---
title: SB 323. Health, Insurance, and Professions and Businesses; medically necessary tests for metal allergies and metal sensitivities to be administered prior to any cardiovascular, dental, or orthopedic surgery involving the insertion of a metal implant; provide
collection: bills
id: 2025-2026/sb323
cite_as: SB 323, 2025-2026 Regular Session (Ga.)
canonical_url: https://georgiacommons.org/bills/2025-2026/sb323
md_url: https://georgiacommons.org/bills/2025-2026/sb323.md
text_url: https://georgiacommons.org/bills/2025-2026/sb323/text
source_url: https://www.legis.ga.gov/legislation/71126
date: 2025-03-06
status: introduced
corpus_version: bills-2026-09-12
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/sb322.md
next: https://georgiacommons.org/bills/2025-2026/sb324.md
index: https://georgiacommons.org/bills/index.md
omitted: votes and history
omitted_chars: 95
omitted_url: https://georgiacommons.org/bills/2025-2026/sb323.md?full=1
bill_number: SB 323
session: 2025-2026 Regular Session
session_slug: 2025-2026
chamber: Senate
bill_type: bill
status_date: 2025-03-04
last_action: Senate Read and Referred
sponsors:
- Donzella James
- Harold Jones
- Sally Harrell
- Kenya Wicks
- Gail Davenport
- Tonya Anderson
- Michael Rhett
- Kim Jackson
- Jason Esteves
- Derek Mallow
- Nan Orrock
- Sonya Halpern
- Randal Mangham
- Sheikh Rahman
- David Lucas
- Nabilah Islam Parkes
- Elena Parent
text_version: Introduced
has_text: true
legiscan_url: https://legiscan.com/GA/bill/SB323/2025
upstream_id: 1991486
summaries_model: claude-sonnet-5
topic_tags:
- metal allergy testing
- health insurance coverage
- surgical implants
- medical licensing
- patient rights
---
# SB 323. Health, Insurance, and Professions and Businesses; medically necessary tests for metal allergies and metal sensitivities to be administered prior to any cardiovascular, dental, or orthopedic surgery involving the insertion of a metal implant; provide
## Text
Senate Bill 323
By: Senators James of the 28th, Jones II of the 22nd, Harrell of the 40th, Wicks of the 34th,
Davenport of the 17th and others
A BILL TO BE ENTITLED
AN ACT
To amend Titles 31, 33, and 43 of the Official Code of Georgia Annotated, relating to health,
insurance, and professions and businesses, respectively, so as to provide for medically
necessary tests for metal allergies and metal sensitivities to be administered prior to any
cardiovascular, dental, or orthopedic surgery involving the insertion of a metal implant; to
provide for definitions; to provide for health benefit policies to cover such tests; to provide
for cost-sharing requirements; to provide for rules and regulations; to provide for continuing
education requirements for dental surgeons and surgeons; to provide for requirements for
certain healthcare providers; to provide for a private cause of action; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in Chapter
1, relating to general provisions, by adding a new Code section to read as follows:
"31-1-26.
(a) The department, in consultation with the Georgia Board of Dentistry and the Georgia
Composite Medical Board, shall identify and compile information on metal allergies and
metal sensitivities to identify medically necessary and recommended tests to protect
individuals prior to any cardiovascular, dental, or orthopedic surgery involving the
insertion of a metal implant into a human body. Such information shall be reviewed
annually and updated, if necessary.
(b) The information identified and compiled pursuant to subsection (a) of this Code section
shall be posted in a prominent location on the department's website for the purpose of
providing information to healthcare providers and the general public. Such information
shall be annually distributed by the Georgia Board of Dentistry to all dental surgeons
licensed to practice dentistry in this state and by the Georgia Composite Medical Board to
all surgeons licensed to practice medicine in this state."
SECTION 2.
Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended in
Chapter 24, relating to insurance generally, by adding a new Code section to read as follows:
"33-24-59.34.
(a) As used in this Code section, the term:
(1) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any
maximum limitation on the application of such deductible, coinsurance, copayment, or
similar out-of-pocket expense.
