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Georgia Commons

Título 33. INSURANCE

Capítulo 46. CERTIFICATION OF PRIVATE REVIEW AGENTS

31 secciones · 33-46-1 a 33-46-32

Legible por máquinas https://georgiacommons.org/code/33-46.md · https://georgiacommons.org/code/index.md · MCP https://mcp.georgiacommons.org/mcp

Artículo 1. GENERAL PROVISIONS

  1. 33-46-1Construction.
  2. 33-46-2Application.
  3. 33-46-3Legislative purposes and intent.
  4. 33-46-4Definitions.
  5. 33-46-5Certification of private review agents; exemption.
  6. 33-46-6Requirements for certification; utilization of nationally recognized accreditation standards; website identifying nationally recognized accreditation entities.2 versiones
  7. 33-46-7Certificate application fees; information to be submitted with application.
  8. 33-46-8Expiration and renewal of certificate.
  9. 33-46-9Jurisdiction of Commissioner over private review agents and utilization review entities.
  10. 33-46-10Applicability of Chapter 39 of Title 33.
  11. 33-46-11Listings of certificate holders.
  12. 33-46-12Reporting requirements.
  13. 33-46-13Adoption of rules and regulations.
  14. 33-46-14Exemptions from certificate requirements.
  15. 33-46-15Exemptions from applicability of chapter.
  16. 33-46-16Commissioner to issue annual report.

Artículo 2. PRIOR AUTHORIZATIONS

  1. 33-46-20Prior authorization requirements posted on website; statistical reporting.
  2. 33-46-20.1Program for selective application of reductions in prior authorization requirements.
  3. 33-46-21Insurer responsibility for compliance; periodic reviews; evaluation of adverse determinations.
  4. 33-46-22Review of appeals by appropriate healthcare provider.
  5. 33-46-23Restrictions on authorizations when service timely rendered.
  6. 33-46-23.1Prior authorization of prescription medications for chronic conditions.
  7. 33-46-24Medically necessary unanticipated emergency or urgent healthcare services.
  8. 33-46-25Prior authorization for ambulance transportation or emergency healthcare services prohibited.
  9. 33-46-26Timely notification of prior authorization or adverse determination.
  10. 33-46-27Notification time for prior authorization or adverse determination.
  11. 33-46-28Honoring of prior authorizations.
  12. 33-46-29Noncompliance resulting in automatic authorization.
  13. 33-46-30Mandatory compliance.
  14. 33-46-31Role of Commissioner; compliance enforced by Department of Community Health.
  15. 33-46-32Commissioner’s authority not reduced.