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Article 1 - Patient Protection
§ 33-20A-1. Short Title - This article shall be known and may be cited as...
§ 33-20A-2. Legislative Findings - History. Code 1981, § 33-20A-2 , enacted by Ga. L....
§ 33-20A-3. Definitions - As used in this article, the term: History. Code 1981,...
§ 33-20A-4. Certification Requirements; Review and Recertification; Sanctions for Failure to Meet Requirements; Alternative Methods for Certification - History. Code 1981, § 33-20A-4 , enacted by Ga. L....
§ 33-20A-5. Standards for Certification - The Commissioner shall establish standards for the certification of qualified...
§ 33-20A-6. Financial Incentive Programs Prohibited; Capitated Payment Arrangement Allowed - History. Code 1981, § 33-20A-6 , enacted by Ga. L....
§ 33-20A-7. Penalizing Provider for Discussing Necessary or Appropriate Care With Patient Prohibited; Penalty for Providing Records and Assistance Prohibited; Penalty for Violations - History. Code 1981, § 33-20A-7 , enacted by Ga. L....
§ 33-20A-7.1. Application; Managed Care Plan’s Liability Following Precertification; Availability of Personnel for Precertification Procedure - History. Code 1981, § 33-20A-7.1 , enacted by Ga. L....
§ 33-20A-8. Confidentiality and Accuracy of Patient Records - Each managed care plan shall establish procedures to safeguard the...
§ 33-20A-9. Emergency Services Requirements; Restrictive Formulary Requirements - Every managed care plan shall include provisions that: History. Code...
§ 33-20A-9.1. Legislative Intent; Consumer Choice Option; Provisions; Increased Expenses; Covered Benefits; Forms - Managed care plans offering the preferred provider organization network plan...
§ 33-20A-10. Chapter Inapplicable to Workers’ Compensation Provisions - Nothing in this article shall apply to Chapter 9 of...
Article 2 - Patient’s Right to Independent Review
§ 33-20A-30. Short Title - This article shall be known and may be cited as...
§ 33-20A-31. Definitions - As used in this article, the term: (1.1) “Department” means...
§ 33-20A-32. Right to Appeal - An eligible enrollee shall be entitled to appeal to an...
§ 33-20A-33. Minimum Expense of Treatment Prior to Review - Except where required pursuant to Code Section 51-1-49, a proposed...
§ 33-20A-34. Representatives for Enrollee; Cost of Review; Cooperation - History. Code 1981, § 33-20A-34 , enacted by Ga. L....
§ 33-20A-35. Request for Independent Review - History. Code 1981, § 33-20A-35 , enacted by Ga. L....
§ 33-20A-36. Additional Information Required for Independent Review - Upon request, the managed care entity shall provide a copy...
§ 33-20A-37. Effect of Favorable Determinations - History. Code 1981, § 33-20A-37 , enacted by Ga. L....
§ 33-20A-38. Organizational and Employee Liability - Neither an independent review organization nor its employees, agents, or...
§ 33-20A-39. Certification of Independent Review Organizations; Conflict of Interest; Quality Assurance Mechanism; Copies of Nonproprietary Information - History. Code 1981, § 33-20A-39 , enacted by Ga. L....
§ 33-20A-40. Determining Medical Necessity or Whether a Treatment Is Experimental - For either determination, the expert reviewer shall apply prudent professional...
§ 33-20A-41. Rules and Regulations - The department shall provide necessary rules and regulations for the...
§ 33-20A-42. Grievance Procedures and Hearings for Medicaid Care Management Members - Medicaid care management members shall, after first exhausting the grievance...
Article 3 - Managed Health Care Plans
§ 33-20A-60. Definitions - As used in this article, the term: History. Code 1981,...
§ 33-20A-61. Physician Contracts - History. Code 1981, § 33-20A-61 , enacted by Ga. L....
§ 33-20A-62. Payment - History. Code 1981, § 33-20A-62 , enacted by Ga. L....