(2) 'Health benefit policy' means any individual or group plan, policy, or contract for
healthcare services issued, delivered, issued for delivery, or renewed in this state which
provides major medical benefits, including those contracts executed by the State of
Georgia on behalf of indigents and on behalf of state employees under Article 1 of
Chapter 18 of Title 45, by a healthcare corporation, health maintenance organization,
preferred provider organization, accident and sickness insurer, fraternal benefit society,
hospital service corporation, medical service corporation, or any similar entity and any
self-insured healthcare plan not subject to the exclusive jurisdiction of the Employee
Retirement Income Security Act of 1974, 29 U.S.C. Section 1001, et seq.
(3) 'Medically necessary' shall have the same meaning as set forth in Code Section
33-46-4 and shall be in accordance with guidelines established pursuant to Code Section
31-1-26; provided, however, that, if a patient informs a healthcare provider that he or she
has a metal allergy or metal sensitivity, a lymphocyte transformation test or other more
advanced test shall be considered medically necessary.
(4) 'Metal implant' means any medical device made of metal that is used to support or
replace any human body part, including but not limited to any bone, joint, or tooth. Such
term shall not include any medical injection, surgical tool, or dental filling.
(b) All health benefit policies issued, delivered, issued for delivery, or renewed on or after
July 1, 2025, shall include coverage for medically necessary tests for metal allergies and
metal sensitivities prior to any cardiovascular, dental, or orthopedic surgery involving the
insertion of a metal implant into the human body.
(c) The coverage provided for in subsection (b) of this Code section shall be subject to any
cost-sharing requirement of the covered person's health benefit policy and shall not
diminish or limit any other benefits provided under such policy.
(d) If application of the provisions of this Code section would result in health savings
account ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then
such provisions shall apply only to health savings accounts with qualified high deductible
health plans with respect to the deductibles of such plans after an individual has satisfied
the minimum deductibles; provided, however, that the provisions of this Code section shall
apply to items or services that are preventive care.
(e) The Commissioner shall promulgate rules and regulations necessary to implement the
provisions of this Code section."
SECTION 3.
Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,
is amended in Chapter 11, relating to dentists, dental hygienists, and dental assistants, by
adding a new subsection to Code Section 43-11-46.1, relating to continuing education
requirements and waiver, to read as follows:
"(f) On and after January 1, 2025, continuing education requirements for dental surgeons
shall include one hour of education and training on metal allergies and metal sensitivities
and any medically necessary and recommended tests to be administered prior to any dental
surgery involving the insertion of a metal implant into a human body."
SECTION 4.
Said title is further amended in Chapter 34, relating to physicians, acupuncture, physician
assistants, cancer and glaucoma treatment, respiratory care, clinical perfusionists, and
orthotics and prosthetics practice, by adding a new paragraph to subsection (a) of Code
Section 43-34-11, relating to continuing education requirement and required training for
physicians, to read as follows:
"(7) On and after January 1, 2025, all surgeons shall be required to receive one hour of
education and training on metal allergies and metal sensitivities and any medically
necessary and recommended tests to be administered prior to any surgery involving the
insertion of a metal implant into a human body."
SECTION 5.
Said title is further amended in said chapter by adding a new Code section to read as follows:
"43-34-16.
(a) As used in this Code section, the term:
(1) 'Healthcare provider' means a physician or other person licensed or otherwise
authorized to perform surgical services in this state.
(2) 'Medically necessary' shall have the same meaning as set forth in Code Section
33-46-4 and shall be in accordance with clinical practice guidelines established pursuant
to Code Section 31-1-26; provided, however, that, if a patient informs a healthcare
provider that he or she has a metal allergy or metal sensitivity, a lymphocyte
transformation test or other more advanced test shall be considered medically necessary.
(3) 'Metal implant' means any medical device made of metal that is used to support or
replace any human body part, including but not limited to any bone, joint, or tooth. Such
term shall not include any medical injection, surgical tool, or dental filling.
(b) Prior to performing any cardiovascular, dental, or orthopedic surgery involving the
insertion of a metal implant into a human body, a healthcare provider shall:
(1) Ask a patient if he or she has any metal allergy or metal sensitivity; and
(2) Perform any medically necessary tests for metal allergies and metal sensitivities.
