Georgia Prior Authorization Requirements
A guide to prior authorization rules, turnaround times, and laws for medical practices operating in Georgia (GA).
PA Turnaround Times
Standard Requests
14 calendar days
Urgent / Expedited
72 hours
Gold Card Law
Georgia enacted gold card legislation (SB 80) that allows providers with a 90% or higher PA approval rate over a 12-month period to be exempt from PA requirements for specific services.
PA Reform Legislation
Georgia has been a leader in PA reform with gold card legislation and turnaround time mandates.
Key Regulations
- Gold card exemption for providers with 90%+ approval rate
- Standard PA turnaround of 14 calendar days
- Urgent requests within 72 hours
- Payers must publish PA criteria publicly
- Written denial reasons with appeal rights required
Georgia Medicaid PA
Georgia Medicaid (Peach State Health Plan, CareSource, Amerigroup) uses managed care. PA requirements vary by plan.
Recent Changes (2025-2026)
- Gold card law (SB 80) implementation continues with additional provider enrollment
- Payers are required to track and report gold card eligibility
Top Payers in Georgia
State Regulatory Body: Georgia Office of Insurance and Safety Fire Commissioner
File PA complaints or appeals through your state insurance department.
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