Rules and Regulations of the State of Georgia
 

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  • 1. In the address bar, type about:config and press Enter.
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<xmp>.</xmp> <form name="form1" method="post" action="350-1?urlRedirected=yes&amp;data=admin&amp;lookingfor=350-1" id="form1"> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUKLTY5ODkwOTM2Nw8WAh4Ec3BhbQIFFgJmD2QWAgIFDw8WAh4EVGV4dAUFMyArIDJkZGTK4uP9JKUeM7zVSFq1XK3nUDk1Dg==" /> <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="EEBB6393" /> <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEWCAKI1NSLDQLniKOhBALV5cpNAoa5iIEFAoznisYGAsrv5u0MAsrv4u0MAsrv3u0M6PhjZgX8UhV/h7spCH874dV9EqU=" /> <div class='popup'> <div class='cnt223'> <div style="margin-bottom:6px;"> <img alt="Rules and Regulations of the State of Georgia" src="/images/new.gif"/> </div> <div class="header"> Terms and Conditions of Agreement for Access to Rules and Regulations of the State of Georgia Website </div> <div class="scroll"> <p>(Note: certain features of this site have been disabled for the general public to prevent digital piracy. If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree that you will not copy, print, or download anything from this website for any commercial use. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website.</p> <p> You agree that you will not sell, will not license, and will not otherwise make available in exchange for anything of value, anything that you download, print, or copy from this site.</p> <p> You agree that you will not copy, print, or download any portion of the regulations posted on this site exceeding a single chapter of regulations for sale, license, or other transfer to a third party, except that you may quote a reasonable portion of the regulations in the course of rendering professional advice.</p> <p> If you violate this agreement, or if you access or use this website in violation of this agreement, you agree that Lawriter will suffer damages of at least $20,000. </p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website. </p> <p> You agree that you will not sell or license anything that you download, print, or copy from this website.</p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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Title 49, Article 7.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Administrative Review" means the formal reconsideration, as a result of the proper and timely submission of a provider's request therefor, by any Departmental Division, Office, or Unit which has proposed an adverse action which will aggrieve a party if it is carried out.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Adverse Action" means an instance in which the Department: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> denies or reduces the amount of reimbursement claimed by a provider;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> recovers funds previously paid to a provider, other than through lawsuit;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> sets or changes a provider's reimbursement rate;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> withholds reimbursement from a provider;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> denies payment for future admissions to a nursing facility, except as provided in Chapter 350-3 of these Rules;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> suspends, terminates, or refuses to enroll, re-enroll, or reinstate a provider or prospective provider; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(3)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> performs any other act which aggrieves a provider.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Aggrieved" means to have received notice of a loss or injury in fact to an interest within the zone of interests protected by a law or regulation governing Medical Assistance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Applicant for medical assistance" means a person who has made application for certification as being eligible, generally, to have medical assistance paid in his/her behalf pursuant to the terms of the State Plan and whose application has not been acted upon favorably.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Board" means the Board of Medical Assistance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Business day" means day on which the Department is officially open to conduct its affairs.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Commissioner" means the Commissioner of Medical Assistance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Department" means the Department of Medical Assistance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Hearing" means a formal proceeding before an Administrative Law Judge in which parties affected by an action or an intended action of the Department shall be allowed to present testimony, documentary evidence, and argument as to why such action should or should not be taken.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Administrative Law Judge (ALJ)" means a member of the State Bar of Georgia authorized by the Commissioner to administer the hearing provisions of the medical assistance program as set out in O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=49-4-153&amp;title=49#" target="_newtab">49-4-153</a>.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(12)">(12)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Medical Assistance" means payment to a provider of a part of or all of the cost of certain items of medical or remedial care or services rendered by a provider to a recipient of medical assistance, provided such items are rendered and received in accordance with such provisions of Title XIX of the federal Social Security Act of 1935, as amended, regulations promulgated pursuant thereto by the Secretary of Health and Human Services, all applicable laws of the State of Georgia, the State Plan, and regulations of the Department which are in effect on the date on which the care or services are rendered.