(c) A patient aggrieved by a healthcare provider's failure to satisfy the requirements
provided for in subsection (b) of this Code section may bring a private cause of action
against such provider for damages and any other relief a court of competent jurisdiction
deems appropriate."
SECTION 6.
All laws and parts of laws in conflict with this Act are repealed.
## 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 Georgia Senate bill would require doctors and dentists to ask patients about metal allergies and run medically necessary tests before surgeries that implant metal, with insurance required to cover the tests.
### Plain-language summary
Currently, Georgia law does not specifically require testing for metal allergies or sensitivities before surgeries that insert metal implants, such as joint replacements, dental implants, or cardiovascular devices. This bill would change that by directing the Department of Public Health, working with the Georgia Board of Dentistry and the Georgia Composite Medical Board, to compile guidance on which tests are medically necessary and to publish it online, updating it annually.
The bill also requires health insurance plans issued or renewed on or after July 1, 2025 to cover these tests, subject to normal deductibles and copays. Dental surgeons and physicians who perform surgery would need one hour of continuing education on metal allergies starting January 1, 2025. Before performing cardiovascular, dental, or orthopedic surgery involving a metal implant, healthcare providers must ask patients about metal allergies and perform necessary tests, or a patient could sue them for damages if they fail to do so.
### What it does
- Directs the Department of Public Health to compile and annually update guidance on medically necessary tests for metal allergies before implant surgeries, in consultation with state dental and medical boards.
- Requires health insurance policies renewed or issued on or after July 1, 2025 to cover tests for metal allergies and sensitivities before implant surgeries, subject to normal deductibles and copays.
- Adds a one-hour continuing education requirement on metal allergies and sensitivities for dental surgeons and physicians who perform surgery, starting January 1, 2025.
- Requires healthcare providers to ask patients about metal allergies and perform medically necessary tests before cardiovascular, dental, or orthopedic implant surgery.
- Creates a private cause of action allowing a patient to sue a healthcare provider for damages if the provider fails to ask about or test for metal allergies before implant surgery.
### Who it affects
The bill affects patients undergoing cardiovascular, dental, or orthopedic surgery involving metal implants, surgeons and dental surgeons licensed in Georgia, health insurance companies and self-insured health plans, and state agencies including the Department of Public Health and the Georgia Composite Medical Board.
### Why it matters
Patients could get tested for metal allergies before receiving implants like joint replacements or dental devices, potentially avoiding complications from metal sensitivities. Insurers would have to pay for these tests, and providers who skip the required questions or tests could face lawsuits for damages.
### Key provisions
- Section 1 creates O.C.G.A. § 31-1-26, requiring the Department of Public Health to compile and publish online guidance on necessary metal allergy tests, updated annually.
- Section 2 creates O.C.G.A. § 33-24-59.34, requiring health benefit policies issued or renewed on or after July 1, 2025 to cover metal allergy testing before implant surgery, subject to cost-sharing.
- Section 2 defines 'medically necessary' to automatically include a lymphocyte transformation test or more advanced test if a patient reports a metal allergy.
- Section 3 amends O.C.G.A. § 43-11-46.1 to require dental surgeons to complete one hour of continuing education on metal allergies starting January 1, 2025.
- Section 4 amends O.C.G.A. § 43-34-11 to require all surgeons to complete one hour of continuing education on metal allergies starting January 1, 2025.
- Section 5 creates O.C.G.A. § 43-34-16, requiring healthcare providers to ask about metal allergies and perform necessary tests before implant surgery, and creates a private right to sue for failure to comply.
## Status
- Status: Introduced (2025-03-04)
- Last action: Senate Read and Referred (2025-03-06)
- Sponsors: Donzella James, Harold Jones, Sally Harrell, Kenya Wicks, Gail Davenport, Tonya Anderson, Michael Rhett, Kim Jackson, Jason Esteves, Derek Mallow, Nan Orrock, Sonya Halpern, Randal Mangham, Sheikh Rahman, David Lucas, Nabilah Islam Parkes, Elena Parent
- Official page: https://www.legis.ga.gov/legislation/71126
> The history, votes, and amendments (95 characters) are at https://georgiacommons.org/bills/2025-2026/sb323.md?full=1