The Act requires that health insurance plans of all types allow participation by qualified rural health care providers. The Act first provides that health plans must give rural providers the opportunity to apply to become a participating provider. The Act requires that if the rural providers' applications are denied or rejected, or if they are later terminated by the plan, the health plan must notify them of the specific reasons for the adverse action and provide an opportunity to cure the deficiency. Further, rural providers may appeal any adverse decision to the Insurance Commissioner; however, any confidential or proprietary information discussed at such a hearing is not subject to the State's open records requirements, and, thus, may not be accessed by the public. Finally, the Act clarifies a hospital authority provision relating to the method of filling vacancies in their governing bodies and includes additional language relating to home health care and certificates of need.
Georgia State University Law Review
"INSURANCE Essential Rural Health Care Provider Access Act: Prohibit Exclusion of Essential Rural Health Care Providers from Health Benefit Plans,"
Georgia State University Law Review:
1, Article 26.
Available at: http://digitalarchive.gsu.edu/gsulr/vol15/iss1/26