Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-106 - SURPRISE BILLING
Rule 120-2-106-.11 - Hospital Surprise Bill Rating

Insurers shall make available online and in print a health benefit plan surprise bill rating for hospitals as required in Chapter 20C of Title 33. For each hospital, health benefit plans shall clearly display a rating denoting the health benefit plan surprise bill rating factor. This factor shall range from 0, denoting no specialties are in-network, to 4, which means all specialty groups are in-network. For any rating less than 4, the health benefit plan shall display which specialty group is not in-network by marking the specialty with a red X and any specialty group that is included by a green checkmark X. If a hospital does not provide one of the qualified hospital-based specialties, the absence of that specialty shall be designated by a green N/A. The factor and markings shall be clearly displayed for the covered person or potential covered person to easily understand. Qualified hospital-based specialty groups are medical groups that include anesthesiologists, pathologists, radiologists, or emergency medicine physicians. Any changes in the hospital rating factor shall be changed by the health benefit plan within 30 days.

O.C.G.A. §§ 33-2-9, 33-20E.