[{"_1":2,"_123":-5,"_124":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,99,111],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6352856,"mediaKeyId","2222334-d34632c7a542f9773826d846c2c23870","parentId",2222334,"title","Hearing on prosthetics, orthotics coverage draws personal testimony and insurer concerns over medical‑necessity language","audioSeconds",2035,"startMs",1208000,"endMs",3243000,"viewUrl","/Search/View?dp=1&key=2222334-d34632c7a542f9773826d846c2c23870&start=1208&end=3243","thumbnailUrl","https://assets.pipeline.soar.com/2222334-d34632c7a542f9773826d846c2c23870/thumbnail_1208000.jpg","articleUrl","/articles/6352856/Georgia/Hearing-on-prosthetics-orthotics-coverage-draws-personal-testimony-and-insurer-concerns-over-medicalnecessity-language","mediaUrl","https://secure.pipeline.soar.com/6352856-39660db4d19e57839c48dc22e965ab3d/orig.mp4?Expires=1776485376&Signature=be17IR6qjYD4lpQ8zmxAmayNa7a14mbQWsZB6ys-ty-xZgVIYCLgZq84DusPvYT5WHrKzEBgk6y5pPUhg89c7ZoMNTTK5Ln3TxHmHzX8u1xvJZ7pbT2JdU4uYqhZDZxafnRZP2Uy2z6qX7WwCTfNNPW5z~MMtvGT2iW4L4yNpKFWyKO~EL6mQlk7Z0q99VBmf19JZ0zEbKtVkfCnjJI9rbAxavkZuN6vD-9varo1U4ZLkymx9wQ-ysxWGHzSKsdMpYRITKU~4j4uZvqGZTaR-U6Q7~KiS0-1CvDIOwTw0RMRjdve9uRyhlhAOC6Guo7Y8rSp~1lGQhiVOcunWaYspg__&Key-Pair-Id=KUT5TJCACFTXG","author","Georgia State Legislature ","date","2025-02-03T00:00:00Z","article","Representative David Clark introduced House Bill 87 in a hearing-only session to change how medical necessity is defined for orthotics and prosthetics, seeking to allow coverage for additional devices tailored to activities of daily living and physical activity.

Clark said current law and common insurer criteria exclude devices described with specific activities — for example, running or showering — and that the bill would permit coverage when a licensed prosthetist‑orthotist (CPO) and treating physician determine a second device is medically appropriate to meet a patient’s goals and functional needs.

Multiple Georgians described how coverage gaps affect daily life. Susie Barrett, the mother of a child born without a right leg, said families often face large out‑of‑pocket expenses and must travel to metro Atlanta for services. Brad O’Malley described paying privately for heavy‑duty braces and said he had repeatedly been denied coverage for devices that allow greater activity. He told lawmakers each of his orthotic devices cost about $3,000.

Amputee athlete Merrill Wallace described raising funds and working with prosthetic manufacturers to obtain a running blade and later setting world records; he urged lawmakers to allow others the same opportunity without having to rely on donations. Rachel Oyer, who operates Alliance Prosthetics and Orthotics, urged cooperative conversations with insurers and said patients are the people caught in the middle.

Jesse Wellington, president and CEO of the Georgia Association of Health Plans, expressed a specific technical concern: the bill’s repeated language that a treating physician’s determination constitutes medical necessity. Wellington said his members have requested that language be struck because it would remove insurers’ ability to perform utilization review, which they view as necessary to prevent fraud, waste or abuse. Wellington also called committee attention to a potential Affordable Care Act issue: expanding benefit classes beyond those in effect in 2013 can trigger state budgetary impacts under federal rules.

Committee members asked whether the bill would change the existing replacement frequency for devices: current practice mentioned in testimony provides one prosthesis every three years for adults; the sponsor said the bill would allow an additional device when medically appropriate so that patients could shower or exercise without risking their primary device.

