(3.1) “Interprofessional consultation” means an assessment and management service in which a patient’s health care provider seeks treatment advice from a consulting provider with specific specialty expertise to assist the patient’s health care provider in diagnosing or treating the patient.
History. Code 1981, § 33-24-56.4 , enacted by Ga. L. 2005, p. 481, § 3/HB 291; Ga. L. 2009, p. 859, § 11/HB 509; Ga. L. 2011, p. 752, § 33/HB 142; Ga. L. 2019, p. 386, § 56/SB 133; Ga. L. 2019, p. 512, § 1/SB 118; Ga. L. 2021, p. 378, § 1/HB 307.
The 2019 amendments.
The first 2019 amendment, effective July 1, 2019, in paragraph (b)(1), substituted “the state” for “the State of Georgia”; and, in paragraph (b)(2), deleted “hospital service corporation, medical service corporation,” following “fraternal benefits society,”. The second 2019 amendment, effective January 1, 2020, substituted “telemedicine” for “telehealth” in the middle of subsections (c) and (i); substituted “Telehealth” for “Telemedicine” in subsection (a); rewrote subsection (b), which read: “(b) As used in this Code section, the term:
“(1) ‘Health benefit policy’ means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the State of Georgia on behalf of state employees under Article 1 of Chapter 18 of Title 45, by an insurer.
“(2) ‘Insurer’ means an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, health maintenance organization, preferred provider organization, provider sponsored health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.
“(3) ‘Telemedicine’ means the practice, by a duly licensed physician or other health care provider acting within the scope of such provider’s practice, of health care delivery, diagnosis, consultation, treatment, or transfer of medical data by means of audio, video, or data communications which are used during a medical visit with a patient or which are used to transfer medical data obtained during a medical visit with a patient. Standard telephone, facsimile transmissions, unsecured e-mail, or a combination thereof do not constitute telemedicine services.”; added subsections (d) through (h); redesignated former subsection (d) as subsection (i); and, in subsection (i), substituted “January 1, 2020” for “July 1, 2005”, inserted “this Code section,”, and deleted the last sentence, which read: “The coverage required in this Code section may be subject to all terms and conditions of the applicable health benefit plan.” See the Code Commission notes regarding the effect of these amendments.
The 2021 amendment, effective May 4, 2021, added “, which may include the home of the health care provider” at the end of paragraph (b)(1); added paragraph (b)(3.1); in paragraph (b)(4), deleted “in this state” following “means a site” at the beginning and substituted “which may include a patient’s home, workplace, or school” for “unless the term is otherwise defined with respect to the provision in which it is used” in the middle; in paragraph (b)(7), substituted “real-time” for “real time” near the beginning of the first sentence, inserted “as prescribed by applicable federal and state laws, rules, and regulations” near the end of the first sentence, and added the last sentence; added subsections (f) and (h) and redesignated former subsections (f), (g), (h), and (i) as present subsections (g), (i), (j), and (k), respectively; in subsection (g), inserted “(1)” and “or (2) and insurer to pay for a telemedicine service provided through an audio-only call for any service other than mental or behavioral health services” at the end of the first sentence, and added the proviso at the end of the second sentence; in subsection (i), inserted “deductible or” and substituted “than a deductible or annual” for “than an annual” near the beginning; and added subsections (l) through (p).
Code Commission notes.
Pursuant to Code Section 28-9-5, in 2019, the amendment of subsection (b) of this Code section by Ga. L. 2019, p. 386, § 56/SB 133, was treated as impliedly repealed and superseded by Ga. L. 2019, p. 512, § 1/SB 118, due to irreconcilable conflict.
