GEORGIA CODE (Last Updated: August 20, 2013) |
Title 33. INSURANCE |
Chapter 51. GEORGIA AFFORDABLE HSA ELIGIBLE HIGH DEDUCTIBLE HEALTH PLAN |
Section 33-51-5. Nonpreferred provider reimbursement
Latest version.
- There shall be no required relationship between preferred provider and nonpreferred provider plan reimbursements for health savings account eligible high deductible plans using nonpreferred provider reimbursements. Such plans, however, shall not:
(1) Unfairly deny health benefits for medically necessary covered services;
(2) Have differences in benefit levels payable to preferred providers compared to other providers that unfairly deny benefits for covered services;
(3) Have a plan coinsurance percentage applicable to benefit levels for services provided by nonpreferred providers that is less than 60 percent of the benefit levels under the policy for such services; or
(4) Have an adverse effect on the availability or the quality of services.
Code 1981, § 33-51-5, enacted by Ga. L. 2008, p. 292, § 3/HB 977.