Chapter

Chapter 20A

O.C.G.A. § 33-20A-1— Short title
O.C.G.A. § 33-20A-2— Legislative findings
O.C.G.A. § 33-20A-3— Definitions
O.C.G.A. § 33-20A-4— Certification requirements; review and recertification; sanctions for failure to meet requirements; alternative methods for certification
O.C.G.A. § 33-20A-6— Financial incentive programs prohibited; capitated payment arrangement allowed
O.C.G.A. § 33-20A-7— Penalizing provider for discussing necessary or appropriate care with patient prohibited; penalty for providing records and assistance prohibited; penalty for violations
O.C.G.A. § 33-20A-7.1— Application; managed care plan’s liability following precertification; availability of personnel for precertification procedure
O.C.G.A. § 33-20A-8— Confidentiality and accuracy of patient records
O.C.G.A. § 33-20A-9— Emergency services requirements; restrictive formu- lary requirements
O.C.G.A. § 33-20A-9.1— Legislative intent; consumer choice option; provisions; increased expenses; covered benefits; forms
O.C.G.A. § 33-20A-10— Chapter inapplicable to workers’ compensation pro- visions
O.C.G.A. § 33-20A-30— Short title
O.C.G.A. § 33-20A-31— Definitions
O.C.G.A. § 33-20A-32— Right to appeal
O.C.G.A. § 33-20A-33— Minimum expense of treatment prior to review
O.C.G.A. § 33-20A-34— Representatives for enrollee; cost of review; cooperation
O.C.G.A. § 33-20A-35— Request for independent review
O.C.G.A. § 33-20A-36— Additional information required for independent review
O.C.G.A. § 33-20A-37— Effect of favorable determinations
O.C.G.A. § 33-20A-38— Organizational and employee liability
O.C.G.A. § 33-20A-39— Certification of independent review organizations; conflict of interest; quality assurance mechanism; copies of nonproprietary information
O.C.G.A. § 33-20A-40— Determining medical necessity or whether a treatment is experimental
O.C.G.A. § 33-20A-41— Rules and regulations
O.C.G.A. § 33-20A-42— Grievance procedures and hearings for Medicaid care management members
O.C.G.A. § 33-20A-60— Definitions
O.C.G.A. § 33-20A-61— Physician contracts
O.C.G.A. § 33-20A-62— Payment