As used in this article, the term:
(1.1) “Department” means the Department of Insurance.
(2.1) “Generally accepted standards of mental health or substance use disorder care” means evidence based independent standards of care and clinical practice that are generally recognized by health care providers practicing in relevant clinical specialties such as psychiatry, psychology, clinical sociology, addiction medicine and counseling, and behavioral health treatment. Valid, evidence based sources reflecting generally accepted standards of mental health or substance use disorder care may include peer reviewed scientific studies and medical literature, consensus guidelines and recommendations of nonprofit health care provider professional associations and specialty societies, and nationally recognized clinical practice guidelines, including, but not limited to, patient placement criteria and clinical practice guidelines; guidelines or recommendations of federal government agencies; and drug labeling approved by the United States Food and Drug Administration.
(7.1) “Mental health or substance use disorder” means a mental illness or addictive disease.
(7.2) “Mental illness” has the same meaning as in Code Section 37-1-1.
History. Code 1981, § 33-20A-31 , enacted by Ga. L. 1999, p. 350, § 3; Ga. L. 2002, p. 415, § 33; Ga. L. 2005, p. 1438, § 2/SB 140; Ga. L. 2006, p. 72, § 33/SB 465; Ga. L. 2009, p. 453, § 1-7/HB 228; Ga. L. 2022, p. 26, § 1-3/HB 1013.
The 2022 amendment, effective July 1, 2022, added present paragraphs (1), (2.1), (7.1), and (7.2); redesignated former paragraph (1) as paragraph (1.1) and substituted “Department of Insurance” for “Department of Community Health established under Chapter 2 of Title 31” at the end; designated the existing provisions of paragraph (7) as paragraph (7) and present subparagraph (7)(A), and redesignated former subparagraphs (7)(A) through (7)(E) as present divisions (7)(A)(i) through (7)(A)(v), inserted a colon at the end of present paragraph (7), added “Except as otherwise provided in subparagraph (B) of this paragraph” at the beginning of present subparagraph (7)(A), added “; or” at the end of division (7)(A)(v), added subparagraph (7)(B); and inserted “or mental health or substance use disorder” in the middle of paragraph (8).
Editor’s notes.
Ga. L. 2022, p. 26, § 1-1/HB 1013, not codified by the General Assembly, provides that: “This part shall be known and may be cited as the ‘Georgia Mental Health Parity Act.’”
Ga. L. 2022, p. 26, § 1-9/HB 1013, not codified by the General Assembly, provides that: “If necessary to implement any of the provisions of this part relating to the Medicaid program, the Department of Community Health shall submit a Medicaid state plan amendment or waiver request to the United States Department of Health and Human Services.”
Ga. L. 2022, p. 26, § 1-10/HB 1013, not codified by the General Assembly, provides that: “Nothing in this part shall be construed to impair any contracts in effect on June 30, 2022.
Structure Georgia Code
Chapter 20A - Managed Health Care Plans
Article 2 - Patient’s Right to Independent Review
§ 33-20A-33. Minimum Expense of Treatment Prior to Review
§ 33-20A-34. Representatives for Enrollee; Cost of Review; Cooperation
§ 33-20A-35. Request for Independent Review
§ 33-20A-36. Additional Information Required for Independent Review
§ 33-20A-37. Effect of Favorable Determinations
§ 33-20A-38. Organizational and Employee Liability
§ 33-20A-40. Determining Medical Necessity or Whether a Treatment Is Experimental
§ 33-20A-41. Rules and Regulations
§ 33-20A-42. Grievance Procedures and Hearings for Medicaid Care Management Members