§ 33-18-9 - Issuance of certificate of authorization generally; limitations in certificate of authorization - Georgia Statutes

O.C.G.A. 33-18-9 (2010)
33-18-9. Issuance of certificate of authorization generally; limitations in certificate of authorization

(a) The Commissioner shall issue a certificate of authorization upon compliance by the medical service corporation with this chapter and other proper requirements of the Commissioner and upon being satisfied upon the following points:

(1) That all items required to be filed are in proper form and meet the approval of the Commissioner;

(2) That the applicant is established as a bona fide medical service corporation, that the services rendered by the medical service corporation are not an unnecessary duplication of similar services in the community served, that they are desirable for public necessity and convenience, and that a fair opportunity to become participating physicians has been given to all practicing physicians of standing in the area to be served;

(3) That the solicitation of contracts by the medical service corporation and its conditions or methods of operation are fair and reasonable;

(4) That the rates charged are fair, reasonable, adequate, and not unfairly discriminatory and that benefits to be provided are fair, reasonable, and not unfairly discriminatory. The rates may differ between subscribers in recognized groups and individual subscribers not in groups, subject to the approval of the Commissioner;

(5) That the amount of money actually available for working capital is sufficient to carry all acquisition costs and operating expenses for a period of at least six months from the date of the issuance of the certificate;

(6) That the amount provided as working capital shall only be provided by individuals or groups who have no financial interest in the activities of the medical service corporation or by the participating physicians. Interest charged on the working capital, if any, shall not exceed 6 percent per annum; and payment of interest, if any, and repayment of the working capital shall be permitted only after provision has been adequately made for operating expenses, payments to participating physicians for medical and surgical, dental, or podiatric services, and the establishment of legal reserves and such other reserves as may be required by the Commissioner; and

(7) That a provision has been made in the subscription contract authorizing medical and surgical, dental, or podiatric services by other than participating physicians, in which case money benefits shall be provided as specified in the subscription contract and approved as fair by the Commissioner.

(b) The certificate of authorization issued by the Commissioner to operate a medical service plan or plans shall be limited by the Commissioner to the contracts and practices approved by him.