Federal Law Payor Guidelines and Criteria Not a Legal Basis for Negligence or Standard of Care for Medical Malpractice or Product Liability

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  5. Federal Law Payor Guidelines and Criteria Not a Legal Basis for Negligence or Standard of Care for Medical Malpractice or Product Liability

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  1. As used in this Code section, the term:
    1. "Criteria" means criteria relating to administrative procedures and shall not include criteria relating to medical treatment, quality of care, or best practices.
    2. "Guideline" means a guideline relating to administrative procedures and shall not include guidelines relating to medical treatment, quality of care, or best practices.
    3. "Payor" means any insurer, health maintenance organization, self-insurance plan, or other person or entity which provides, offers to provide, or administers hospital, outpatient, medical, or other health care benefits to persons treated by a health care provider in this state pursuant to any policy, plan, or contract of accident and sickness insurance as defined in Code Section 33-7-2.
    4. "Standard" means a standard relating to administrative procedures and shall not include standards relating to medical treatment, quality of care, or best practices.
  2. The development, recognition, or implementation of any guideline by any public or private payor or the establishment of any payment standard or reimbursement criteria under any federal laws or regulations related to health care shall not be construed, without competent expert testimony establishing the appropriate standard of care, to establish a legal basis for negligence or the standard of care or duty of care owed by a health care provider to a patient in any civil action for medical malpractice or product liability. Nor shall compliance with such a guideline, standard, or criteria establish a health care provider's compliance with the standard of care or duty of care owed by a health care provider to a patient in any civil action for medical malpractice or medical product liability without competent expert testimony establishing the appropriate standard of care.

(Code 1981, §51-1-52, enacted by Ga. L. 2013, p. 627, § 1/HB 499.)

Cross references.

- Expert opinion testimony in civil cases, § 24-7-702.

Code Commission notes.

- Pursuant to Code Section 28-9-5, in 2009, Code Section 51-1-52, as enacted by Ga. L. 2008, p. 702, § 4/SB 239, was redesignated as Code Section 51-3-30.

Pursuant to Code Section 28-9-5, in 2013, Code Section 51-1-52, as enacted by Ga. L. 2013, p. 870, § 1/HB 382, was redesignated as Code Section 51-1-53.


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