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).
As used in this article, the term: “Applicant for medical assistance” means a person who has made application for certification as being eligible, generally, to have medical assistance paid in his or her behalf pursuant to the state plan and whose application has not been acted upon favorably. “Board” means the Board of Community Health […]
The Department of Community Health established under Chapter 2 of Title 31 is authorized to adopt and administer a state plan for medical assistance in accordance with Title XIX of the federal Social Security Act, as amended (Act of July 30, 1965, P.L. 89-97, 79 Stat. 343, as amended), provided such state plan is administered […]
On and after May 3, 2006, neither the department, the board, nor any other representative of the state shall submit any request to the United States Department of Health and Human Services Centers for Medicare and Medicaid Services for a waiver pursuant to Section 1115 of the federal Social Security Act without legislative notification. This […]
On and after July 1, 2014, neither the department, the board, nor any other representative of the state shall expand Medicaid eligibility under this article through an increase in the income threshold without prior legislative approval; provided, however, that this shall not apply to any increase resulting from a cost-of-living increase in the federal poverty […]
The department shall be authorized to submit a waiver request, on or before June 30, 2020, to the United States Department of Health and Human Services Centers for Medicare and Medicaid Services pursuant to Section 1115 of the federal Social Security Act, which may include an increase in the income threshold up to a maximum […]
Beginning Fiscal Year 2024, and at least every four years thereafter, the department shall conduct a comprehensive review of provider reimbursement rates for home and community based services covered by the New Options Waiver (NOW) program, the Comprehensive Supports Waiver Program (COMP), the Independent Care Waiver Program (ICWP), the Georgia Pediatric Program (GAPP), and the […]
No later than December 31, 2022, the department shall submit a waiver request to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to authorize private institutions for mental disease (IMDs) to qualify for Medicaid reimbursement for mental health and substance use disorder treatment. Upon approval of […]
The Board of Community Health established under Chapter 2 of Title 31 is empowered to establish the general policy to be followed by the department. The Board of Medical Assistance which existed June 30, 1999, is abolished July 1, 1999, and no person shall be appointed to such board on or after July 1, 1999. […]
The commissioner of community health established under Chapter 2 of Title 31 shall be the chief administrative officer of the department and, subject to the general policy established by the board, shall supervise, direct, account for, organize, plan, administer, and execute the functions vested in the department. History. Ga. L. 1977, p. 384, § 6; […]
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, […]
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.
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 […]
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 […]
As used in this Code section, the term: “Civil forfeiture proceeding” shall have the same meaning as set forth in Code Section 9-16-2. “Medicaid fraud” means: A violation of Code Section 49-4-146.1; or A violation relating to the obtaining of medical assistance benefits or payments under this article of any provision of: Chapter 8 of […]
Medical assistance payable by virtue of this article shall be subject to any claim, lien, or offset of this state against the payee and to any claim of the United States of America made against the payee pursuant to a federal statute, but such moneys shall not otherwise be subject to execution, levy, garnishment, or […]
In accordance with applicable federal law and regulations, including those under Title XIX of the federal Social Security Act, the department may make claim against the estate of a Medicaid recipient for the amount of any medical assistance payments made on such person’s behalf by the department. A claim shall be made against the estate […]
Notwithstanding the provisions of Code Section 49-4-141, as used in this Code section the term “department” means the Department of Community Health or its officers, agents, or employees solely in their capacity as such officers, agents, or employees. Notwithstanding the provisions of Code Section 7-4-12, 7-4-15, 7-4-16, or 13-6-13, or any other statute or judicial […]
Should medical assistance be paid in behalf of a recipient of medical assistance on account of any sickness, injury, disease, or disability for which another person is legally liable, the Department of Community Health may seek reimbursement for such medical assistance from such other person. The department shall be subrogated, but only to the extent […]
The Department of Community Health shall have a lien for the charges for medical care and treatment provided a medical assistance recipient upon any moneys or other property accruing to the recipient to whom such care was furnished or to his legal representatives as a result of sickness, injury, disease, disability, or death, due to […]
