SB528: SB528 Insurance; health benefit plans, policies, or contracts executed by the state to cover medically necessary orthotic devices and prosthetic devices and their materials and components; require

Georgia law already requires many health insurance plans to cover medically necessary orthotic devices (braces and other supportive equipment) and prosthetic devices (artificial limbs and similar equipment), along with their materials and components, under O.C.G.A. § 33-24-59.35. That law currently excludes health plans the state provides to state employees, public school teachers and staff, and University System of Georgia employees and retirees from counting as a 'health benefit policy' covered by the mandate. This bill revises that definition by adding the phrase 'on or after January 1, 2027' to the exclusion for those state-provided plans. It leaves in place the separate exclusions for Medicaid contracts and for self-funded employer health plans governed by the federal ERISA law. The bill would take effect immediately once signed by the Governor or allowed to become law without a signature, and it repeals any conflicting laws.

• Revises the definition of 'health benefit policy' in Georgia's orthotic and prosthetic device coverage law (O.C.G.A. § 33-24-59.35).
• Adds a January 1, 2027 date to the exclusion covering health plans for state employees, public school teachers and staff, and University System of Georgia employees and retirees.
• Leaves unchanged the existing exclusions for Medicaid managed care contracts and for self-funded employer health plans regulated under the federal ERISA law.
• Sets the Act's effective date as the date the Governor signs it, or the date it becomes law without a signature if he does not.
• Repeals any other Georgia laws that conflict with this change.

State employees, public school teachers and staff, and University System of Georgia employees, retirees, and dependents whose health coverage comes through state-administered plans, along with the Department of Community Health, the Board of Regents, and insurers that administer these state health plans.

Whether these state-run health plans count as a 'health benefit policy' determines whether they must cover medically necessary orthotic and prosthetic devices and their components under Georgia law. The added 2027 date changes when that exclusion applies, affecting when state employees and teachers can expect this coverage.

• Section 1 amends paragraph (3) of subsection (a) of O.C.G.A. § 33-24-59.35 to insert 'On or after January 1, 2027' before the clause excluding state employee, teacher, and University System health plans from the definition of 'health benefit policy.'
• Section 1 keeps the existing exclusion for healthcare services provided under Medicaid contracts between insurers and the Department of Community Health.
• Section 1 keeps the existing exclusion for self-funded, employer-sponsored health plans subject to the federal Employee Retirement Income Security Act of 1974 (ERISA).
• Section 2 makes the Act effective upon the Governor's approval or upon it becoming law without approval.
• Section 3 repeals any conflicting Georgia laws.

1. 2026-02-19Senate Read and Referred (Senate)
2. 2026-02-18Senate Hopper (Senate)

• Randy Robertson (R, SD-029)Primary sponsor
• Clint Dixon (R, SD-045)
• Matt Brass (R, SD-006)
• Brian Strickland (R, SD-042)
• Billy Hickman (R, SD-004)
• Mike Hodges (R, SD-003)
• Max Burns (R, SD-023)
• Jason T. Dickerson (R, SD-021)
• Lee Anderson (R, SD-024)
• Shawn Still (R, SD-048)
• Chuck Payne (R, SD-054)

• health insurance coverage
• prosthetic and orthotic devices
• state employee benefits
• teacher health plans
• insurance regulation