For either determination, the expert reviewer shall apply prudent professional practices and shall assure that at least two documents of medical and scientific evidence support the decision.
History. Code 1981, § 33-20A-40 , enacted by Ga. L. 1999, p. 350, § 3; Ga. L. 2005, p. 1438, § 2/SB 140.
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