05 LC 28
1964
House
Bill 43
By:
Representatives Randall of the
138th,
Manning of the
32nd,
Hugley of the
133rd,
McClinton of the
84th,
Hill of the
180th,
and others
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Code Section 33-24-59.7 of the Official Code of Georgia Annotated,
relating to coverage of morbidly obese patients, so as to require that every
health benefit policy that is delivered, issued, executed, or renewed in this
state or approved for issuance or renewal in this state by the Commissioner of
Insurance on or after July 1, 2005, which provides major medical benefits shall
provide coverage for the treatment of morbid obesity; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Code
Section 33-24-59.7 of the Official Code of Georgia Annotated, relating to
coverage of morbidly obese patients, is amended by striking subsection (c) and
inserting in lieu thereof a new subsection (c) to read as follows:
"(c)(1)
As used in this Code section, the term:
(A)
'Health benefit policy' means any individual or group plan, policy, or contract
for health care services issued, delivered, issued for delivery, or renewed in
this state which provides major medical benefits, including those contracts
executed by the State of Georgia on behalf of indigents and on behalf of state
employees under Article 1 of Chapter 18 of Title 45, by a health care
corporation, health maintenance organization, preferred provider organization,
accident and sickness insurer, fraternal benefit society, hospital service
corporation, medical service corporation, or other insurer or similar
entity.
(B)
'Health care providers' means those physicians and medical institutions that are
specifically qualified to treat in a comprehensive manner the entire complex of
illness and disease associated with morbid obesity.
(C)
'Insurer' means an accident and sickness insurer, fraternal benefit society,
hospital service corporation, medical service corporation, health care
corporation, health maintenance organization, or any similar entity authorized
to issue contracts under this title and also means any state program funded
under Title XIX of the federal Social Security Act, 42 U.S.C.A. Section 1396 et
seq., and any other publicly funded state health care program.
(D)
'Morbid obesity' means a weight which is at least 100 pounds over or twice the
ideal weight for frame, age, height, and gender as specified in the 1983
Metropolitan Life Insurance tables. Morbid obesity also means a body mass index
(BMI) equal to or greater than 35 kilograms per meter squared with comorbidity
or coexisting medical conditions such as hypertension, cardiopulmonary
conditions, sleep apnea, or diabetes or a BMI of 40 kilograms per meter squared
without such comorbidity. BMI equals weight in kilograms divided by height in
meters squared.
(2)
Every health benefit policy that is delivered, issued, executed, or renewed in
this state or approved for issuance or renewal in this state by the Commissioner
on or after July 1,
1999
2005,
which provides major medical benefits
may
offer
shall
provide coverage for the treatment of
morbid
obesity."
SECTION
2.
All
laws and parts of laws in conflict with this Act are repealed.