Document Type
Peach Sheet
Abstract
The Act creates a tort with liability for Health Maintenance Organization (HMO) decisions concerning medical conditions that result in death or injury. A plaintiff may recover actual damages from an HMO or managed care provider if the plaintiff can prove he or she suffered from a poor decision made by an HMO. The Act excludes punitive damages. The purpose of the Act is to provide a remedy for patients whose HMOs refused medical services or denied them timely diagnostic procedures. The Act also creates an independent review panel to review claims before lawsuits proceed.
Recommended Citation
Georgia State University Law Review,
INSURANCE Managed Health Plans: Provide Certain Enrollees of Managed Care Plans with an Independent Review of Plan Determination and Provide Standards, Conditions, and Procedures Relating Thereto; Provide for Duties, Powers, and Functions of the Health Planning Agency with Regard to Such Reviews and Provide for Certification of Independent Review Organizations; Provide for Expert Reviewers and Decisions Thereof; Provide for Costs and Expedited Reviews; Provide Immunity from Liability and Presumptions; Prohibit Certain Conflicts of Interest; Provide for Quality Assurance; and Provide for Applicability,
16
Ga. St. U. L. Rev.
(2012).
Available at:
https://readingroom.law.gsu.edu/gsulr/vol16/iss1/34