1. HB 93 was drafted and approved by the legal counsel of the State of Georgia.

2. After HB 93 was passed by the Georgia Rouse of Representatives, a Senate committee met to review and scrutinize HB 93. This committee determined that HB 93 was worthy of accepting as law.

3. Four different legal people gave their opinions as to the meaning of HB 93, and the following information is an aggregation of those opinions. It should be noted that all four legal people arrived at the same conclusions regarding HB 93.

I. The law provides that beginning July 1, 1999, all insurance policies in the State of Georgia that provide coverage for services which are within the lawful scope of practice of athletic trainers shall be construed to provide reimbursement for such services regardless of whether the services are rendered by a doctor OR an athletic trainer. If a particular contract requires reimbursement for certain services which can be and are rendered by a duly qualified athletic trainer, then the services must be reimbursed. (A duly qualified athletic trainer is defined pursuant to O.C.G.A. sec. 43-5-8(a)(l) and (2).)

This means that any health care insurance policy providing coverage for athletic injuries, (or injuries preventing athletic participation, or any injury comparable thereof as defined in O.C.G.A. sec. 43-5-1) to individuals in the State of Georgia must reimburse such individuals when they receive treatment by an athletic trainer if a doctor of medicine would receive reimbursement for providing the same service. Indeed, if an insurance policy covers services within the lawful scope of practice of athletic trainers, HB 93 prohibits such policies from excluding patients from receiving reimbursement for services rendered by athletic trainers.

2. An insurance policy does not have to state that it specifically includes coverage for services rendered by an athletic trainer, but rather so long as the policy covers services typically and legally provided by athletic trainers, then the athletic trainer will receive reimbursement if a doctor or other provider would receive such reimbursement.

Insurance carriers may exclude coverage for certain injuries, sicknesses, or accidents, however, HB 93 prohibits them from excluding athletic trainers from reimbursement for treatment of those injuries, sicknesses or accidents if they fall within the athletic trainer scope of practice and would otherwise be reimbursed if delivered by a physician.

For example, if a patient with health insurance coverage suffers an injury to his back or fractures his ankle, and is treated by an athletic trainer within his scope of practice for such injury, such patient shall be reimbursed as a matter of law for such treatment by the athletic trainer if such treatment would also be reimbursed to a physician. This is true whether or not the insurance policy specifically mentions athletic trainers or athletic injuries, so long as the policy covers care and treatment of back and ankle injuries.

3. The last sentence in Section 2 states that "nothing contained herein shall require an insurance [sic] to offer such coverage." The term "coverage" refers to the nature of injury, sickness, or accident, and not to the health care provider of the treatment for the injury, sickness or accident.

4. HB 93 amended the definition of a "health care provider" in managed healthcare plans across the State of Georgia so as to include athletic trainers who are qualified pursuant to O.C.G.A. sec. 43-5-8(a)( 1) and (2), providing that athletic trainers are now included as a provider of health care services. (This does not mean that athletic trainers are not health care providers under other types of health care plans.)

A duly qualified athletic trainer is a health care provider under managed care plans and reimbursement cannot be denied because they are athletic trainers. If a particular contract requires reimbursement for certain services which can be and are rendered by a duly qualified athletic trainer, then they must be reimbursed.