Each party shall submit one proposed payment amount to the arbitrator. The arbitrator shall pick one of the two amounts submitted and shall reveal that amount in the arbitrator’s final decision. The arbitrator may not modify such selected amount. In making such a decision, the arbitrator shall consider the complexity and circumstances of each case, including, but not limited to, the level of training, education, and experience of the relevant physicians or other individuals at the facility who are licensed or otherwise authorized in this state to furnish healthcare services and other factors as determined by the Commissioner through rule. The arbitrator’s final decision shall be in writing and shall describe the basis for such decision, including citations to any documents relied upon. Notwithstanding Code Section 33-20E-14, such decision shall be made within 30 days of the Commissioner’s referral. Any default or final decision issued by the arbitrator shall be binding upon the parties and is not appealable through the court system.
History. Code 1981, § 33-20E-15 , 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