Representative Clark and advocates said they will continue to work with insurers to find a compromise; the committee recorded the bill as hearing-only and requested a fiscal note before further action.","mediaType","Video","parentTitle","02.03.2025 Health","oneSentenceSummary","House Bill 87 drew a hearing of patients, clinicians and insurers after the sponsor asked lawmakers to expand the definition of medical necessity so insurers may cover additional prosthetic and orthotic devices for activities such as showering, exercising and adaptive sports.","taxTitle","2025 Legislature Georgia , Georgia","taxId",77688,"location","Georgia","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6352861,"Committee backs bill to require insurers cover harvesting and one-year storage of reproductive tissue for select diagnoses",901,368000,1269000,"/Search/View?dp=1&key=2222334-d34632c7a542f9773826d846c2c23870&start=368&end=1269","https://assets.pipeline.soar.com/2222334-d34632c7a542f9773826d846c2c23870/thumbnail_368000.jpg","/articles/6352861/Georgia/Committee-backs-bill-to-require-insurers-cover-harvesting-and-one-year-storage-of-reproductive-tissue-for-select-diagnoses","https://secure.pipeline.soar.com/6352861-6e0f9e15659e63e23d43bfc455ff8835/orig.mp4?Expires=1776485376&Signature=WK-~PbNXgYEcqaLpF~1B2Pla~xzzTsp1HOWlkNbDAFBPR6wyrIyc5eesbVuN2hRtMIfRUGgpWWNxJG3wFFRC2UBF0WgWpt7XH2uZ9uiKcH5iJgniUak9e0Q1fv-AZ8ipWLeCj1qzEleM6XzCozvtq1Inn3iH13-xhuXVills8itwGnCk5LKtO7oPS2M6AdR9ixbtLP1Z2WwknEI-fYLBcBCtMqyZPZsTBmUTKZHU8dvWULXI-ioYQUcLplKPLMr-4iTQ6p8IQFGUbJdM4Y9h7b98PelKX2Wu86CshHuXoFFFun1EKgSdVVRm9Cp5ykKigEBJj5Y8NX2j5V4tEoVa2w__&Key-Pair-Id=KUT5TJCACFTXG","House Bill 94 (LC520653) won a do-pass recommendation from the House Health Committee after supporters said it would remove a financial barrier to fertility preservation for people facing medical treatments that can cause infertility.

Representative Lumsden, the bill sponsor, told the committee the measure “will provide insurance coverage for costs associated with the harvesting and storage for up to 1 year of certain biological tissues necessary for future in vitro fertilization for those individuals who have been diagnosed” with the specified conditions. He added, “This bill does not cover the cost of in vitro fertilization. It only addresses the cost of harvesting and storage of the biological materials necessary for future in vitro fertilization for those individuals who have been so diagnosed.”

Medical witnesses described the decisions patients face after a diagnosis. Jennifer Colas, a reproductive endocrinologist at Emory who spoke as a private citizen and member of the Georgia Fertility Network, said clinicians frequently see young patients told to make a fast decision about freezing eggs or sperm. “It is incredibly devastating, when the decision comes down to cost and finances,” Colas said, describing patients who want the chance to build a family but decline preservation because of cost.

Breast cancer survivor Alexandra French said she had three weeks from diagnosis to the start of chemotherapy and was fortunate to have her eggs retrieved; she told the committee that other patients do not have that option because of expense. Lynn Goldman, president of the Georgia Fertility Network and a fertility attorney, said advocates had included sickle cell disease because Georgia has among the highest rates in the country.

Jesse Wellington, president and CEO of the Georgia Association of Health Plans, told the panel that his members did not have objections to the bill. Committee members asked technical questions about age limits and scope: Representative Clark noted that line 44 of the bill allows insurers to establish age restrictions, and the sponsor said the insurance commissioner’s office typically sets criteria for those rules.

A motion to give the bill a do-pass recommendation carried by voice vote; committee members recorded no opposition on the transcript. The committee recorded the bill as House Bill 94, LC520653.

