March 13, 2015 Atlanta: Sen. Dean Burke (R-Bainbridge) listens to debate on the Senate floor Friday March 13, 2015. Friday was Crossover Day, the last day of the legislative session for legislation to pass out of the House or Senate and have a realistic chance of becoming law. BEN GRAY / BGRAY@AJC.COM
Photo: Ben Gray
Photo: Ben Gray

Georgia Senate approves bill aiming to allow patients to keep doctors

Georgia senators unanimously approved legislation Tuesday that could allow patients to keep their doctors for the remainder of the year if their physician leaves the insurance network.

Senate Bill 352 aims to protect insurance policyholders by saying that the provider directory the insurance company shows them when they’re signing up — the policy’s network of covered hospitals and doctors — is legally binding. Under the bill the company must cover those caregivers as being in-network for the whole policy year.

“If you choose a provider, you get to keep that provider,” said Bainbridge Republican state Sen. Dean Burke who sponsored the bill and is a physician.

The legislation has exceptions that include if the provider “unilaterally” leaves the network. 

Had the legislation been in place last year, it could have given people like those in Cobb County, where the insurance giant Anthem dropped WellStar hospitals from its individual networks just over a month after the policy year started. 

Under current law, if a Georgian signs up with an insurance company because their doctor or hospital is in network, and that ends up to not be true, the patient either has to change doctors or pay out-of-network costs.

That is true in cases where the directory was mistaken because the insurance company didn’t update it, or if the insurance company decides to drop the provider mid-year.

The legislation now heads to the House for its consideration.

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