HB 1119: Labor and industrial relations; pharmacy care guidelines and pharmacy management networks under workers' compensation; provide

Georgia's workers' compensation system currently has no specific state law governing how doctors prescribe medications or how pharmacies dispense them to injured workers. This bill adds two new sections to the workers' compensation code addressing pharmacy care. It limits prescribing providers to a 30 day supply of off-label medications and a 90 day supply (in 30 day increments) of compounded medications, each requiring documentation of medical necessity and prior authorization. In the first seven days after an injury, dispensing providers can give only a 5 day supply of Schedule II or III drugs or a 14 day supply of other medications, unless they are part of a pharmacy management network, which follows its own contract terms instead. The bill also lets employers set up or contract with pharmacy management networks, requires notice to employees about how those networks work, requires networks to register with the State Board of Workers' Compensation and pay a fee, and sets rules networks must follow, such as prompt reimbursement and a dispute process. The law would take effect January 1, 2027.

• Limits prescribing providers to a 30 day supply of off-label medications and requires proof of medical necessity and prior authorization.
• Caps compounded medication prescriptions at a 90 day total supply given in 30 day increments, with documentation and prior authorization required.
• Limits dispensing providers to a 5 day supply of Schedule II or III drugs or a 14 day supply of other medications during the first week after an injury.
• Allows employers to create or contract with pharmacy management networks and requires them to notify workers about how to use these networks.
• Requires pharmacy management networks to register with the State Board of Workers' Compensation, pay a fee, and follow rules like prompt reimbursement and a claims dispute process.
• Exempts registered pharmacy management networks from Georgia's laws on administrator licensing and pharmacy benefit manager regulation.

Injured employees receiving workers' compensation benefits, doctors and pharmacists who prescribe or dispense their medications, employers who manage workers' compensation claims, and pharmacy management networks that contract with employers to provide drug benefits.

Injured workers could see limits on how much medication they can initially receive and might be steered toward specific pharmacy networks chosen by their employer, while doctors and pharmacists would face new documentation and supply limits for certain prescriptions, changing how quickly and where workers can fill prescriptions.

• New Code Section 34-9-201.1 defines terms like 'compounded medication,' 'off-label medication,' and 'pharmacy management network' and sets prescribing and dispensing limits.
• Subsection (c) requires prescribers to document medical necessity and get prior authorization before prescribing off-label or compounded drugs, with specific day-supply caps.
• Subsection (d) limits early dispensing (within 7 days of injury) to 5 days for Schedule II/III drugs or 14 days for other medications, unless the provider is in a pharmacy management network.
• New Code Section 34-9-201.2 lets employers require pharmacy care exclusively through a network if they give proper notice to employees.
• Subsection (c) requires reimbursement at the board's fee schedule for out-of-network providers until formal notice of network requirements is given.
• Subsection (d) requires pharmacy management networks to register with the State Board of Workers' Compensation and pay a licensing fee.
• Subsection (e) lists network obligations, including prompt reimbursement, a dispute process, no added fees to providers, and a mail order option.
• Section 2 sets the effective date as January 1, 2027.

1. 2026-02-05House Withdrawn, Recommitted (Cámara de Representantes)
2. 2026-02-04House Second Readers (Cámara de Representantes)
3. 2026-02-03House First Readers (Cámara de Representantes)
4. 2026-02-02House Hopper (Cámara de Representantes)

• Kasey Carpenter (R, HD-004)Patrocinador principal
• Josh Bonner (R, HD-073)
• Joseph Gullett (R, HD-019)
• Bill Yearta (R, HD-152)

• workers' compensation
• pharmacy benefits
• prescription drug rules
• injured workers
• healthcare regulation