This article shall be known and may be cited as the “Patient Protection Act of 1996.” History. Code 1981, § 33-20A-1 , enacted by Ga. L. 1996, p. 485, § 1; Ga. L. 1999, p. 350, § 2. Law reviews. For review of 1996 health care plans legislation, see 13 Ga. St. U.L. Rev. 190 […]
Nothing in this article shall apply to Chapter 9 of Title 34, relating to workers’ compensation. History. Code 1981, § 33-20A-10 , enacted by Ga. L. 1996, p. 485, § 1; Ga. L. 1999, p. 350, § 2.
The General Assembly finds and declares that it is a vital government concern that the citizens of the State of Georgia have access to quality health care services and that informed consumers will be better able to identify and select plans that offer quality health care services if they are provided specific information before they […]
As used in this article, the term: “Emergency services” or “emergency care” means those physical or mental health care services that are provided for a condition of recent onset and sufficient severity, including, but not limited to, severe pain, regardless of the initial, interim, final, or other diagnoses that are given, that would lead a […]
In addition to other requirements of law, prior to offering a managed care plan to any resident in Georgia, a managed care entity must first obtain a certificate from the Commissioner of Insurance indicating that such managed care plan meets the requirements of this article. The Commissioner may impose such costs, by rule or regulation, […]
The Commissioner shall establish standards for the certification of qualified managed care plans that conduct business in this state. Such standards must include the following provisions: Disclosure to enrollees and prospective enrollees. A managed care entity shall disclose to enrollees and prospective enrollees who inquire as individuals into a plan or plans offered by the […]
A managed care plan may not use a financial incentive or disincentive program that directly or indirectly compensates a health care provider or hospital for ordering or providing less than medically necessary and appropriate care to his or her patients or for denying, reducing, limiting, or delaying such care. Nothing in this Code section shall […]
No health care provider may be penalized for considering, studying, or discussing medically necessary or appropriate care with or on behalf of his or her patient. No health care provider may be penalized by a managed care plan for providing testimony, evidence, records, or any other assistance to an enrollee who is disputing a denial, […]
The provisions of this chapter shall apply to any managed care plan offered pursuant to Article 1 of Chapter 18 of Title 45 and to any managed care plan offered by any managed care entity. When an enrollee, provider, facility, or home health care provider calls during regular business hours to request verification of benefits […]
Each managed care plan shall establish procedures to safeguard the privacy of individually identifiable patient information and to maintain accurate and timely records for patients. History. Code 1981, § 33-20A-8 , enacted by Ga. L. 1996, p. 485, § 1; Ga. L. 1999, p. 350, § 2.
Every managed care plan shall include provisions that: In the event that a patient seeks emergency services and if necessary in the opinion of the emergency health care provider responsible for the patient’s emergency care and treatment and warranted by his or her evaluation, such emergency provider may initiate necessary intervention to stabilize the condition […]
It is the intent of the General Assembly to allow citizens to have the right to choose their own health care providers and hospitals with as few mandates from government and business as possible. It is also the intent to allow these choices with minimal additional cost to any business or consumer in this state. […]