The bill now advances to the next committee or calendar step for further consideration, pending scheduling and any fiscal analysis required for later stages.","House Bill 94 (LC520653) won a do-pass recommendation from the House Health Committee after witnesses said the measure would require insurers to cover the cost of harvesting and storing reproductive tissue for up to one year for people diagnosed with cancer, sickle cell disease or lupus.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6352842,"Advocates ask committee to study arts‑as‑medicine agenda; resolution would create arts and health commission",0,3869000,"/Search/View?dp=1&key=2222334-d34632c7a542f9773826d846c2c23870&start=3869&end=3869","https://assets.pipeline.soar.com/2222334-d34632c7a542f9773826d846c2c23870/thumbnail_3869000.jpg","/articles/6352842/Georgia/Advocates-ask-committee-to-study-artsasmedicine-agenda-resolution-would-create-arts-and-health-commission","https://secure.pipeline.soar.com/6352842-46b9be31d479b6e0f7439156b29024e2/orig.mp4?Expires=1776485376&Signature=NFNTXk8nDi7xCWmDurIY~miiOosxaHTpUtQmwCoT1YQgm~WYO~LDfzwZMXVgsxV7IJKPiWDOH8Q0R12TLfXVvpRPLR9tkV5QfbDK7ValycyYI-a4ZRROHQB77uGfwy~OX0B8EjF2qZjUd0My~f7i0hmqfxJf4PnhYbi20IM61FnQSNoqINSQvwjsFDmkUw711aIfzR54fRpo1C-tieCTZN45C8MN~XjT2S1kQsuFJWsxkadgneuAgC6zUivI9s2xiFr6lwUe3qih4XnZ08u18nMeAvmxMzqDDPUY0uSwjXWRPUSZaLUpMnllQ18RmZgN5Z6P1obkxuYviWtws-D1jQ__&Key-Pair-Id=KUT5TJCACFTXG","Representative Scofield introduced proponents of House Resolution 117, which would establish a statewide commission to study and recommend arts‑based interventions for mental health and well‑being.

Witnesses included Eve Bird of the Carter Center, Erin Jones of the Atlanta Symphony Orchestra and Christopher Moses of the Alliance Theater. They cited peer‑review literature and program experience: testimony included statements that listening to relaxing music can lower cortisol substantially, that music therapy produced measurable improvements for some patients with major depressive disorder, and that arts engagement can improve cognitive function in people with dementia. The Atlanta Symphony cited a program expanding concerts for people with Alzheimer’s disease and early evaluation work in partnership with Emory’s Goizueta Alzheimer’s Research Center.

Speakers emphasized evidence and existing models: examples cited included state arts‑and‑health plans in other states and military music therapy programs for PTSD. Christopher Moses described a seven‑year Alliance Theater study finding positive effects on young people’s concentration, tolerance of multiple viewpoints and hope after arts field‑trip experiences.

Committee members asked practical questions about access and whether recorded or streamed arts experiences provide the same benefits as live, shared experiences. Advocates answered that community access and shared in‑person experiences were important and that an arts‑and‑health commission could help scale and coordinate public‑health and cultural resources. The committee did not take a vote on HR117 during the hearing; proponents asked lawmakers to consider the resolution and next steps for study and pilot programs.","Advocates testified in support of House Resolution 117, an initiative to study arts‑based interventions for mental health and propose a statewide arts‑and‑health commission. Witnesses cited research linking arts engagement to reduced anxiety, improved cognition in dementia and other mental‑health benefits.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6352847,"Hemophilia of Georgia outlines services, 340B participation and telehealth expansion to committee",743,3300000,4043000,"/Search/View?dp=1&key=2222334-d34632c7a542f9773826d846c2c23870&start=3300&end=4043","https://assets.pipeline.soar.com/2222334-d34632c7a542f9773826d846c2c23870/thumbnail_3300000.jpg","/articles/6352847/Georgia/Hemophilia-of-Georgia-outlines-services-340B-participation-and-telehealth-expansion-to-committee","https://secure.pipeline.soar.com/6352847-a28c03172f8dc76e42c29afac3247fe7/orig.mp4?Expires=1776485376&Signature=VYnVJ4kQlxC2NBP27gN4ARPQR8UgsdJnXa-tK5kDDbBi~TVNHX8M4O7scQ06y2Qo5waeDaOol7gbI~fQZnQ9hseOAEZkZjS2mX~1xFIK2eN5RYa57XnpV2vCIeN7R0MO0hPBQDOJb4bP3lYmt8kgftGM7mr0z3XTS20JtvJ4GiFuZoIFnpdfqvxdFdrlDpxGbcQgBVPcO6jNnMVz3a3HrX6ZtdnMI1ZZholn9lnfiwQisO89A7CWZj7lvrn08nCdWYtmv-NOl6WfhptoAdSuPn0dIf4FVEDhw0ERKOT8xWnxA3LAyvLR65rf3GgrxO8Ra9i97UWLSrmnvxY-vf35Aw__&Key-Pair-Id=KUT5TJCACFTXG","Michelle Condie, senior director of advocacy for Hemophilia of Georgia, told the committee the nonprofit has served the state for more than 50 years and participates in the 340B program to support patients with bleeding disorders.

