Georgia CommonsHB 931: Health; control high costs of prescription drugs; establish framework
Last action January 12, 2026 · House Second Readers
HB931 would create a new Georgia board with power to set price caps on high-cost prescription drugs, requiring insurers and drug makers to report pricing data and follow affordability reviews.
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 LegiScan holds.
In plain language
Right now Georgia has no state agency that reviews prescription drug prices or sets limits on what can be charged for them. This bill would add a new article to Georgia's health code creating the Prescription Drug Affordability Board, a five-member panel appointed by the Governor and confirmed by the Senate. The board would identify expensive or fast-rising drugs each year, collect pricing data from health benefit plans, manufacturers, pharmacy benefits managers, and wholesale distributors, and review whether a drug's cost poses an 'affordability challenge.' If the board finds a drug unaffordable, it can set an upper payment limit on purchases and reimbursements in Georgia, with that limit taking effect six months later unless the board sets a different date. Manufacturers who want to pull a capped drug from the Georgia market must give six months' notice or face a penalty up to $500,000. The bill also requires certain indigent care programs funded through Georgia's indigent care trust fund to negotiate specialist rates. It would take effect immediately if signed by the Governor.
What the bill does
- Creates the five-member Prescription Drug Affordability Board, appointed by the Governor and confirmed by the Senate, to review drug prices in Georgia.
- Requires health benefit plans to annually report their most costly and frequently dispensed drugs, along with rebate and premium data, to the board.
- Authorizes the board to set an upper payment limit, a price cap, on prescription drugs it finds pose an 'affordability challenge' after formal review.
- Requires manufacturers to give six months' notice before withdrawing a price-capped drug from sale in Georgia, with penalties up to $500,000 for failing to do so.
- Directs the board to fund itself through annual assessments on manufacturers, health plans, pharmacy benefits managers, and wholesale drug distributors.
- Requires certain indigent care programs funded by the state's indigent care trust fund to negotiate specialist care rates with primary healthcare programs.
Who it affects
Drug manufacturers, pharmacy benefits managers, and wholesale drug distributors that would face new reporting duties and assessments; health insurers and health benefit plans that must submit annual pricing data; ERISA plans that can opt in; state agencies purchasing drugs for public programs; and Georgia patients and consumers who buy prescription drugs.
Why it matters
If enacted, some Georgians could see lower prices or reduced out-of-pocket costs for high-cost drugs subject to a board-set payment limit, while drug makers, insurers, and distributors would face new reporting requirements, fees, and potential penalties for withdrawing capped drugs from the state without notice.
Key provisions
- Section 2 reorganizes existing Department of Community Health code sections into Article 1 to make room for the new board's provisions.
- Section 3 (new O.C.G.A. § 31-2-31) establishes the board's five members, four-year staggered terms, qualifications, and conflict of interest rules.
- New § 31-2-32 sets thresholds triggering review, including drugs costing $3,000 or more per year or with wholesale price increases of $300 or 200 percent within 12 months.
- New §§ 31-2-33 and 31-2-34 lay out what data and criteria the board may use in affordability reviews, including cost, market competition, and impact on underserved communities.
- New § 31-2-35 authorizes the board to set upper payment limits, applying six months after adoption, and creates an appeal process under the Georgia Administrative Procedure Act.
- New § 31-2-37 requires manufacturers to give six months' notice before withdrawing a price-capped drug from Georgia or face a penalty up to $500,000.
- New § 31-2-39 requires the board to submit an annual report starting December 1, 2026 to state health officials and legislative committees.
- Section 4 amends O.C.G.A. § 31-8-154 to require certain indigent care hospital programs to negotiate specialist rates with primary healthcare programs.
From the bill
“There is hereby established the Prescription Drug Affordability Board for the purpose of protecting residents of this state, state and local governments, health benefit plans, healthcare providers, pharmacies, and other stakeholders within the healthcare system in this state from the high costs of prescription drugs.”
“The board shall assess a penalty not to exceed $500,000.00 if the board determines that a manufacturer failed to provide the notice required by subsection (a) of this Code section before withdrawing from sale or distribution within this state any prescription drug for which the board has established an upper payment limit.”
“An upper payment limit does not include a pharmacy dispensing fee, and nothing in this article shall be interpreted to prevent a retail pharmacy from receiving a payment that includes a dispensing fee above the upper payment limit.”
Status timeline
- House Second Readers (House)
- House First Readers (House)
- House Hopper (House)
Sponsors
- Karen Lupton (D, HD-083)
- Marvin Lim (D, HD-098)
Topics
- prescription drug prices
- health insurance regulation
- drug affordability board
- Medicaid and indigent care
- state health policy