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Current as of March 28, 2024 | Updated by Findlaw Staff
(a) No pharmacy benefits manager shall engage in the practice of medicine, except as otherwise provided in subsection (b) of this Code section.
(b) Any physician employed by or contracted with a pharmacy benefits manager advising on or making determinations specific to a Georgia insured in connection with a prior authorization or step therapy appeal or determination review shall:
(1) Have actively seen patients within the past five years; and
(2) Have practiced in the same specialty area for which he or she is providing advisement within the past five years.
(c) For contracts and amendments entered into with a pharmacy benefits manager on and after July 1, 2021, the department is encouraged to require the use of a licensed Georgia physician for prior authorization or step therapy appeal or determination reviews.
Cite this article: FindLaw.com - Georgia Code Title 33. Insurance § 33-64-4 - last updated March 28, 2024 | https://codes.findlaw.com/ga/title-33-insurance/ga-code-sect-33-64-4/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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