Georgia Code
Article 1 - General Provisions
§ 33-24-59.27. Right to Shop for Insurance Coverage; Disclosure of Pricing Information; Notice

The Commissioner shall promulgate rules and regulations which define the following terms: risk adjusted hospital readmission rates, absolute hospital readmission rates, risk adjusted hospitalization rates, absolute hospitalization rates, admission volume, utilization volume, risk adjusted rates of adverse events, risk adjusted total cost of care, and absolute relative total cost of care. Such terms shall be defined in accordance with federal law or regulation or as otherwise determined necessary by the Commissioner; and
History. Code 1981, § 33-24-59.27 , enacted by Ga. L. 2020, p. 666, § 1/SB 303; Ga. L. 2021, p. 402, § 1A/HB 454; Ga. L. 2021, p. 922, § 33/HB 497; Ga. L. 2022, p. 598, § 7/HB 1324.
Effective date.
This Code section becomes effective July 1, 2021.
The 2021 amendments.
The first 2021 amendment, effective July 1, 2021, added subsection (i). The second 2021 amendment, effective May 10, 2021, part of an Act to revise, modernize, and correct the Code, substituted “sponsored health care” for “sponsored heath care” in the middle of paragraph (b)(7).
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 (b)(2).
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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