Georgia Code
Chapter 21A - Medicaid Care Management Organizations
§ 33-21A-2. Definitions

As used in this chapter, the term:
History. Code 1981, § 33-21A-2 , enacted by Ga. L. 2008, p. 704, § 1/HB 1234; Ga. L. 2022, p. 598, § 6/HB 1324.
The 2022 amendment, effective July 1, 2022, inserted “physical or mental” and “regardless of the initial, interim, final, or other diagnoses that are given,” in the introductory language of paragraph (4).
Editor’s notes.
Ga. L. 2022, p. 598, § 1/HB 1324, not codified by the General Assembly, provides: “The General Assembly finds that:
“(1) This state recognizes a ‘prudent layperson’ standard with regard to the need for emergency care;
“(2) Insurance companies operating in this state are required to adhere to that standard;
“(3) Patients in this state have had emergency medical claims denied due to insurers’ failure to adhere to the prudent layperson standard as intended;
“(4) The federal court system has recognized that this standard is not intended to look to the diagnosis that a patient receives. Rather, the only relevant considerations are the patient’s symptoms and whether a prudent layperson would think that emergency medical attention is necessary based on those symptoms;
“(5) This legislative body has intended and continues to intend that the prudent layperson standard be applied in the same manner;
“(6) In order to better protect Georgians seeking emergency care, legislation is needed not to change the meaning but to clarify the intended application of the prudent layperson standard in this state; and
“(7) Nothing in this Act is intended to be applicable to healthcare plans which are subject to the exclusive jurisdiction of the Employee Retirement Income Security Act of 1974, 29 U.S.C. Section 1001, et seq.

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