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Georgia Commons

Código Oficial de Georgia Anotado

Título 33. INSURANCE · Capítulo 20A. MANAGED HEALTH CARE PLANS · Artículo 2. PATIENT’S RIGHT TO INDEPENDENT REVIEW

33-20A-40. Determining medical necessity or whether a treatment is experimental.

Vigente

Actualizado hasta: Including Acts of the 2025 Regular Session of the General Assembly.

El texto siguiente es la ley tal como la imprime el estado, en inglés.

  1. (a)

    For the purposes of this article, in making a determination as to whether a treatment is medically necessary and appropriate, the expert reviewer shall use the definition provided in paragraph (7) of Code Section 33-20A-31.#

  2. (b)

    For the purposes of this article, in making a determination as to whether a treatment is experimental, the expert reviewer shall determine:#

    1. (1)

      Whether such treatment has been approved by the federal Food and Drug Administration; or#

    2. (2)

      Whether medical and scientific evidence demonstrates that the expected benefits of the proposed treatment would be greater than the benefits of any available standard treatment and that the adverse risks of the proposed treatment will not be substantially increased over those of standard treatments.#

    3. For either determination, the expert reviewer shall apply prudent professional practices and shall assure that at least two documents of medical and scientific evidence support the decision.

Las notas siguientes se imprimen con la sección, pero no son ley promulgada (O.C.G.A. § 1-1-1(c)). Se muestran aparte del texto.

History

Code 1981, § 33-20A-40, enacted by Ga. L. 1999, p. 350, § 3; Ga. L. 2005, p. 1438, § 2/SB 140.

Leer la página oficial (el PDF del estado, abierto en la página de la que se leyó este texto).

Actualizado hasta: Including Acts of the 2025 Regular Session of the General Assembly.

Texto leído de t33-ch1-22-(v24)-2020-pdf.pdf, Volumen V24, edición 2020, páginas 834 a 835; acción de fusión: carried; SHA-256 del archivo 4ecec175d949.