09 LC 28
4565
House
Bill 403
By:
Representatives Hembree of the
67th,
Dollar of the
45th,
Neal of the
1st,
and Coan of the
101st
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia
Annotated, relating to insurance generally, so as to provide definitions; to
require certain disclosures regarding the provision of certain anatomic
pathology services; to prohibit physicians from charging a markup, commission,
or profit on the actual amount paid or to be paid for an anatomic pathology
service performed or supervised by another physician; to provide for exceptions;
to provide for enforcement; to provide that no patient, insurer, or third party
payor shall be required to reimburse and licensed practitioner for charges or
claims for anatomic pathology services that are not in accordance with the
provisions of law regarding payment for such services; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Article
1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating
to insurance generally, is amended by adding a new Code section to read as
follows:
"33-24-27.3.
(a)
For purposes of this Code section, the term 'anatomic pathology service'
means:
(1)
Histopathology or surgical pathology, which means the gross and microscopic
examination and histologic processing of organ tissue performed by a physician
or under the supervision of a physician;
(2)
Cytopathology, which means the microscopic examination of cells from the
following: fluids, aspirates, washings, brushings, or smears, including a Pap
test examination, performed by a physician or under the supervision of a
physician;
(3)
Hematology, which means the microscopic evaluation of bone marrow aspirates and
biopsies performed by a physician or under the supervision of a physician and
peripheral blood smears when the attending or treating physician or technologist
requests that a blood smear be reviewed by the pathologist;
(4)
Subcellular pathology and molecular pathology; or
(5)
Blood banking services performed by pathologists.
Anatomic
pathology service does not include the initial collection or packaging of a
specimen for transport.
(b)
A physician who orders an anatomic pathology service for a patient and does not
supervise or perform a component of the service shall disclose in any bill or in
a separate statement for such service presented to the patient, insurer, or
other third-party payor:
(1)
The name and address of the physician or laboratory that provided the anatomic
pathology service; and
(2)
The actual amount paid or to be paid for each anatomic pathology service
provided to the patient by the physician or laboratory that performed the
service.
(c)
The disclosure requirement under subsection (b) of this Code section shall not
be required when the anatomic pathology service is ordered by a hospital, a
public health clinic, or a state or federal agency, or the agent of that agency,
on behalf of the patient.
(d)
Any physician subject to subsection (b) of this Code section shall not charge a
markup, commission, or profit on the actual amount paid or to be paid for an
anatomic pathology service performed or supervised by another physician;
provided, however, that a physician taking a patient specimen may make an
acquisition charge or processing charge that is coded distinct from the anatomic
pathology service.
(e)
The Composite State Board of Medical Examiners may revoke, suspend, or deny
renewal of the license of any physician who violates the provisions of this Code
section.
(f)
No patient, insurer, or third party payor shall be required to reimburse any
licensed practitioner for charges or claims submitted for anatomic
pathology services that are not in accordance with the provisions of this Code
section."
SECTION
2.
All
laws and parts of laws in conflict with this Act are repealed.