§ 49-4-152.1. Medicaid Prescription Drug Bidding and Rebate Program
The General Assembly finds that the department frequently must pay more for prescription drugs furnished to recipients of medical assistance under this article than certain health care providers pay for the same products. In order to control more effectively the costs of such drugs, the department may establish a Medicaid Prescription Drug Bidding and Rebate […]
§ 49-4-145. Time Limitations on Claims for Assistance; Form of Claims
Claims for medical assistance must be submitted not more than six months after the month in which the service is rendered and shall be in the form prescribed by the commissioner, except that the commissioner may, where he finds that delay in submission of claims was caused by circumstances beyond the control of the provider, […]
§ 49-4-152.2. Rebates for Sole-Source and Multiple-Source Drugs Included in Controlled Medical Assistance Drug List
The department is authorized to negotiate and enter into agreements directly with manufacturers and distributors whose prescription drug products are sold in the state for sole-source and multiple-source drugs to be paid for under the state plan for eligible recipients under this article. Such agreements shall provide for a periodic rebate of a negotiated percentage […]
§ 49-4-146. Time for Action on Claim
The Department of Community Health, within three months of receiving a claim submitted on or after July 1, 1978, shall pay or deny the claim. History. Ga. L. 1977, p. 384, § 15A; Ga. L. 1999, p. 296, § 24.
§ 49-4-152.3. Reuse of Unit Dosage Drugs
As used in this Code section, the term: “Long-term care facility” or “facility” means an intermediate care home, skilled nursing home, or intermingled home subject to regulation as such by the Department of Community Health. “Unit dosage drug” means any dangerous drug regulated under Chapter 13 of Title 16 which is individually packaged to contain […]
§ 49-4-146.1. Unlawful Acts; Violations and Penalties; Recovery of Excess Amounts; Termination and Reinstatement of Providers; Duty of Department to Identify and Investigate Violations; Notifications; Authorization to Obtain Income Eligibility Verification
As used in this Code section, the term: “Agent” means any person who has been delegated the authority to obligate or act on behalf of a provider. “Convicted” means that a judgment of conviction has been entered by any federal, state, or other court, regardless of whether an appeal from that judgment is pending. “Indirect […]
§ 49-4-152.4. Department Contracts to Require Refund of Prescription Drug Rebates
The department shall provide that any department contract with a provider of medical assistance which is renewed or executed on or after July 1, 1997, shall require a refund to the department of any prescription drug rebate, as established in this article or in federal law in Section 1927 of Title XIX of the Social […]
§ 49-4-146.2. Requirements for Voluntary Termination of Provider Agreements by Nursing Facilities; Adjustment of Medical Assistance Rate; Decertification
As used in this Code section, the term: “Assist” means that the provider will, at a minimum, do the following: Provide the resident, the resident’s legal guardian, or the resident’s representative with the names, addresses, phone numbers, and contact persons at other facilities appropriate to the needs of the resident; Contact the identified facilities initially […]
§ 49-4-152.5. Restocking Fees
In the provision of medical assistance pursuant to this article, the department shall allow for the payment and coverage of appropriate restocking fees incurred by a pharmacy which receives and dispenses unused over-the-counter and prescription drugs pursuant to Article 10 of Chapter 8 of Title 31. History. Code 1981, § 49-4-152.5 , enacted by Ga. […]
§ 49-4-140. Short Title
The short title for this article shall be the “Georgia Medical Assistance Act of 1977.” History. Ga. L. 1977, p. 384, § 2. Law reviews. For article, “Privatization of Rural Public Hospitals: Implications for Access and Indigent Care,” see 47 Mercer L. Rev. 991 (1996).