Ga. Comp. R. & Regs. R. 100-17-.01 - Peer Reviewer

Current through Rules and Regulations filed through April 4, 2022

(1) For purposes of this rule "Peer Reviewer" means any person rendering a professional chiropractic written or verbal opinion, which has the capacity or intent of affecting the frequency, duration, necessity, or outcome of chiropractic treatment or patient care and who is being compensated by a 3rd party payer or other contractual parties.

(2) Chiropractic care shall include offering or rendering a professional chiropractic written or verbal opinion, which has the capacity or intent of affecting the frequency, duration, necessity, or outcome of chiropractic treatment or patient care. Any person practicing as a Peer Reviewer in Georgia must:

(a) Notify the Georgia Board of Chiropractic Examiners of his/her intent to act as a Peer Reviewer. Such notification must include the individual's Georgia license number.

(b) Possess a valid Georgia chiropractic license;

(c) Have completed a certification program totaling a minimum of 100 hours in performing utilization peer review;

(d) Have the physiotherapy modalities certification listed as a secondary license type on their Georgia license;

(e) Identify themselves by name, degree designation, location of practice, and Georgia chiropractic license number;

(f) Have established not less than five (5) years of active private clinical practice in Georgia immediately prior to rendering such opinion; and

(g) Have earned a minimum of seventy percent (70%) of chiropractic related income from the active treatment of patients in Georgia in each of the previous five (5) years.

(3) Licensed chiropractors conducting peer review on behalf of a Georgia professional association, as approved by the board by policy, are exempt from this rule.

(4) Effective from the effective date of this rule amendment through January 31, 2010, the Board will consider requests from Georgia licensed doctors of chiropractic to be grand-fathered as Peer Reviewers.

Notes

Ga. Comp. R. & Regs. R. 100-17-.01

O.C.G.A. §§ 43-1-25, 43-9-1, 43-9-12, 43-9-16.

Original Rule entitled "Review Agent" adopted. F. Nov. 30, 2009; eff. Dec. 20, 2009. Amended: F. Jan. 26, 2010; eff. Feb. 15, 2010. Amended: New title "Peer Reviewer." F. Nov. 17, 2017; eff. Dec. 7, 2017.