Condie said Hemophilia of Georgia treats about 2,000 patients in the state and that a typical annual cost of care for a person with a bleeding disorder can range from $300,000 to $500,000 in a healthy year; costs can exceed $1 million if complications occur. The organization uses 340B pharmacy revenue, plus grant and program dollars, to help patients pay for medications, premiums, deductibles, copayments and other needs through programs the speaker identified as CAP (client assistance program) and IPAP (insurance premium assistance program).

Condie described five hemophilia treatment centers around the state (Atlanta, Augusta, Savannah plus two hybrid/telehealth sites) and said the organization receives roughly $400,000 a year from the state Department of Public Health to support premium and deductible assistance. She said telehealth and hybrid sites, created in 2021, have brought many patients back into care and reduced unmet needs from rural areas.

The presentation emphasized family camps, mentoring for self‑infusion, nursing and social‑work outreach, and the organization’s role leading the Southeast Regional Hemophilia Network, which administers 340B grants across multiple states. Condie asked lawmakers to support policies that protect the 340B program, expand telehealth and address mental‑health and equity issues in the rare‑disease community.","A Hemophilia of Georgia representative briefed the committee on the organization’s services, 340B pharmacy participation, telehealth outreach and the scale of care needs for Georgia patients with bleeding disorders.",{"_33":112,"_35":36,"_37":38,"_39":113,"_41":114,"_43":115,"_45":116,"_47":117,"_49":118,"_51":119,"_53":120,"_55":56,"_57":58,"_59":121,"_61":62,"_63":64,"_65":122,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6352852,"Committee adopts resolution recognizing Biomedical Research Day",343,3017000,3360000,"/Search/View?dp=1&key=2222334-d34632c7a542f9773826d846c2c23870&start=3017&end=3360","https://assets.pipeline.soar.com/2222334-d34632c7a542f9773826d846c2c23870/thumbnail_3017000.jpg","/articles/6352852/Georgia/Committee-adopts-resolution-recognizing-Biomedical-Research-Day","https://secure.pipeline.soar.com/6352852-65aace5bb99901d4691234ab2b4eca35/orig.mp4?Expires=1776485376&Signature=f9c32TRqukSAEapNZpHZU5s~XfpPOnQiVLVc3vb80OwhX7oMO90OpD1TPR1xA1uHaSQppkvgzJLe1D8PHPirUlaUJoY4FkAeze4QnlexApChV6s9ELuXBmGMOTzXRiR9W-FweI1LuQaSUhYpwOvaQtvIbT--QFjd68KlkuTIXeJO69bsVwOW-JLRIUzMRlQELggzQP03Sy5LrNYCpWplaZHRAbiu1c2doKNE9aF2pOzIopg~QdjwS7GDx5OImBDTQUA7-JLRfxzjcEPliCsLPPIk4rkyCZ2mGeb4u4pWSc8DN43bLO1H-fdhP0U7emJozeM7mr6fWfassxNGbgtNNg__&Key-Pair-Id=KUT5TJCACFTXG","Representative Imani Barnes introduced House Resolution 69 to recognize Biomedical Research Day, proposing observance on the third Thursday in April to raise awareness of biomedical research and its contributions to medical advances.

Barnes, who identified herself as a biomedical researcher at Emory University, described biomedical research as preclinical and translational work spanning biology, genetics and pharmacology that leads to therapies and devices. Supporters called for greater public understanding of researchers’ contributions to the state and local healthcare ecosystem.

Representative Bennett moved to pass the resolution, a second was offered, and the committee approved the resolution by voice vote. The record shows “Aye” with no recorded opposition on the transcript.

The resolution is honorary: it acknowledges a day of recognition and encourages initiatives that promote public understanding of biomedical research; it does not create a program or new spending in the committee record.","The committee voted to adopt House Resolution 69, which acknowledges a proposed Biomedical Research Day (to be observed the third Thursday in April) and encourages awareness of biomedical research contributions to health and the state’s research ecosystem.","actionData","errors"]

Article not found

Hearing on prosthetics, orthotics coverage draws personal testimony and insurer concerns over medical‑necessity language

Committee backs bill to require insurers cover harvesting and one-year storage of reproductive tissue for select diagnoses

Advocates ask committee to study arts‑as‑medicine agenda; resolution would create arts and health commission

Hemophilia of Georgia outlines services, 340B participation and telehealth expansion to committee

Committee adopts resolution recognizing Biomedical Research Day