HB1122: HB1122 Insurance; group or individual accident and sickness plans; provisions

Peripheral artery disease (PAD) is a circulation problem that raises the risk of heart attack, stroke, and amputation, but many people with risk factors never get screened. This bill adds new sections to Georgia insurance law requiring health benefit policies sold in the state, the State Health Benefit Plan for state employees, and Georgia Medicaid to cover a PAD screening test at least once every 12 months for people defined as 'at-risk,' such as those 65 or older, or younger people with diabetes and other risk factors like smoking history or high blood pressure. The screening coverage cannot come with extra deductibles or copays beyond what the rest of the plan already charges. The insurance policy requirement would generally take effect January 1, 2027. The state employee plan and Medicaid provisions only take effect if the General Assembly specifically appropriates funding for them, and self-funded employer plans governed by federal ERISA law are exempted.

• Adds a new law (O.C.G.A. § 33-24-59.37) requiring private and group health insurance policies in Georgia to cover PAD screening tests once every 12 months for at-risk individuals.
• Adds a similar requirement for the State Health Benefit Plan covering state employees (O.C.G.A. § 45-18-4.3), but only if lawmakers appropriate money for it.
• Adds a similar Medicaid coverage requirement (O.C.G.A. § 49-4-159.5), also contingent on a specific budget appropriation, and directs the state to seek federal approval if needed.
• Defines 'at-risk individual' by age and specific health risk factors like diabetes, smoking history, high blood pressure, or prior artery disease.
• Bars insurers from charging separate, higher deductibles or copays for this screening than they charge for other covered benefits.
• Exempts self-funded employer health plans governed by the federal ERISA law from the new insurance mandate.

Georgians enrolled in individual or group health insurance policies, state employees and retirees on the State Health Benefit Plan, Medicaid recipients, and insurers, HMOs, and other health plan administrators operating in Georgia who would need to add this coverage.

People with diabetes, high blood pressure, a smoking history, or who are over 65 could get a covered annual test to catch artery blockages before they lead to amputation, heart attack, or stroke. Whether state employees and Medicaid recipients actually get this benefit depends on the legislature later approving specific funding.

• Section 1 lays out legislative findings on peripheral artery disease and its links to amputation, heart attack, and stroke risk.
• Section 2 creates O.C.G.A. § 33-24-59.37, requiring health benefit policies renewed or issued on or after January 1, 2027 to cover PAD screening tests annually for at-risk individuals.
• Section 3 creates O.C.G.A. § 45-18-4.3, applying the same annual screening requirement to the state employee health plan.
• Section 4 creates O.C.G.A. § 49-4-159.5, requiring Georgia Medicaid to cover the screenings and allowing the department to seek a federal state plan amendment or waiver.
• Section 5 sets the general effective date at January 1, 2027, but makes the state employee plan and Medicaid provisions effective only if the General Assembly appropriates specific funding for them.
• Section 5 also exempts self-funded ERISA employer health plans from the insurance policy mandate.
• Section 6 repeals any conflicting laws.

1. 2026-03-09Senate Read and Referred (Senate)
2. 2026-03-06House Passed/Adopted By Substitute (House)
3. 2026-03-06House Third Readers (House)
4. 2026-03-04House Postponed (House)
5. 2026-03-03House Postponed (House)
6. 2026-02-24House Committee Favorably Reported By Substitute (House)
7. 2026-02-10House Withdrawn, Recommitted (House)
8. 2026-02-04House Second Readers (House)

• Demetrius Douglas (D, HD-078)Primary sponsor
• Mark Newton (R, HD-127)
• Carolyn Hugley (D, HD-141)
• Lee Hawkins (R, HD-027)
• Karlton Howard (D, HD-129)

1. PassedHouse voteMarch 6, 2026

   167 yea, 2 nay (4 not voting, 4 absent)

   Passage: House Vote #664

• health insurance coverage
• peripheral artery disease
• Medicaid benefits
• state employee health plan
• medical screening mandates