HB1427: HB1427 State employees; require state health benefit plan to cover cranial prostheses for certain covered persons

26 LC 52 9009 House Bill 1427 By: Representatives Willis of the 55th, Crawford of the 89th, Miller of the 62nd, and Cannon of the 58th A BILL TO BE ENTITLED AN ACT To amend Article 1 of Chapter 18 of Title 45 of the Official Co de of Georgia Annotated,1 relating to state employees' health insurance plan and post-employment health benefit fund,2 so as to require the state health benefit plan to cover cranial prostheses for certain covered3 persons experiencing partial or complete loss of body hair; to provide for definitions; to4 provide for cost-sharing requirements; to repeal conflicting laws; and for other purposes.5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:6 SECTION 1.7 Article 1 of Chapter 18 of Title 45 of the Official Code of Geo rgia Annotated, relating to8 state employees' health insurance plan and post-employment health benefit fund, is amended9 by adding a new Code section to read as follows:10 "45-18-4.3.11 (a) As used in this Code section, the term:12 (1) 'Alopecia' means the partial or complete loss of body hair caused by a severe13 autoimmune condition. Such term includes alopecia totalis, alo pecia universalis,14 ophiasis, other alopeicia areata, and alopecia areata, unspecified.15 H. B. 1427 - 1 - 26 LC 52 9009 (2) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any16 maximum limitation on the application of such a deductible, coinsurance, copayment, or17 similar out-of-pocket expense.18 (3) 'Covered person' means an individual covered under the state health benefit plan.19 (4) 'Cranial prosthesis' means a medical wig or hairpiece.20 (5) 'State health benefit plan' means the health insurance pla n or plans established21 pursuant to this article, for public school teachers and employ ees, dependents, and22 retirees pursuant to Part 6 of Article 17 of Chapter 2 of Title 20, and for members,23 employees, dependents, and retirees of the Board of Regents of the University System of24 Georgia pursuant to Code Section 31-2-4.25 (b) Beginning January 1, 2027, th e state health benefit plan s hall include coverage for26 cranial prostheses for any covered persons experiencing permane nt or temporary full or27 partial hair loss when such prostheses are prescribed by a licensed provider for use as part28 of a course of rehabilitative treatment for a diagnosed health condition, illness, or injury,29 including, but not limited to, alopecia, cancer, hair loss afte r cancer treatments such as30 chemotherapy or radiation, or scalp injuries.31 (c) The benefits of the state health benefit plan as provided in subsection (b) of this Code32 section shall be subject to the same cost-sharing requirements established for other covered33 benefits within such state health benefit plan. Special deductibles, coinsurance, copayment,34 or other limitations that are not generally applicable to other medical devices or services35 covered by the state health benefit plan shall not be imposed regarding such benefits."36 SECTION 2.37 All laws and parts of laws in conflict with this Act are repealed.38 H. B. 1427 - 2 -