--- title: O.C.G.A. § 33-30-22. Definitions. collection: code id: 33-30-22 cite_as: O.C.G.A. § 33-30-22 (2025) canonical_url: https://georgiacommons.org/code/33-30-22 md_url: https://georgiacommons.org/code/33-30-22.md text_url: https://georgiacommons.org/code/33-30-22/text source_url: https://www.legis.ga.gov/api/document/docs/default-source/joint-features-document-library/t33-ch23-66-(v25)-pdf.pdf?sfvrsn=e52ed458_0#page=107 date: 2025 status: active corpus_version: 2025-supplement-89aa39ab3c68 license: CC0-1.0 publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice. up: https://georgiacommons.org/code/33-30.md previous: https://georgiacommons.org/code/33-30-21.md next: https://georgiacommons.org/code/33-30-23.md index: https://georgiacommons.org/code/index.md version: the only printed version in_force: true current_through: Including Acts of the 2025 Regular Session of the General Assembly heading_path: INSURANCE / GROUP OR BLANKET ACCIDENT AND SICKNESS INSURANCE / PREFERRED PROVIDER ARRANGEMENTS --- # O.C.G.A. § 33-30-22. Definitions. As used in this article, the term: (1) “Emergency services” or “emergency care” means those physical or mental health care services that are provided for a condition, including but not limited to a mental health condition or substance use disorder, in which a person is exhibiting acute symptoms of 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 prudent layperson, possessing an average knowledge of medicine and health, to believe that his or her condition, sickness, or injury is of such a nature that failure to obtain immediate medical care could result in: (A) Placing the patient’s health in serious jeopardy; (B) Serious impairment to bodily functions; or (C) Serious dysfunction of any bodily organ or part. “Emergency services” or “emergency care” includes medical services rendered after such person is stabilized and as part of outpatient observation or an inpatient or outpatient stay with respect to the visit in which such services are furnished, unless each of the conditions of subdivision (a)(3)(C)(ii)(II) of the federal Public Health Service Act, 42 U.S.C. Section 300gg-111 are met. (2) “Health benefit plan” means the health insurance policy or subscriber agreement between the covered person or the policyholder and the health care insurer which defines the covered services and benefit levels available. (3) “Health care insurer” means an insurer, a fraternal benefit society, a health care plan, or a health maintenance organization authorized to sell accident and sickness insurance policies, subscriber certificates, or other contracts of insurance by whatever name called under this title. (4) “Health care provider” means any person duly licensed or legally authorized to provide health care services. (5) “Health care services” means services rendered or products sold by a health care provider within the scope of the provider’s license or legal authorization. The term includes, but is not limited to, hospital, medical, surgical, dental, vision, chiropractic, psychological, and pharmaceutical services or products. (6) “Preferred provider” means a health care provider or group of providers who have contracted to provide specified covered services. (7) “Preferred provider arrangement” means a contract between or on behalf of the health care insurer and a preferred provider which complies with all the requirements of this article. ## History Code 1981, § 33-30-22, enacted by Ga. L. 1988, p. 1483, § 1; Ga. L. 2005, p. 481, § 15/HB 291; Ga. L. 2017, p. 164, § 50/HB 127; Ga. L. 2022, p. 598, § 8/HB 1324; Ga. L. 2022, p. 750, § 3/SB 566. ## 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.” Ga. L. 2022, p. 750, § 4/SB 566, not codified by the General Assembly, makes paragraph (1) applicable to all policies or contracts issued, delivered, issued for delivery, or renewed in this state on or after July 1, 2022. ## Amendments The first 2022 amendment, effective July 1, 2022, inserted “physical or mental” and “regardless of the initial, interim, final, or other diagnoses that are given,” at the beginning of paragraph (1). The second 2022 amendment, effective July 1, 2022, in paragraph (1), substituted “condition, including but not limited to a mental health condition or substance use disorder, in which a person is exhibiting acute symptoms of sufficient” for “condition of recent onset and sufficient” at the beginning and added the last undesignated sentence. See Editor’s notes for applicability.