Bill Text: GA HB1263 | 2009-2010 | Regular Session | Introduced

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Bill Title: Insurance; payment or reimbursement of oral chemotherapy; provide definitions

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2010-03-09 - House Second Readers [HB1263 Detail]

Download: Georgia-2009-HB1263-Introduced.html

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10 LC 37 1015

House Bill 1263

By: Representatives Dawkins-Haigler of the 93rd, Jones of the 44th, Stephenson of the 92nd, and Stephens of the 161st

A BILL TO BE ENTITLED
AN ACT

To amend Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to general provisions relative to insurance generally, so as to provide for definitions; to provide for payment or reimbursement of orally administered chemotherapy at the same reimbursement rate as intravenously administered chemotherapy; to provide for related matters; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to general provisions relative to insurance generally, is amended by adding a new Code section to read as follows:

"33-24-56.5.

(a) As used in this Code section, the term:

(1) 'Health benefit policy' means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, amended, executed, or renewed in this state by an insurer on or after July 1, 2010, including, but not limited to, those contracts executed by the State of Georgia on behalf of state employees under Article 1 of Chapter 18 of Title 45.

(2) 'Insurer' means an accident and sickness insurer, fraternal benefit society, hospital service corporation, health care corporation, health maintenance organization, preferred provider organization, provider sponsored health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

(3) 'Intravenously administered chemotherapy' means a physician prescribed cancer treatment that is administered through injection directly into the patient's circulatory system in a hospital, medical office, or other clinical setting by a physician, physician assistant, nurse practitioner, nurse, or other medical personnel under the supervision of a physician.

(4) 'Oral chemotherapy' means a United States Food and Drug Administration approved, physician prescribed cancer treatment that is taken orally in the form of a tablet or capsule that may be administered in a hospital, medical office, or other clinical setting or delivered to the patient for self-administration outside a hospital, medical office, or other clinical setting under the direction or supervision of a physician.

(b) Every health benefit policy that includes coverage or benefits for the treatment of cancer shall provide payment or reimbursement for all chemotherapy that is considered medically necessary, including oral chemotherapy, at the same copayment percentage or relative coinsurance amount as is applied to intravenously administered chemotherapy."

SECTION 2.

All laws and parts of laws in conflict with this Act are repealed.