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O.C.G.A. § 33-46-12 <-- --> O.C.G.A. §33-46-14

2010 Georgia Code

TITLE 33 - INSURANCE

CHAPTER 46 - CERTIFICATION OF PRIVATE REVIEW AGENTS
§ 33-46-13 - Exemptions from applicability of chapter

O.C.G.A. 33-46-13 (2010)
33-46-13. Exemptions from applicability of chapter


(a) This chapter shall not apply to any contract with the federal government for utilization and review of patients eligible for hospital services under Title XVIII or XIX of the Social Security Act.

(b) This chapter shall not apply to any private review agent when such private review agent is working under contract, or an extension or renewal thereof, with a licensed insurer operating under an agreement, providing administrative services pursuant to the provisions of subsection (b) of Code Section 33-20-17 to a health care benefit plan negotiated through collective bargaining as that term is defined in the federal National Labor Relations Act, as amended, if the original agreement was executed and in effect prior to January 1, 1990.

(c) This chapter shall not apply to audits of the medical record for the purposes of verifying that health care services were ordered and delivered.