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Georgia State Code
Title      33
Chapter      30  
Section Navigation     1 ... 4.5         5 ... 14    
      15 ... 27      
Section<<< 15 20 21 22 23 24 25 26 27  
Title 33, Chapter 30, Section 24 (33-30-24)

Health care insurers may issue health benefit plans which provide for incentives for covered persons to use the health care services of preferred providers. Such policies or subscriber certificates shall contain at least the following provisions:

(1) A provision that if a covered person receives emergency care for services specified in the preferred provider arrangement and cannot reasonably reach a preferred provider, that emergency care rendered during the course of the emergency will be paid for in accordance with the terms of the health benefit plan, at benefit levels at least equal to those applicable to treatment by preferred providers for emergency care in an amount based on the usual, customary, and reasonable charges in the area where the treatment is provided; and

(2) A provision which clearly identifies the differences in benefit levels for health care services of preferred providers and benefit levels for health care services of nonpreferred providers.

Wednesday October 15 17:21 CDT


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