HB 432 - Health insurance; cert coverage; osteoporosis prevention
Georgia House of Representatives - 1995/1996 Sessions
HB 432 - Health insurance; cert coverage; osteoporosis prevention
Page Numbers - 1/ 2/ 3/ 4/ 5/ 6
1. Henson 65th 2. Towery 30th 3. Ashe 46th
4. McBee 88th 5. Childers 13th 6. Taylor 134th
House Comm: Ins / Senate Comm: /
House Vote: Yeas Nays Senate Vote: Yeas Nays
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House Action Senate
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1/26/95 Read 1st Time
1/27/95 Read 2nd Time
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Code Sections amended:
HB 432 LC 15 4028
A BILL TO BE ENTITLED
AN ACT
1- 1 To amend Chapter 29 of Title 33 of the Official Code of
1- 2 Georgia Annotated, relating to individual accident and
1- 3 sickness insurance, and Article 1 of Chapter 30 of Title 33
1- 4 of the Official Code of Georgia Annotated, relating to
1- 5 general provisions regarding group or blanket accident and
1- 6 sickness insurance, so as to provide for legislative
1- 7 findings with regard to osteoporosis; to provide for
1- 8 definitions; to require insurers to provide coverage for
1- 9 bone mass measurement or bone density testing for certain
1-10 individuals; to provide that such coverage may be subject to
1-11 exclusions or limitations as approved by the Commissioner of
1-12 Insurance; to provide for construction; to provide for
1-13 applicability; to provide for matters relative to the
1-14 foregoing; to repeal conflicting laws; and for other
1-15 purposes.
1-16 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
1-17 Chapter 29 of Title 33 of the Official Code of Georgia
1-18 Annotated, relating to individual accident and sickness
1-19 insurance, is amended by adding a new Code Section 33-29-21
1-20 to read as follows:
1-21 "33-29-21. (Index)
1-22 (a) The General Assembly finds and declares the following:
1-23 (1) Osteoporosis affects 25 million Americans and each
1-24 year results in 1.5 million fractures of the hip, spine,
1-25 wrist, and other bones and costs the nation at least $18
1-26 billion annually;
1-27 (2) Osteoporosis progresses silently, in most cases
1-28 undiagnosed until a fracture occurs;
1-29 (3) Once a fracture occurs, the disease is already in an
1-30 advanced stage, and the likelihood is high that another
1-31 fracture will occur;
-1- (Index)
LC 15 4028
2- 1 (4) Since osteoporosis progresses silently and currently
2- 2 has no cure, prevention, early diagnosis, and treatment
2- 3 are key to reducing the prevalence and devastation of
2- 4 this disease;
2- 5 (5) Medical experts agree that osteoporosis is
2- 6 preventable and treatable, but once the disease
2- 7 progresses to the point of fracture its associated
2- 8 consequences often lead to disability and
2- 9 institutionalization, and these consequences exact a
2-10 heavy toll on the quality of life;
2-11 (6) Given the current focus on health care and the
2-12 reduction of unnecessary health care expenditures
2-13 through the use of health promotion and disease
2-14 prevention programs, mandating coverage for bone mass
2-15 measurement is a cost effective approach for states to
2-16 embrace;
2-17 (7) Bone mass measurement is a reliable way to detect
2-18 the presence of low bone mass and to ascertain the
2-19 extent of bone loss, which can help assess the
2-20 individual's risk of fracture, thus aiding in the
2-21 selection of appropriate therapies and interventions;
2-22 (8) Ordinary X-rays are not sensitive enough to detect
2-23 osteoporosis until 25 percent to 40 percent of bone mass
2-24 has been lost and the disease is far advanced;
2-25 (9) Currently available technologies for bone mass
2-26 measurement include single and dual photon
2-27 absorptiometry, computed tomography, and radiographic
2-28 absorptiometry;
2-29 (10) Other technologies for measuring bone mass are
2-30 under investigation and may become scientifically proven
2-31 technologies in the future; and
2-32 (11) Bone mass measurement and other services related to
2-33 the prevention, diagnosis, and treatment of osteoporosis
2-34 can be used effectively to reduce the pain and financial
2-35 burden that osteoporosis inflicts upon its victims.
2-36 (b) As used in this Code section, the term:
2-37 (1) 'Bone mass measurement' or 'bone density testing'
2-38 means a radiologic or radioisotopic procedure or other
2-39 scientifically proven technology performed on an
2-40 individual for the purpose of identifying bone mass or
2-41 detecting bone loss.
-2- (Index)
LC 15 4028
3- 1 (2) 'Qualified insured individual' means an estrogen
3- 2 deficient woman at clinical risk for osteoporosis; an
3- 3 individual with vertebral abnormalities; an individual
3- 4 receiving long-term glucocorticoid therapy; an
3- 5 individual with primary hyperparathyroidism; or an
3- 6 individual being monitored to assess the response to or
3- 7 efficacy of osteoporosis drug therapies.
3- 8 (c) Every insurer authorized to issue an individual
3- 9 accident and sickness policy in this state shall include,
3-10 either as a part of or as a required endorsement to each
3-11 such policy issued, delivered, issued for delivery, or
3-12 renewed on of after July 1, 1995, coverage for bone mass
3-13 measurement or bone density testing with respect to a
3-14 qualified insured individual.
3-15 (d) The coverage required under subsection (c) of this
3-16 Code section may be subject to such exclusions,
3-17 reductions, or other limitations as to coverages,
3-18 deductibles, or coinsurance as may be approved by the
3-19 Commissioner.
