O.C.G.A.
Code text and O.C.G.A. statutory annotations on this page reflect the 2019 Official Code of Georgia Annotated (Public.Resource.Org Release 73, 2019-08-21; public domain per Georgia v. Public.Resource.Org, 2020). The Syfert case-law annotations in Notes of Decisions, below, are current.
(a) Any hospital shall, upon request, provide a written summary of certain hospital and related services charges, including but not limited to: (1) The average total charges per patient day for the facility’s previous fiscal year; (2) The daily rate for a room in said hospital, which rate shall include an explanation of the categories of services included in said charge; (3) Anesthesia charges, with an explanation of the categories of services included in this charge; (4) Operating room charges;
(5) Recovery room charges; (6) Intravenous administration charges; (7) Emergency room charges, with an explanation of the categories of services included in the charge; (8) The charge for the patient care kit or admission kit or other such items furnished to the patient on admission; (9) Charges for specific routine tests, including but not limited to a complete blood count, urinalysis, and chest X-ray; and (10) Charges for specific special tests, including but not limited to electrocardiogram, electroencephalogram, CAT scan of the head, CAT scan of liver, CAT scan of lungs, CAT scan of skeletal system, spirometry, and complete pulmonary function. Such written summary of charges shall be composed in a simple clear fashion so as to enable consumers to compare hospital charges and make cost-effective decisions in the purchase of hospital services. (b) The department shall adopt rules and regulations to implement the provisions of this Code section and shall implement such regulations as provided in Code Section 31-7-2.1.
History
Code 1981, § 31-7-11, enacted by Ga. L. 1983, p. 1307, § 1; Ga. L. 1984, p. 22, § 31.
Annotations
Code Commission notes. - Code Section 31-7-11 was added to the Code by both Ga. L. 1983, p. 1307, § 1 and Ga. L. 1984, p. 778, § 1. The former is set out above and the latter has been redesig-
nated as Code Section 31-7-13 pursuant to the authority granted in Code Section Law reviews. - For article, ‘‘Price Transparency and Incomplete Contracts in Health Care,’’ see 67 Emory L.J. 1 (2017).
JUDICIAL DECISIONS Contract construction. - Under the rules of contract construction, O.C.G.A. § 31-7-11(a) became a part of the contract between a health care provider and two uninsured patients regarding payment for services rendered by the provider, and the parties were presumed to have contracted with reference to the statute and the statute’s effect on the contracts; hence, these rules of contract construction enabled the trial court to conclude that the agreement in the contracts to pay for ‘‘all charges’’ unambiguously referred to the written summary of specific charges required by O.C.G.A. § 31-7-11(a) which established the price terms on which the parties intended to bind themselves. Morrell v.
Wellstar Health Sys., Inc., 280 Ga. App. 1, 633 S.E.2d 68 (2006). Breach of contract claim. - Appellants’ breach of contract claim was properly dismissed as appellants were free to avail themselves of the procedure established in O.C.G.A. § 31-7-11, allowing purchasers of hospital services to use the mandatorily available pricing information to compare hospital charges and to make cost-effective decisions; having agreed to pay a hospital corporation’s fees and charges, appellants could not argue that the appellants agreed to something else. Satterfield v. S. Reg’l Health Sys., 280 Ga. App. 584, 634 S.E.2d 530 (2006). Cited in Cox v. Athens Reg’l Med. Ctr.,
Inc., 279 Ga. App. 586, 631 S.E.2d 792 (2006).
Notes of Decisions
Cox v. Athens Reg'l Med. Ctr., Inc., 631 S.E.2d 792 (Ga. Ct. App. 2006).
· cites it 14× “I Under OCGA § 31-7-11 (a), hospitals must make available to the I public, upon request, certain pricing information, such as the charge for patient care or admission kits, emergency room charges, charges for specific routine and special tests such as chest x-rays and head CAT…”
Morrell v. Wellstar Health Sys., Inc., 633 S.E.2d 68 (Ga. Ct. App. 2006).
· cites it 10× “Applying these principles, the trial court found that the contracts by which the Morrells agreed to pay for “all charges” for medical care provided by Wellstar Health must be construed in light of the statutory requirements set forth in OCGA § 31-7-11 (a) for providing patients…”
Bowden v. the Med. Ctr., Inc., 773 S.E.2d 692 (Ga. 2015).
· cites it 8× “Bowden also alleged that the emergency nature of her injuries and treatment prevented her from utilizing the provisions of OCGA § 31-7-11 to make pre-treatment cost comparisons.”
Banner Health v. Med. Sav. Ins., 163 P.3d 1096 (Ariz. Ct. App. 2007).
· cites it 4× “The court affirmed summary judgment in favor of the hospital, reasoning in part as follows: Moreover, appellants do not allege that they requested pricing information and [the hospital] failed to comply with this scheme, or that the required written summary of charges would not…”
Med. Ctr., Inc. v. Bowden, 761 S.E.2d 116 (Ga. Ct. App. 2014).
· cites it 8× “In her discovery requests, Bowden sought (1) specific, itemized bills of what she would have been charged had she been covered by Medicaid, Medicare, Blue Cross/Blue Shield of Georgia, Tri-care, or TMC’s indigent patient program; (2) total gross revenue received by TMC during…”
Satterfield v. S. Reg'l Health Sys., Inc., 634 S.E.2d 530 (Ga. Ct. App. 2006).
· cites it 4× “As we explained in Cox, Under OCGA§ 31-7-11 (a), hospitals must make available to the public, upon request, certain pricing information, such as the charge for patient care or admission kits, emergency room charges, charges for specific routine and special tests such as chest…”
Med. Ctr., Inc. v. Bowden, 820 S.E.2d 289 (Ga. Ct. App. 2018).
· cites it 2× “Bowden also alleged that the emergency nature of her injuries and treatment prevented her from utilizing the provisions of OCGA § 31-7-11 to make pre-treatment cost comparisons.”
Bowden v. the Med. Ctr., Inc. (Ga. 2015).
· cites it 8× “Bowden also alleged that the emergency nature of her injuries and treatment prevented her from utilizing the provisions of OCGA § 31-7-11 to make pre-treatment cost comparisons.”
The Med. Ctr., Inc. v. Danielle Bowden (Ga. Ct. App. 2014).
· cites it 8× “In her discovery requests, Bowden sought (1) specific, itemized bills of what she would have been charged had she been covered by Medicaid, Medicare, Blue Cross/Blue Shield of Georgia, Tri-care, or TMC’s indigent patient program; (2) total gross revenue received by TMC during…”
The Med. Ctr., Inc. v. Danielle Bowden (Ga. Ct. App. 2018).
· cites it 2× “In her 3 Bowden also alleged that the emergency nature of her injuries and treatment prevented her from utilizing the provisions of OCGA § 31-7-11 to make pre-treatment cost comparisons.”
— 31-7-11(a) — 1 case
Banner Health v. Med. Sav. Ins., 163 P.3d 1096 (Ariz. Ct. App. 2007).
“The court affirmed summary judgment in favor of the hospital, reasoning in part as follows: Moreover, appellants do not allege that they requested pricing information and [the hospital] failed to comply with this scheme, or that the required written summary of charges would not…”
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