Printed directories; accuracy; application to standalone dental plans

(a) The insurer shall make available in print, upon request, the following provider directory information for the applicable network plan: (1) For healthcare professionals: (A) Name; (B) Contact information; (C) Participating office location or locations; (D) Specialty, if applicable; (E) Languages spoken other than English, if applicable; and (F) Whether accepting new patients; (2) For hospitals: (A) Hospital name; (B) Hospital type, such as acute, rehabilitation, children’s, or cancer; (C) Participating hospital location and telephone number; and (D) Health benefit plan surprise bill rating; and (3) For facilities other than hospitals: (A) Facility name; (B) Facility type; (C) Types of services performed; and (D) Participating facility location or locations and telephone number. 836 33-20C-7 (b) The insurer shall include a disclosure in the print directory that the information in subsection (a) of this Code section and included in the directory is accurate as of the date of printing and that covered persons or prospective covered persons should consult the insurer’s electronic provider directory on its website or call a specified customer service telephone number to obtain current provider directory information. (c) Paragraphs (2) and (3) of subsection (a) of this Code section shall not apply to standalone dental plans. History. — Code 1981, § 33-20C-5, enacted by Ga. L. 2016, p. 149, § 1/SB 302; Ga. L. 2017, p. 713, § 1/HB 262; Ga. L. 2020, p. 228, § 3/HB 789. The 2020 amendment, effective November 1, 2020, substituted ‘‘healthcare’’ for ‘‘health care’’ in paragraph (a)(1), deleted ‘‘and’’ at the end of subparagraph (a)(2)(B), and added subparagraph (a)(2)(D). Editor’s notes. — Ga. L. 2020, p. 228, § 1/HB 789, not codified by the General Assembly, provides that: ‘‘This Act shall be known and may be cited as the ‘Surprise Bill Transparency Act.’ ’’ 33-20C-6. Exclusion for services provided through Department of Community Health. This chapter shall not apply to the provision of health care services pursuant to a contract entered into by an insurer and the Department of Community Health for recipients of Medicaid or PeachCare for Kids and the state health benefit plan under Article 1 of Chapter 18 of Title 45. History. — Code 1981, § 33-20C-6, enacted by Ga. L. 2016, p. 149, § 1/SB 302. 33-20C-7. Disclosure of health benefit plan surprise bill rating in advertisement; other disclosures; regulation; optional annual reporting. (a) Each insurer that advertises or designates any hospital as in-network shall be required to disclose the relevant health benefit plan surprise bill rating within such advertisement, notwithstanding the type or form of such advertisement. (b) If a health benefit plan surprise bill rating is less than four checkmarks, each insurer advertising a hospital as in-network shall describe which qualified hospital based specialty group types are not contracted with such health benefit plan. (c) The Commissioner may promulgate rules and regulations which require insurers to provide explanatory footnotes to each health benefit plan surprise bill rating in such special circumstances as the Commissioner may determine to be appropriate. 837 33-20C-7 (d) If an insurer processes a claim on a covered person from an out-of-network qualified hospital based specialty group provider at out-of-network rates, such insurer shall update the relevant health benefit plan surprise bill rating within 30 days to reflect any necessary reduction in such rating. (e) The Commissioner may submit an annual report to the House Committee on Insurance and the Senate Insurance and Labor Committee beginning January 1, 2022. Such report may include such aggregate data as the Commissioner determines beneficial to share with such committees. History. — Code 1981, § 33-20C-7, enacted by Ga. L. 2020, p. 228, § 4/HB 789. Effective date. — This Code section became effective November 1, 2020. Editor’s notes. — Ga. L. 2020, p. 228, § 1/HB 789, not codified by the General Assembly, provides that: ‘‘This Act shall be known and may be cited as the ‘Surprise Bill Transparency Act.’ ’’ 838 T.33, C.20D RENTAL PROVIDER NETWORK 33-20D-1 CHAPTER 20D RENTAL PROVIDER NETWORK Sec. 33-20D-1. Definitions.