Georgia Commons

Official Code of Georgia Annotated

Title 33. INSURANCE · Chapter 20A. MANAGED HEALTH CARE PLANS · Article 3. MANAGED HEALTH CARE PLANS

33-20A-61. Physician contracts.

Active

Current through: Including Acts of the 2025 Regular Session of the General Assembly.

  1. (a)

    Every physician contract entered into, amended, extended, or renewed after July 1, 2002, by a carrier shall contain a specific provision which shall provide that, in the event that an insurance carrier, plan, network, panel, or any agent thereof should terminate a physician’s contract and thereby affect any enrollee’s opportunity to continue receiving health care services from that physician under the plan, any such enrollee who is suffering from and receiving active health care services for a chronic or terminal illness or who is an inpatient shall have the right to continue to receive health care services from that physician for a period of up to 60 days from the date of the termination of the physician’s contract. Any enrollee who is pregnant and receiving treatment in connection with that pregnancy at the time of the termination of that enrollee’s physician’s contract shall have the right to continue receiving health care services from that physician throughout the remainder of that pregnancy, including six weeks’ postdelivery care. During such continuation of coverage period, the physician shall continue providing such services in accordance with the terms of the contract applicable at the time of the termination, and the carrier, plan, network, panel, and all agents thereof shall continue to meet all obligations of such physician’s contract. The enrollee shall not have the right to the continuation provisions provided in this Code section if the physician’s contract is terminated because of the suspension or revocation of the physician’s license or if the carrier, plan, network, panel, or any agent thereof determines that the physician poses a threat to the health, safety, or welfare of enrollees.#

  2. (b)

    Every physician contract entered into, amended, extended, or renewed after July 1, 2002, by a carrier shall contain a specific provision which shall provide that, in the event that a physician should terminate his or her contract with an insurance carrier, plan, network, panel, or any agent thereof and thereby affect any enrollee’s opportunity to continue receiving health care services from that physician under the plan, any such enrollee who is suffering from and receiving active health care services for a chronic or terminal illness or who is an inpatient shall have the right to receive health care services from that physician for a period of up to 60 days from the date of the termination of the physician’s contract. Any enrollee who is pregnant and receiving health care services in connection with that pregnancy at the time of the termination of that enrollee’s physician’s contract shall have the right to continue receiving health care services from that physician throughout the remainder of that pregnancy, including six weeks’ postdelivery care. During such continuation of coverage period, the physician shall continue providing such services in accordance with the terms of the contract applicable at the time of the termination, and the carrier, plan, network, panel, and all agents thereof shall continue to meet all obligations of such physician’s contract. The enrollee shall not have the right to the continuation provisions provided in this Code section if the physician terminates his or her contract because of the suspension or revocation of the physician’s license or for reasons related to the quality of health care services rendered or issues related to the health, safety, or welfare of enrollees.#

The notes below are printed with the section but are not enacted law (O.C.G.A. § 1-1-1(c)). They are shown apart from the text.

History

Code 1981, § 33-20A-61, enacted by Ga. L. 2002, p. 441, § 9.

Editor's notes

For short title and applicability, see the Editor’s notes at the beginning of this article.

Code Commission notes

Pursuant to Code Section 28-9-5, in 2002, ‘‘six weeks’’’ was substituted for ‘‘six-weeks’’ in subsections (a) and (b).

Read the official page (the state's PDF, opened at the page this text was read from).

Current through: Including Acts of the 2025 Regular Session of the General Assembly.

Text read from t33-ch1-22-(v24)-2020-pdf.pdf, Volume V24, 2020 edition, pages 837 to 838; merge action: carried; file SHA-256 4ecec175d949.

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