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GA SB303
Bill
AI Summary
- Requires insurers to provide an interactive tool on their public websites allowing consumers to compare in-network provider payment amounts, average costs, and estimated out-of-pocket costs for nonemergency health care services such as surgical procedures, lab work, radiology, physical therapy, and infusion therapy
- Mandates that the online tool include quality metrics for in-network providers, including risk-adjusted hospital readmission rates, hospitalization rates, adverse event rates, admission and utilization volume, and total cost of care, based on Hierarchical Condition Category Methodology or a Commissioner-designated standard
- Requires out-of-pocket cost estimates to show both scenarios: where the covered person has exceeded their deductible and where they have not, along with a disclaimer that actual costs may vary due to unforeseen services
- Exempts health maintenance organization (HMO) plans from all requirements except the quality metrics comparison provision, and allows insurers to contract with third parties to fulfill the law's requirements
- Effective date of July 1, 2021
Legislative Description
'Georgia Right to Shop Act'; greater transparency of prices for nonemergency healthcare services; provide
Last Action
Effective Date
7/1/2021
Full Bill Text
No bill text available