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GA HB1324
Bill
Status
Passed
5/9/2022
Primary Sponsor
Beth Camp
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AI Summary
- Clarifies Georgia's "prudent layperson" standard for emergency care by specifying that insurers cannot deny emergency medical claims based on the initial, interim, final, or other diagnoses a patient receives; coverage determinations must be based solely on the patient's presenting symptoms
- Amends the definition of "emergency condition" and "emergency services" across six sections of Georgia code — including provisions governing emergency medical services, managed health care plans, surprise billing, Medicaid care management organizations, and preferred provider arrangements — to add uniform diagnosis-neutral language
- Expands the definition of emergency services from "medical" conditions to "physical or mental" conditions across all amended code sections, ensuring mental health emergencies receive equal treatment
- Adds failure to comply with emergency services coverage requirements as a new category of unfair claims settlement practice under Code Section 33-6-34, creating an enforcement mechanism for violations
- Explicitly excludes healthcare plans subject to the federal Employee Retirement Income Security Act (ERISA) from the Act's applicability
Legislative Description
Health and insurance; clarify that the prudent layperson standard is not affected by the diagnoses given
Last Action
Effective Date 2022-07-01
5/9/2022
Committee Referrals
Insurance and Labor3/4/2022
Insurance2/11/2022
Full Bill Text
No bill text available