Title 33, Chapter 24, Section 72
(a) As used in this Code section, the term:
(1) "Attending physician" means any surgeon or other physician
attending the breast cancer patient.
(2) "Health benefit policy" means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, or renewed in this state, including, but not limited to, those contracts executed by the State of Georgia on behalf of indigents and on behalf of state employees under Article 1 of Chapter 18 of Title 45, by a health care corporation, health maintenance organization, preferred provider organization, accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, or other insurer or similar entity; except that such term does not include any policy of limited benefit insurance as defined in paragraph (4) of subsection (e) of Code Section 33-30-12.
(3) "Insurer" means an accident and sickness insurer, fraternal
benefit society, hospital service corporation, medical service
corporation, health care corporation, health maintenance
organization, managed care plan other than a dental plan, or any
similar entity authorized to issue contracts under this title and
also means any state program funded under Title XIX of the federal
Social Security Act, 42 U.S.C.A. Section 1396 et seq., and any
other publicly funded state health care program.
(4) "Lymph node dissection" means the removal of a part of the
lymph node system under the arm using general anesthesia as part
of a diagnostic process that is used to evaluate the spread of
cancer and to determine the need for further treatment.
(5) "Mastectomy" means surgical removal of one or both breasts.
(b) Every health benefit policy that provides surgical benefits for
mastectomies that is delivered, issued, executed, or renewed in this
state or approved for issuance or renewal in this state by the
Commissioner on or after July 1, 1999, shall provide coverage in a
licensed health care facility for inpatient care following a
mastectomy or lymph node dissection until the completion of the
appropriate period of stay for such inpatient care as determined by
the attending physician in consultation with the patient. Coverage
shall be provided also for such number of follow-up visits as
determined to be appropriate by the attending physician after
consultation with the patient. Such follow-up visits shall be
conducted by a physician, a physician's assistant, or a registered
professional nurse with experience and training in postsurgical
care. In consultation with the patient, such attending physician,
physician's assistant, or registered professional nurse shall
determine whether any follow-up visit or visits will be conducted at
home or at the office.
(c) Every insurer shall provide notice to policyholders regarding
the coverage required by this Code section. The notice shall be in
writing and prominently positioned in any of the following
(1) The next mailing to the policyholder;
(2) The yearly informational packets sent to the policyholder; or
(3) Other literature mailed before January 1, 2000.
(d) No insurer covered under this Code section shall deselect,
terminate the services of, require additional utilization review,
reduce capitation payment, or otherwise penalize an attending
physician or other health care provider who orders care consistent
with the provisions of this Code section. For purposes of this
subsection, health care provider shall include the attending
physician and hospital.