The Commissioner shall promulgate rules implementing an arbitration process requiring the Commissioner to select one or more resolution organizations to arbitrate certain claim disputes between insurers and out-of-network providers or facilities. Prior to proceeding with such arbitration, the Commissioner shall allow the parties 30 days from the date the Commissioner received the request for arbitration to negotiate a settlement. The parties shall timely notify the Commissioner of the result of such negotiation. If the parties have not notified the Commissioner of such result within 30 days of the date that the Commissioner received the request for arbitration, the Commissioner shall refer the dispute to a resolution organization within five days. The department shall contract with one or more resolution organizations by July 1, 2021, to review and consider claim disputes between insurers and out-of-network providers or facilities as such disputes are referred by the Commissioner.
History. Code 1981, § 33-20E-12 , enacted by Ga. L. 2020, p. 210, § 1/HB 888.
Structure Georgia Code
Chapter 20E - Surprise Billing Consumer Protection Act
§ 33-20E-2. Application to Insurers; Definitions
§ 33-20E-4. Payment for Emergency Medical Services
§ 33-20E-5. Payment for Nonemergency Medical Services
§ 33-20E-6. Denying or Restricting Benefits Based on Balance Billing; Notice to Insured
§ 33-20E-7. Surprise Bill Exclusion; Requirements
§ 33-20E-8. Payer Health Claims Data Base; Annual Updating of Website
§ 33-20E-9. Arbitration of Payment Issues
§ 33-20E-10. Dismissal or Arbitration Requests
§ 33-20E-11. Submission to Commissioner by Insurer of Data Pending Arbitration
§ 33-20E-12. Regulation; Contracting With Resolution Organizations
§ 33-20E-13. Selection of Arbitrator
§ 33-20E-14. Submission of Final Offers; Supporting Documentation
§ 33-20E-15. Proposed Payment Amounts
§ 33-20E-16. Payment of Expenses and Fees
§ 33-20E-17. Referral of Parties for Violations
§ 33-20E-18. Limitation on Litigation When Arbitration Sought
§ 33-20E-19. Quarterly Reporting by Resolution Organizations
§ 33-20E-20. Annual Reporting by Commissioner
§ 33-20E-21. Exclusion From Other Statutory Provisions
§ 33-20E-22. Reporting to Credit Reporting Agencies
§ 33-20E-23. Financial Responsibilities for Ground Ambulance Transportation