2010 Georgia Code 33-20a-6 Case Law
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One Click Case Law for § 33-20a-6
O.C.G.A. § 33-20a-5 <-- --> O.C.G.A. §33-20a-60



2010 Georgia Code

TITLE 33 - INSURANCE

CHAPTER 20A - MANAGED HEALTH CARE PLANS
ARTICLE 1 - PATIENT PROTECTION
§ 33-20A-6 - Financial incentive programs prohibited; capitated payment arrangement allowed

O.C.G.A. 33-20A-6 (2010)
33-20A-6. Financial incentive programs prohibited; capitated payment arrangement allowed


(a) A managed care plan may not use a financial incentive or disincentive program that directly or indirectly compensates a health care provider or hospital for ordering or providing less than medically necessary and appropriate care to his or her patients or for denying, reducing, limiting, or delaying such care. Nothing in this Code section shall be deemed to prohibit a managed care entity from using a capitated payment arrangement consistent with the intent of this Code section.

(b) A managed care plan shall make full and timely payment or reimbursement to any health care provider or hospital in the same manner and subject to the same penalties as required of insurers for group accident and sickness insurance policies under paragraph (5) of subsection (b) of Code Section 33-30-6.

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Graham W. Syfert, Esq., P.A.
Phone: 904-383-7448
Fax: 904-638-4726

graham@syfert.com