§ 49-4-163. Eligibility for Asset Disregard; Reciprocal Agreements With Other States to Extend Asset Disregard Mutually
An individual who is a beneficiary of a Georgia Qualified Long-term Care Partnership Program approved policy is eligible for assistance under the state Medicaid program using asset disregard pursuant to the provisions of subsection (c) of Code Section 49-4-162. If the Georgia Qualified Long-term Care Partnership Program is discontinued, an individual who purchased a Georgia […]
§ 49-4-164. Requirements for Selling Qualified Long-Term Care Insurance Partnership Policies; Rules and Regulations; Reports
The Commissioner shall: Develop requirements to ensure that any individual who sells a qualified long-term care insurance partnership policy receives training and demonstrates evidence of an understanding of such policies and how they relate to other public and private coverage of long-term care; and Not impose any requirement affecting the terms or benefits of qualified […]
§ 49-4-165. Notice to Consumers
A qualified long-term care insurance partnership policy shall contain a summary notice to the consumer in plain language on the current law pertaining to asset disregard and asset tests. The notice to the consumer under subsection (a) of this Code section shall be developed by the Commissioner of Insurance. History. Code 1981, § 49-4-165 , […]
§ 49-4-168. Definitions
As used in this article, the term: “Claim” includes any request or demand, whether under a contract or otherwise, for money or property, whether or not the Georgia Medicaid program or this state has title to such money or property, which is made to the Georgia Medicaid program, to any officer, employee, fiscal intermediary, grantee, […]
§ 49-4-152.6. Medicaid Coverage for Mood Disorders Prescriptions
The department shall provide Medicaid coverage for any prescription drug prescribed to an adult patient and determined by a duly licensed practitioner in this state to be medically necessary for the treatment and prevention of mood disorders with psychotic symptoms, including, but not limited to, bipolar disorders, schizophrenia and schizotypal, or delusion disorders if: During […]
§ 49-4-168.1. Civil Penalties for False or Fraudulent Medicaid Claims
Any person who: Knowingly presents or causes to be presented to the Georgia Medicaid program a false or fraudulent claim for payment or approval; Knowingly makes, uses, or causes to be made or used a false record or statement material to a false or fraudulent claim; Conspires to commit a violation of paragraph (1), (2), […]
§ 49-4-153. Administrative Hearings and Appeals; Judicial Review; Contested Cases Involving Imposition of Remedial or Punitive Measure Against Nursing Facility
The Board of Community Health is authorized to establish regulations regarding the manner in which the appeals set forth in subsection (b) of this Code section shall be conducted. Any applicant for medical assistance whose application is denied or is not acted upon with reasonable promptness and any recipient of medical assistance aggrieved by the […]
§ 49-4-168.2. Role of Attorney General in Pursuing Cases; Civil Actions by Private Persons; Special Procedures for Civil Actions by Private Persons; Limitation on Participation; Stay of Discovery; Receipt of Proceeds
The Attorney General shall be authorized to investigate suspected, alleged, and reported violations of this article. If the Attorney General finds that a person has violated or is violating this article, then the Attorney General may bring a civil action against such person under this article. Subject to the exclusions set forth in this Code […]
§ 49-4-154. Powers and Duties Retained by Department of Human Resources (Department of Community Health)
The status, position, and rights of persons transferred from the Department of Human Resources (now known as the Department of Community Health for these purposes) to the Department of Medical Assistance pursuant to Ga. L. 1977, p. 384 shall not be affected by the transfer, in and of itself; and such persons shall retain, inter […]
§ 49-4-168.3. Standard of Proof; Procedure; Intervention by Attorney General
In any civil action brought under this article, the State of Georgia or person bringing the civil action shall be required to prove all essential elements of the cause of civil action, including damages, by a preponderance of the evidence. Except as otherwise provided in this article, all civil actions brought under this article shall […]