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(13)">(13)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Notice of hearing" means <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(13)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> for the purpose of rule-making, a written statement of the substance of a proposed rule which will afford notice to all interested persons, such notice being given by mail or by publication at least thirty (30) days prior to the date of hearing; provided, however, that when the Board finds it necessary under Rule <a title="350-2-.04" href="350-2-.04">350-2-.04</a>, such notice may be shortened or eliminated; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(13)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> for the purpose of contested cases, a written statement issued pursuant to Chapter 350-4 of these Rules by an Administrative Law Judge appointed to preside over a hearing.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(14)">(14)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Party" means any person against whom the Department has taken an adverse action and who has been approved to participate in a hearing by the Department or by the presiding Administrative Law Judge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(15)">(15)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Person" means any individual, partnership, corporation, or other entity recognized under Georgia law.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(16)">(16)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Pleadings" consist of the notice of adverse action issued by the Department which aggrieves the provider, the provider's Request for hearing requesting review of the adverse action, and any amendments to such documents.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(17)">(17)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Program" means all of the functions of the Georgia Department of Medical Assistance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(18)">(18)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Provider of medical assistance" means a person or institution, public or private, which possesses all licenses, permits, certificates, approvals, registrations, charters, and other forms of permission issued by entities other than the Department, which forms of permission are required by law either to render care or to receive medical assistance in which federal financial participation is available, which meets the further requirements for participation prescribed by the Department, and which is enrolled, in the manner and according to the terms prescribed by the Department, to participate in the State Plan.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(19)">(19)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Reasonable time" means such time as is appropriate to do what is required to be done, as soon as circumstances will permit; any time which is not manifestly unreasonable may be fixed by agreement of the parties, and what is reasonable depends on the nature, purpose, and circumstances of each case.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(20)">(20)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Recipient of medical assistance" means a person who has been certified eligible, pursuant to the terms of the State Plan, to have medical assistance paid in his/her behalf.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(21)">(21)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Request for Hearing" is a written document submitted to the Department seeking formal redress of an action by the Department which aggrieves the person making the request. To be effective, a request for Hearing must comply with the provisions of Rule <a title="350-4-.05" href="350-4-.05">350-4-.05</a>.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(22)">(22)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Rule" means each Department regulation or written statement of general or particular applicability which implements law governing the Department's organization or its administration of the State Plan pursuant to the authority granted under O.C.G.A., § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=49-4-142&amp;title=49#" target="_newtab">49-4-142</a>, <I>et seq.</I>, as amended; provided, however, that the amount, duration, scope, and terms and conditions of eligibility for and receipt of medical assistance, statements of general or specific policy and interpretations thereof, informational notices, contracts, and policy and procedure manuals and amendments thereto, are specifically excluded.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(23)">(23)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "State Plan" means all documentation submitted by the Commissioner, on behalf of the Department, to and for approval by the Secretary of Health and Human Services pursuant to Title XIX of the federal Social Security Act of 1935, as amended.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(24)">(24)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Time Computed. The computation of any period of time referred to in these Rules shall begin with the first day following that on which the act initiating such period of time occurs. When the last day of the period so computed is a day on which the Department is closed, the period shall run until the end of the next business day.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.01(25)">(25)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All petitions, requests, notices, and decisions referred to in these Rules must be in writing.</td> </tr> </table> <h2><a href="/GAC/350-1-.02" name="350-1-.02" title="350-1-.02">Rule 350-1-.02 Department of Medical Assistance</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department of Medical Assistance was created by the General Assembly in 1977. The Department is authorized to: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> adopt and administer a State Plan for medical assistance as defined in paragraph (23) of Rule <a title="350-1-.01" href="350-1-.01">350-1-.01</a>, provided such State Plan is administered within the appropriations made available to the Department;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> establish the amount, duration, scope, and terms and conditions of eligibility for and receipt of such medical assistance as it may elect to authorize pursuant to Article 7, Title 49 of the Official Code of Georgia Annotated;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> establish such rules and regulations as may be necessary or desirable to execute the State Plan and to receive the maximum amount of federal financial participation available in expenditures made pursuant to the State Plan;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> enter into such reciprocal and cooperative arrangements with other states, persons, and institutions, public and private, as it may deem necessary or desirable in order to execute the State Plan.