Subject 120-2-92 INDEPENDENT ACCREDITATION OF HEALTH MAINTENANCE ORGANIZATIONS
The Commissioner shall establish a list of approved accreditation organizations for purposes of this regulation. A health maintenance organization which is accredited on a continuing basis by an organization on the Approved Accrediting Organizations List and meeting the other requirements of this regulation shall be deemed to have satisfied the requirements of O.C.G.A. § 33-21-3(b.1).
|(1)|| An organization
may become an approved accrediting organization for purposes of this regulation
when it meets the following requirements:
|(2)||An organization seeking approval as an accrediting organization shall submit evidence to the Commissioner of its compliance with the standards in subparagraph (1) of this section. Upon submission of such evidence, the Commissioner, in his or her discretion, may include the organization on the Approved Accrediting Organizations List.|
|(1)|| A health maintenance organization seeking
certification for purposes of O.C.G.A. § 33-21-3(b.1) through proof of
accreditation by a national accreditation organization shall:
|(2)||For purposes of subparagraph (1)(a) of this section, a health maintenance organization may submit proof of accreditation of a company with which it is formally affiliated, provided that the affiliated company supervises or performs the services for the Georgia health maintenance organization using the same standards and procedures for which it has received accreditation by an Approved Accrediting Organization.|
|(1)||A health maintenance organization shall notify the Commissioner of Insurance of the loss of accreditation within 15 days of such occurrence.|
|(2)||Upon receipt of notice of a health maintenance organization's accreditation, the Commissioner of Insurance shall notify the Commissioner of the Department of Human Resources.|
|(3)||The Commissioner of Insurance may investigate and review specific issues relating to access and availability at any time.|
If any provision of this regulation or its application to any person or circumstance is for any reason held to be invalid, the remainder of the regulation and the application of the provision to other persons or circumstances shall not be affected.