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 120-2-111 - PATIENT'S RIGHT TO INDEPENDENT REVIEW
Rule 120-2-111-.01 - Applicability

These Rules shall apply to the applicants for certification as independent review organizations, and all attendant procedures thereto; any and all independent review organizations certified by the State Health Planning Agency, or its successor Agency, the Department of Insurance, hereinafter known as the Department, pursuant to the authority granted by O.C.G.A. § 33-20A-30, which article shall be known and cited as the "Patient's Right to Independent Review Act", and the procedures for the request for independent review; and the procedures for independent review of services previously rendered as well as concurrent or prospective services by a managed care entity to an eligible enrollee as those terms are defined herein. Any independent review organization that has been certified by an independent national accrediting organization that has developed standards for the purpose of bestowing certification or accreditation upon entities of this type, and that can provide documentation to the Department of such certification or accreditation, shall be deemed certified by the Department and shall not have to apply for certification as an independent review organization in Georgia in order to be added to the Department's list of certified independent review organizations.

O.C.G.A. §§ 33-2-9, 33-20A-41.