{"data":{"id":"us-ga/o.c.g.a.-33-64-4","jurisdiction":"us-ga","citation":"O.C.G.A. § 33-64-4","heading":"Pharmacy benefits manager shall not engage in the practice of medicine; recommended use of licensed physician.","body":"(a) No pharmacy benefits manager shall engage in the practice of medicine, except as otherwise provided in subsection (b) of this Code section.\n(b) Any physician employed by or contracted with a pharmacy benefits manager advising on or making determinations specific to a Georgia insured in connection with a prior authorization or step therapy appeal or determination review shall:\n(1) Have actively seen patients within the past five years; and\n(2) Have practiced in the same specialty area for which he or she is providing advisement within the past five years.\n(c) For contracts and amendments entered into with a pharmacy benefits manager on and after July 1, 2021, the department is encouraged to require the use of a licensed Georgia physician for prior authorization or step therapy appeal or determination reviews.","path":["TITLE 33 Insurance","CHAPTER 64 Regulation and Licensure of Pharmacy Benefits Managers"],"source_url":"https://archive.org/download/gov.ga.ocga.2018/release86.2022.11/gov.ga.ocga.title.33.odt","current_through":"Release 86 (2022-11)","vintage":"Public.Resource.Org bulk O.C.G.A., Release 86 (2022-11), retrieved 2026-09-17","retrieved_at":"2026-09-17T19:34:57Z","sha256":"74f4bb9b8e7fb3d296c6fb4dff7c69caf0b026e04de86e1e1fe2012ee6f20c4c","source_id":"us-ga","stale":false,"prev":"us-ga/o.c.g.a.-33-64-3","next":"us-ga/o.c.g.a.-33-64-5"},"notice":"GroundRules: Original legal text. Not legal advice."}