§ 33-46-25. Prior Authorization for Ambulance Transportation or Emergency Healthcare Services Prohibited
An insurer cannot require prior authorization for emergency prehospital ambulance transportation or for the provision of emergency healthcare services. History. Code 1981, § 33-46-25 , enacted by Ga. L. 2021, p. 629, § 2/SB 80.
§ 33-48-1. Short Title
This chapter shall be known and may be cited as the “Business Transacted with Producer Controlled Property and Casualty Insurer Act.” History. Code 1981, § 33-48-1 , enacted by Ga. L. 1991, p. 1424, § 8.
§ 33-46-26. Timely Notification of Prior Authorization or Adverse Determination
Effective January 1, 2022, until December 31, 2022, if an insurer requires prior authorization of a healthcare service, a private review agent or utilization review entity shall notify the covered person’s healthcare provider, or such provider’s appropriately qualified designee, of any prior authorization or adverse determination within 15 calendar days of obtaining all necessary information […]
§ 33-48-2. Definitions
As used in this chapter, the term: “Control” or “controlled” shall have the same meaning as provided in paragraph (3) of Code Section 33-13-1, relating to definitions used with regard to insurance company holding systems. “Independent casualty actuary” means a casualty actuary who is a member of the American Academy of Actuaries and who is […]
§ 33-46-27. Notification Time for Prior Authorization or Adverse Determination
A private review agent or utilization review entity shall render a prior authorization or adverse determination concerning urgent healthcare services and notify such person’s healthcare provider, or such provider’s appropriately qualified designee, of that prior authorization or adverse determination no later than 72 hours after receiving all information needed to complete the review of the […]
§ 33-46-10. Applicability of Chapter 39 of Title 33
Private review agents and utilization review entities shall be subject to the provisions of Chapter 39 of this title. History. Code 1981, § 33-46-8 , enacted by Ga. L. 1990, p. 1088, § 1; Code 1981, § 33-46-10 , as redesignated by Ga. L. 2021, p. 629, § 2/SB 80. The 2021 amendment, effective January […]
§ 33-46-11. Listings of Certificate Holders
The Commissioner shall periodically, not less than once a year, provide a list of private review agents and utilization review entities issued certificates and the renewal date for those certificates to all hospitals and to any other individual or organization requesting such list. History. Code 1981, § 33-46-9 , enacted by Ga. L. 1990, p. […]
§ 33-46-12. Reporting Requirements
The Commissioner shall establish such reporting requirements upon private review agents and utilization review entities as are necessary to determine if the utilization review programs are in compliance with the provisions of this chapter and applicable rules and regulations. History. Code 1981, § 33-46-10 , enacted by Ga. L. 1990, p. 1088, § 1; Code […]
§ 33-46-13. Adoption of Rules and Regulations
The Commissioner shall adopt rules and regulations to implement the provisions of this chapter. History. Code 1981, § 33-46-11 , enacted by Ga. L. 1990, p. 1088, § 1; Code 1981, § 33-46-13 , as redesignated by Ga. L. 2021, p. 629, § 2/SB 80. The 2021 amendment, effective January 1, 2022, redesignated former Code […]
§ 33-46-14. Exemptions From Certificate Requirements
No certificate is required for utilization review by any Georgia licensed pharmacist or pharmacy while engaged in the practice of pharmacy, including but not limited to review of the dispensing of drugs, participation in drug utilization review, and monitoring patient drug therapy. History. Code 1981, § 33-46-12 , enacted by Ga. L. 1990, p. 1088, […]