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 120-2-92 - INDEPENDENT ACCREDITATION OF HEALTH MAINTENANCE ORGANIZATIONS
Rule 120-2-92-.03 - Certification Pursuant to Accreditation by a National Accrediting Organization

Universal Citation: GA Rules and Regs r 120-2-92-.03

Current through Rules and Regulations filed through March 20, 2024

(1) A health maintenance organization seeking certification for purposes of O.C.G.A. § 33-21-3(b.1) through proof of accreditation by a national accreditation organization shall:

(a) Submit to the Commissioner a copy of the certificate of provisional or final accreditation issued by a national accreditation agency qualified under this regulation; and

(b) Submit evidence that its services are reasonably available and accessible in its service area or proposed service area according to its written standards for establishing and measuring appropriate member access to health care services.

(2) For purposes of subparagraph (1)(a) of this section, a health maintenance organization may submit proof of accreditation of a company with which it is formally affiliated, provided that the affiliated company supervises or performs the services for the Georgia health maintenance organization using the same standards and procedures for which it has received accreditation by an Approved Accrediting Organization.

O.C.G.A. Secs. 33-2-9, 33-21-3, 33-21-18.

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