3-20 (e) Nothing in this Code section shall be construed to
3-21 prohibit the issuance of individual accident and sickness
3-22 policies which provide benefits greater than those
3-23 required by subsection (c) of this Code section or more
3-24 favorable to the insured than those required by subsection
3-25 (c) of this Code section.
3-26 (f) The provisions of this Code section shall apply to
3-27 individual insurance policies issued by a fraternal
3-28 benefit society, a nonprofit hospital service corporation,
3-29 a nonprofit medical service corporation, a health care
3-30 plan, a health maintenance organization, or any similar
3-31 entity."
SECTION 2.
3-32 Chapter 30 of Title 33 of the Official Code of Georgia
3-33 Annotated, relating to group or blanket accident and
3-34 sickness insurance, is amended by adding at the end of
3-35 Article 1 a new Code Section 33-30-15 to read as follows:
3-36 "33-30-15. (Index)
3-37 (a) The General Assembly finds and declares the following:
3-38 (1) Osteoporosis affects 25 million Americans and each
3-39 year results in 1.5 million fractures of the hip, spine,
-3- (Index)
LC 15 4028
4- 1 wrist, and other bones and costs the nation at least $18
4- 2 billion annually;
4- 3 (2) Osteoporosis progresses silently, in most cases
4- 4 undiagnosed until a fracture occurs;
4- 5 (3) Once a fracture occurs, the disease is already in an
4- 6 advanced stage and the likelihood is high that another
4- 7 fracture will occur;
4- 8 (4) Since osteoporosis progresses silently and currently
4- 9 has no cure, prevention, early diagnosis, and treatment
4-10 are key to reducing the prevalence and devastation of
4-11 this disease;
4-12 (5) Medical experts agree that osteoporosis is
4-13 preventable and treatable, but once the disease
4-14 progresses to the point of fracture its associated
4-15 consequences often lead to disability and
4-16 institutionalization, and these consequences exact a
4-17 heavy toll on the quality of life;
4-18 (6) Given the current national focus on health care
4-19 reform and the reduction of unnecessary health care
4-20 expenditures through the use of health promotion and
4-21 disease prevention programs, mandating coverage for bone
4-22 mass measurement is a cost effective approach for states
4-23 to embrace;
4-24 (7) Bone mass measurement is a reliable way to detect
4-25 the presence of low bone mass and to ascertain the
4-26 extent of bone loss, which can help assess the
4-27 individual's risk of fracture, thus aiding in the
4-28 selection of appropriate therapies and interventions;
4-29 (8) Ordinary X-rays are not sensitive enough to detect
4-30 osteoporosis until 25 percent to 40 percent of bone mass
4-31 has been lost and the disease is far advanced;
4-32 (9) Currently available technologies for bone mass
4-33 measurement include single and dual photon
4-34 absorptiometry, computed tomography, and radiographic
4-35 absorptiometry;
4-36 (10) Other technologies for measuring bone mass are
4-37 under investigation and may become scientifically proven
4-38 technologies in the future; and
4-39 (11) Bone mass measurement and other services related to
4-40 the prevention, diagnosis, and treatment of osteoporosis
-4- (Index)
LC 15 4028
5- 1 can be used effectively to reduce the pain and financial
5- 2 burden that osteoporosis inflicts upon its victims.
5- 3 (b) As used in this Code section, the term:
5- 4 (1) 'Bone mass measurement' or 'bone density testing'
5- 5 means a radiologic or radioisotopic procedure or other
5- 6 scientifically proven technology performed on an
5- 7 individual for the purpose of identifying bone mass or
5- 8 detecting bone loss.
5- 9 (2) 'Qualified insured individual' means an estrogen
5-10 deficient woman at clinical risk for osteoporosis; an
5-11 individual with vertebral abnormalities; an individual
5-12 receiving long-term glucocorticoid therapy; an
5-13 individual with primary hyperparathyroidism; or an
5-14 individual being monitored to assess the response to or
5-15 efficacy of approved osteoporosis drug therapies.
5-16 (c) Every insurer authorized to issue a group or blanket
5-17 accident and sickness policy in this state shall include,
5-18 either as a part of or as a required endorsement to each
5-19 such policy issued, delivered, issued for delivery, or
5-20 renewed on of after July 1, 1995, coverage for bone mass
5-21 measurement or bone density testing with respect to a
5-22 qualified insured individual.
5-23 (d) The coverage required under subsection (c) of this
5-24 Code section may be subject to such exclusions,
5-25 reductions, or other limitations as to coverages,
5-26 deductibles, or coinsurance as may be approved by the
5-27 Commissioner.
5-28 (e) Nothing in this Code section shall be construed to
5-29 prohibit the issuance of group or blanket accident and
5-30 sickness policies which provide benefits greater than
5-31 those required by subsection (c) of this Code section or
5-32 more favorable to the insured than those required by
5-33 subsection (c) of this Code section.
5-34 (f) The provisions of this Code section shall apply to
5-35 group or blanket insurance policies issued by a fraternal
5-36 benefit society, a nonprofit hospital service corporation,
5-37 a nonprofit medical service corporation, a health care
5-38 plan, a health maintenance organization, or any similar
5-39 entity."
-5- (Index)
LC 15 4028
SECTION 3.
6- 1 All laws and parts of laws in conflict with this Act are
6- 2 repealed.
-6- (Index)
Office of the Clerk of the House
Robert E. Rivers, Jr., Clerk of the House
Last Updated on 01/02/97