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department shall administer the State Plan for Medical Assistance in accordance with these Rules.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department shall publish the terms and conditions for receipt of medical assistance in Policies and Procedures Manuals for each of the categories of service authorized under the State Plan. A copy of the Manual for each category of service shall be disseminated to each provider enrolled for that category and to each prospective provider seeking to enroll for that category. Such manuals shall be amended from time to time when the Department finds it necessary or appropriate to do so. All such amendments shall be disseminated to affected providers at the addresses at which they are then registered with the Department. Amended provisions shall be effective as specified by the Department at the time of dissemination. Each Manual shall specify, at a minimum, the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> conditions of participation;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> recordkeeping, claims submission, and payment requirements;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> requirements for prior approval of services;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> scope of services;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> reimbursement methodology;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> adverse actions the Department may take against a provider and the circumstances under which such actions may be taken; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.02(3)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> administrative review and hearing rights available to a provider.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/350-1-.03" name="350-1-.03" title="350-1-.03">Rule 350-1-.03 Commissioner of Medical Assistance</a></h2> <P>The Commissioner of Medical Assistance 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.</P> <h2><a href="/GAC/350-1-.04" name="350-1-.04" title="350-1-.04">Rule 350-1-.04 Board of Medical Assistance</a></h2> <P>The Board of Medical Assistance is empowered to establish the general policy to be followed by the Department.</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.04(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Board is composed of five (5) persons appointed by the Governor and confirmed by the Senate.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.04(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The presiding officer of the Board shall be its Chairperson, who shall be selected by the board and serve as such at the pleasure of the Board.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.04(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A quorum shall consist of a majority of its members.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.04(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Governor shall appoint Board members to four-year terms of office.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.04(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Vacancies in office shall be filled by the appointment of the Governor and said appointments shall be submitted to the Senate for confirmation at the next session of the General Assembly. An appointment to fill a vacancy, other than a vacancy created by the expiration of a term of office, shall be for the balance of the unexpired term of the Board member succeeded.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="350-1-.04(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Board members, if eligible therefor, shall receive per diem and expenses commensurate with the amounts established by O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=45-7-21&amp;title=45#" target="_newtab">45-7-21</a>.</td> </tr> </table> <h2><a href="/GAC/350-1-.05" name="350-1-.05" title="350-1-.05">Rule 350-1-.05 Practice of Non-Discrimination</a></h2> <P>In accordance with Title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, and Section 504 of the Rehabilitation Act of 1973, no individual shall be excluded from participation, or be denied benefits, or be subjected to any other form of discrimination by the Department or providers of medical assistance, by reason of handicap, race, color, sex, age, religion, or national origin.</P> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/350-1-.01" name="350-1-.01" title="350-1-.01">Rule 350-1-.01 Definitions</a></li><li><a href="/GAC/350-1-.02" name="350-1-.02" title="350-1-.02">Rule 350-1-.02 Department of Medical Assistance</a></li><li><a href="/GAC/350-1-.03" name="350-1-.03" title="350-1-.03">Rule 350-1-.03 Commissioner of Medical Assistance</a></li><li><a href="/GAC/350-1-.04" name="350-1-.04" title="350-1-.04">Rule 350-1-.04 Board of Medical Assistance</a></li><li><a href="/GAC/350-1-.05" name="350-1-.05" title="350-1-.05">Rule 350-1-.05 Practice of Non-Discrimination</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 2019 Lawriter LLC - All rights reserved.</span>| <a href="mailto:support@casemakerlegal.com?subject=Rules and Regulations of the State of Georgia">Email Us</a> | 844-838-0769 | <a href="http://livechat.casemakerlegal.com/client.php?locale=en" target="_blank" onclick="if(navigator.userAgent.toLowerCase().indexOf('opera') != -1 && window.event.preventDefault)window.event.preventDefault();this.newWindow = window.open('http://livechat.casemakerlegal.com/client.php?locale=en&url='+escape(document.location.href)+'&referrer='+escape(document.referrer), 'webim','toolbar=0,scrollbars=0,location=0,status=1,menubar=0,width=640,height=480,resizable=1');this.newWindow.focus();this.newWindow.opener=window;return false;">Live Chat</a> </div> </div> </body> </html>