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Official Code of Georgia Annotated

Title 33. INSURANCE · Chapter 46. CERTIFICATION OF PRIVATE REVIEW AGENTS · Article 1. GENERAL PROVISIONS

33-46-15. Exemptions from applicability of chapter.

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

  1. (a)

    This chapter shall not apply to any contract with the federal government for utilization and review of patients eligible for hospital services under Title XVIII or XIX of the Social Security Act.#

  2. (b)

    This chapter shall not apply to any private review agent or utilization review entity when such private review agent or utilization review entity is working under contract, or an extension or renewal thereof, with a licensed insurer operating under an agreement, providing administrative services pursuant to the provisions of subsection (b) of Code Section 33-20-17 to a healthcare benefit plan negotiated through collective bargaining as that term is defined in the federal National Labor Relations Act, as amended, if the original agreement was executed and in effect prior to January 1, 1990.#

  3. (c)

    This chapter shall not apply to audits of the medical record for the purposes of verifying that healthcare services were ordered and delivered.#

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, § 33-46-13, enacted by Ga. L. 1990, p. 1088, § 1; Code 1981, § 33-46-15, as redesignated by Ga. L. 2021, p. 629, § 2/SB 80.

Amendments

The 2021 amendment, effective January 1, 2022, redesignated former Code Section 33-46-13 as this Code section, inserted “or utilization review entity” in two places in subsection (b), and substituted “healthcare” for “health care” in subsections (b) and (c).

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-ch23-66-(v25)-pdf.pdf, Volume V25, 2020 edition, 2025 supplement, page 148; merge action: added; file SHA-256 e6be8da2a3c1.