Managed care plans offering the preferred provider organization network plan under this subparagraph shall not place capacity limits on the number or classes of providers authorized to be preferred providers except where the services regularly performed by a particular class of providers are not covered services within the scope of the health benefit plan or plans offered by the managed care plan pursuant to Article 2 of Chapter 30 of this title. This subparagraph shall not supersede any other requirement of this title regarding the coverage of a certain class or classes of providers.
History. Code 1981, § 33-20A-9.1 , enacted by Ga. L. 1999, p. 342, § 3; Ga. L. 2008, p. 1088, § 1/HB 1328; Ga. L. 2015, p. 1088, § 23/SB 148.
Code Commission notes.
Pursuant to Code Section 28-9-5, in 1999, in subsection (c), “; and” was substituted for a period, the formerly undesignated paragraph was designated as paragraph (2), and “paragraph (1) of this subsection” was substituted for “this paragraph” in three places in paragraph (2); in subsection (d), a semicolon was substituted for a comma in subdivision (d)(2)(A)(i), “toward” was substituted for “towards” in the last sentence of subparagraph (d)(3)(D), and, in the last sentence of paragraph (d)(4), “paragraphs” was substituted for “paragraph” and capitalization changes were made; and “The plan” was substituted for “A plan” in the last sentence in subsection (f).
Editor’s notes.
Ga. L. 1999, p. 342, § 7, not codified by the General Assembly, provides that: “This Act shall become effective on July 1, 1999, for purposes of preparing for implementation of the consumer choice option and shall be applicable to any contract, policy, or other agreement of a managed care plan or health maintenance organization if such contract, policy, or agreement provides for health care services or reimbursement therefor and is issued, issued for delivery, delivered, or renewed on or after January 1, 2000.”
Law reviews.
For note on 1999 enactment of this Code section, see 16 Ga. St. U.L. Rev. 163 (1999).
Structure Georgia Code
Chapter 20A - Managed Health Care Plans
Article 1 - Patient Protection
§ 33-20A-2. Legislative Findings
§ 33-20A-5. Standards for Certification
§ 33-20A-6. Financial Incentive Programs Prohibited; Capitated Payment Arrangement Allowed
§ 33-20A-8. Confidentiality and Accuracy of Patient Records
§ 33-20A-9. Emergency Services Requirements; Restrictive Formulary Requirements
§ 33-20A-10. Chapter Inapplicable to Workers’ Compensation Provisions