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GA HB872

Bill

Status

Introduced

2/7/2018

Primary Sponsor

David Knight

Click for details

Origin

House of Representatives

2017-2018 Regular Session

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