Structure Georgia Code
Chapter 24 - Insurance Generally
Article 1 - General Provisions
§ 33-24-2. Applicability of Chapter
§ 33-24-3. Insurable Interest; Personal Insurance
§ 33-24-4. Insurable Interest; Property Insurance
§ 33-24-6.1. Prerequisites for Replacement Life Insurance Exceeding Insurance Being Surrendered
§ 33-24-8. Admissibility in Evidence of Applications in Actions Between Insurer and Insured
§ 33-24-9. Approval or Disapproval of Forms
§ 33-24-10. Grounds for Disapproval of Forms
§ 33-24-10.1. Standard or Uniform Claim Form
§ 33-24-13. Execution of Policies; Use of Facsimile Signatures
§ 33-24-14.1. Electronic Delivery of Plan Documentation
§ 33-24-15. When Policies or Contracts Become Effective
§ 33-24-16. Construction of Policies
§ 33-24-16.1. Clarification of Term “Actual Charge” or “Actual Fee”
§ 33-24-17. Assignment of Policies
§ 33-24-18. Contents of Insurance Policies and Annuity Contracts Generally
§ 33-24-19. Incorporation of Constituent Documents in Policies
§ 33-24-22. Provision in Health Insurance Policies for Coverage of Newly Born or Adopted Children
§ 33-24-28. Termination of Coverage of Dependent Child Upon Attainment of Specified Age
§ 33-24-28.1. Coverage of Treatment of Mental Health or Substance Use Disorders
§ 33-24-28.2. Coverage of Outpatient Surgery
§ 33-24-30. Excluding or Denying Coverage on Basis of Violation of Civil Air Regulations
§ 33-24-30.1. Excluding or Denying Coverage on Basis of Lawful Firearms Possession
§ 33-24-32. Underwriters’ and Combination Policies
§ 33-24-33. Binders and Other Contracts for Temporary Insurance
§ 33-24-35. Withdrawal or Retirement From Group Insurance Plan
§ 33-24-38. Renewal or Extension of Policies by Certificate or Endorsement
§ 33-24-41. Discharge of Insurer by Payment Generally
§ 33-24-41.2. Written Notice by Insurer to Claimant of Payment of Claim in Third-Party Settlement
§ 33-24-42. Payment of Claims in Event of Simultaneous Deaths
§ 33-24-44. Cancellation of Policies Generally
§ 33-24-44.1. Procedure for Cancellation by Insured and Notice
§ 33-24-46. Cancellation or Nonrenewal of Certain Property Insurance Policies
§ 33-24-49. Deposit of Funds Covered by Bonds
§ 33-24-50. Action as Sureties Upon Guaranteed Arrest Bond Certificates; Acceptance of Certificates
§ 33-24-52. Direct Response Insurance Business
§ 33-24-54. Payments to Nonparticipating or Nonpreferred Providers of Health Care Services
§ 33-24-56. Prohibition Against Requiring Referral From Primary Care Physician to Dermatologist
§ 33-24-56.2. Surveillance Tests for Ovarian Cancer
§ 33-24-56.3. Colorectal Cancer Screening and Testing
§ 33-24-56.4. Short Title; Definitions; Payment for Telehealth Services
§ 33-24-58. Newborn Baby and Mother Protection Act; Short Title
§ 33-24-58.1. Newborn Baby and Mother Protection Act; Legislative Findings and Declaration
§ 33-24-59.1. Coverage for Treatment of Dependent Children With Cancer
§ 33-24-59.3. Payments Sent Directly to Health Care Provider by Insurer
§ 33-24-59.6. Prescribed Female Contraceptive Drugs or Devices; Insurance Coverage
§ 33-24-59.9. Registered Nurse First Assistants
§ 33-24-59.10. Coverage for Autism
§ 33-24-59.12. Patient Access to Eye Care
§ 33-24-59.14. Definitions; Prompt Pay Requirements; Penalties
§ 33-24-59.15. Definitions; Dental Insurance
§ 33-24-59.16. Equal Access to Child’s Health Insurance Information; Exceptions
§ 33-24-59.18. Coverage for Treatment of a Terminal Condition
§ 33-24-59.20. Access to Stage Four Advanced, Metastatic Cancer Treatments in Health Benefit Plans
§ 33-24-59.22. Prescription Drug Program Defined; Cost Sharing; Denial of Coverage; Dispensing Fees
§ 33-24-59.23. Carrier Issuing Health Benefit Plans to Pay Insurance Agent’s Commissions; Regulation
§ 33-24-59.26. Limitation on Definition of “Preexisting Condition”
§ 33-24-59.27. Right to Shop for Insurance Coverage; Disclosure of Pricing Information; Notice
§ 33-24-59.28. Insurer Obligations for Early Prescription Refills During Emergencies