recommended by a provider following recognized clinical guidelines. - Allows insurers to still apply normal deductibles, copayments, or coinsurance (cost-sharing) to this new coverage. - Protects people enrolled in high-deductible health plans linked to health savings accounts from losing their tax eligibility because of this mandate. - Directs the Insurance Commissioner to create rules for implementing the requirement based on guidelines like those from the National Comprehensive Cancer Network. - Applies the new coverage requirement to health benefit policies issued or renewed on or after July 1, 2025. ### Who it affects People covered by individual or group health plans in Georgia, including state employees, public school teachers, and University System of Georgia employees; health insurers, HMOs, and similar entities that issue these policies; healthcare providers who recommend genetic testing or cancer imaging; and the state Insurance Commissioner's office, which must write implementing rules. ### Why it matters Georgians with a personal or family history of cancer, or those at increased cancer risk, would gain a guaranteed right to insurance coverage for genetic testing and cancer imaging when a doctor recommends it, though they could still owe deductibles or copays for these services. ### Key provisions - Section 1 adds new Code Section 33-24-59.34 defining key terms including 'cancer imaging,' 'genetic testing for an inherited mutation,' and 'health benefit policy.' - Subsection (b) requires covered policies renewed or issued on or after July 1, 2025 to cover genetic testing for inherited mutations and cancer imaging under specified conditions. - Subsection (c) clarifies that this new coverage remains subject to the policy's existing cost-sharing requirements like deductibles and copays. - Subsection (d) protects health savings account eligibility by limiting the mandate's application for high-deductible health plans until minimum deductibles are met, except for preventive care. - Subsection (e) directs the Insurance Commissioner to issue rules implementing the section in line with guidelines from groups such as the National Comprehensive Cancer Network. - Section 2 repeals any conflicting laws. ## Status - Status: Introduced (2025-02-12) - Last action: House Withdrawn, Recommitted (2025-04-04) - Sponsors: Darlene Taylor, Lee Hawkins, Katie Dempsey, Karen Mathiak, Patty Stinson, Angie O'Steen - Official page: https://www.legis.ga.gov/legislation/70264 > The history, votes, and amendments (369 characters) are at https://georgiacommons.org/bills/2025-2026/hb420.md?full=1