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O.C.G.A. § 33-30-25 — Reasonable limits on number or classes of preferred providers | Georgia Code

O.C.G.A. § 33-30-25 (2018) Copy Cite Official Site Syfertize CourtListener Scholar Amendments

TITLE 33 INSURANCE

Section 30. Group or Blanket Accident and Sickness Insurance, 33-30-1 through 33-30-29.

ARTICLE 2 PREFERRED PROVIDER ARRANGEMENTS

33-30-25. Reasonable limits on number or classes of preferred providers.

Subject to the approval of the Commissioner under such procedures as he may develop, health care insurers may place reasonable limits on the number or classes of preferred providers which satisfy the standards set forth by the health care insurer, provided that there be no discrimination against providers on the basis of religion, race, color, national origin, age, sex, or marital or corporate status, and provided, further, that all health care providers within any defined service area who are licensed and qualified to render the services covered by the preferred provider arrangement and who satisfy the standards set forth by the health care insurer shall be given the opportunity to apply and to become a preferred provider.

(Code 1981, §33-30-25, enacted by Ga. L. 1988, p. 1483, § 1.)

JUDICIAL DECISIONS

Approval of Insurance Commissioner to limit providers.

- Applying the "Any Willing Provider" (AWP) statute to a health insurer did not conflict with O.C.G.A. § 33-30-25 because that statute required the approval of the Insurance Commissioner to limit providers in preferred provider arrangements. Northeast Ga. Cancer Care, LLC v. Blue Cross & Blue Shield of Ga., Inc., 315 Ga. App. 521, 726 S.E.2d 714 (2012), cert. denied, No. S12C1322, 2012 Ga. LEXIS 1018 (Ga. 2012); cert. denied, No. S12C1413, 2012 Ga. LEXIS 1033 (Ga. 2012).

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This Georgia Code resource is curated by Graham W. Syfert, Esq., a personal injury and workers' compensation attorney admitted in Georgia (State Bar of Georgia No. 881027, since 2006) and Florida. Attorney Syfert regularly works with Title 33 in the context of Georgia insurance coverage law and represents clients throughout Northeast Florida and South Georgia. For legal consultation, call 904-383-7448.