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GA HB872
Bill
Status
Introduced
2/7/2018
Primary Sponsor
David Knight
Click for details
AI Summary
- Requires health insurers in Georgia to develop and publish standards for selecting providers in their network plans and for placing providers within tiered networks, with plain-language descriptions made available to the public
- Prohibits insurers from using tiered network criteria to discriminate against high-risk populations, including excluding or tier-placing providers based on their location in geographic areas with high-risk populations or because they specialize in treating such populations
- Mandates at least 60 days' written notice to providers before termination or tier placement, including detailed reasons for the action and information about the reconsideration process
- Establishes an informal reconsideration process that insurers must complete within 45 days, during which the pending termination or tier change cannot be implemented until a final decision is issued
- Requires insurers that advertise a physician as in-network during a patient's plan selection to cover that provider at in-network rates for the entire contract year, and grants the Insurance Commissioner enforcement authority through corrective action plans
Legislative Description
Insurance; require insurers to develop selection standards for provider participation; provisions
Last Action
House Second Readers
2/12/2018
Full Bill Text
No bill text available