{"id":"GA-047","kind":"order","level":"sector-regulator","jurisdiction":"Georgia","state":"GA","metro":"","industry":"","agency":"","eco":"","issuer":"Insurance and Safety Fire Commissioner John F. King","authority":"O.C.G.A. Title 33 (Commissioner\u0027s regulatory authority over insurers, HMOs and utilization review agents); Governor\u0027s Public Health State of Emergency","instrument":"Directive 20-EX-7","title":"Temporary Suspension of Certain Utilization Review and Notification Requirements","dateIssued":"2020-03-26","effective":"2020-03-26","end":"60 days (to May 25, 2020), subject to further evaluation","startDate":"2020-03-26","endDate":"2020-05-25","quarters":["2020Q2"],"types":["HC","OTHER"],"addressees":["all insurers authorized to write accident and health insurance and health benefit plans","HMOs","utilization review agents","independent adjusters"],"clause":"As hospitals plan for high demand of inpatient hospital services and redeploy staff to provide direct patient care, their ability to perform certain administrative functions will be impacted. Moreover, with many hospitals delaying or suspending many scheduled procedures, the need for certain administrative functions is less necessary. The purpose of this Directive is to advise insurers... that certain utilization review and notification requirements should be suspended for 60 days from the date of this letter... 1. Suspension of Preauthorization Requirements for Scheduled Surgeries or Admissions at Hospitals... 2. Suspension of Concurrent Review for Inpatient Hospital Services... 3. Suspension of Retrospective Review for Inpatient Hospital Services and Emergency Services at In-Network Hospitals and Payment of Claims","enforcement":"Regulator\u0027s directive to licensees (phrased \u0027should\u0027); Commissioner\u0027s licensing and examination powers","functions":["IN insurance operations (utilization review and preauthorization functions suspended)","SX hospital scheduled surgeries (regulator\u0027s finding that hospitals were \u0027delaying or suspending many scheduled procedures\u0027)","OF insurer administration"],"notes":"","sourceUrl":"https://oci.georgia.gov/document/directive/directive-20-ex-7-temporary-suspension-certain-requirements/download","snapshot":"","fileExists":true,"fileBytes":251362,"grade":"primary","character":"","description":"","collection":"GA","url":"/library/GA-047","exhibitUrl":"/exhibit/GA-047","citation":"Insurance and Safety Fire Commissioner John F. King, Directive 20-EX-7 (Mar. 26, 2020) (Ex. GA-047)","stateName":"Georgia","related":[]}