Rules and Regulations of the State of Georgia
 

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charset=UTF-16"> </HEAD> <div id="infobar"><a href="javascript:;" accesskey="r" Name="Route" title="Route" class="quickkey"><em class="mnemonic">R</em>oute </a>:<div class="searchtips" style="float:right;margin-right:10px;color: rgb(47, 79, 79);"> <a style="text-decoration:none;color: rgb(47, 79, 79);" title="search tips" name="searchtip" href="../help.aspx#searching" target="_blank"><em class="mnemonic">S</em>earch tips</a></div><ul class="breadcrumb"> <li><a href="/GAC" name="GAC" title="GAC">GA R&amp;R</a></li> <li>&raquo; <a href="/GAC/350" title="350">Department 350</a></li> <li>&raquo; Chapter 350-2</li> </ul> </div> </div><div id="doc" class="container"> <div id="doc-content" class="content"> <h1><nllchapter>Chapter 350-2 PROCEDURES FOR ADOPTION, AMENDMENT, AND REPEAL OF RULES AND FOR PUBLIC NOTICE OF CHANGES IN METHODS AND STANDARDS FOR SETTING PAYMENT RATES</nllchapter></h1> <h2><a href="/GAC/350-2-.01" name="350-2-.01" title="350-2-.01">Rule 350-2-.01 Adoption, Amendment, and Repeal of Rules</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="350-2-.01(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When in the judgment of the Department it is appropriate to adopt, amend, or repeal one or more rules to secure satisfactory compliance with the provisions of any Georgia statute or federal law or regulation, or otherwise to assure effective administration of the Department, the Commissioner shall prepare a draft whic h shall include a proposed text of the rule(s), a statement of the legal authority empowering the Department to adopt and promulgate the rule(s), and the proposed effective date(s).</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="350-2-.01(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Board shall review the draft and make additions, deletions, or amendments thereto as are agreed to by a majority vote of the members present.</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="350-2-.01(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Upon the Board's approval of the proposed draft, but prior to the adoption, amendment, or repeal of any such rule, the Department shall: <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="350-2-.01(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> give at least thirty (30) days notice of its intended action by mail 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="350-2-.01(3)(a)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> interested persons, except that whenever the Commissioner determines that such persons are so numerous as to make individual notices impractical, notice ma y be given by publication, 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="350-2-.01(3)(a)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> all persons who have requested in writing that they be placed upon a mailing list, which list shall be maintained by the Department for advance notice of its rule-making proceedings, and who have tendered the actual cost of such mailing as from time to time estimated by the Department; 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="350-2-.01(3)(a)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> legislative counsel;</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="350-2-.01(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> afford to all interested persons reasonable opportunity to submit testimony, documentary evidence, and arguments orally or in writing; in the case of substantive rules, opportunity for oral hearing must be granted if requested by twenty-five (25) persons who will be directly affected by the proposed rule, by a governmental subdivision, or by an association having not less than twenty-five (25) members; 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="350-2-.01(3)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> issue a concise statement of the principa l reasons for and against the adoption of the rule if requested in writing by an interested person affected by the action, either prior to the adoption of the rule or within thirty (30) days thereafter, and incorporate therein its reasons for overruling the consideration urged against its adoption.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/350-2-.02" name="350-2-.02" title="350-2-.02">Rule 350-2-.02 Petitions for Adoption, Amendment, or Repeal</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="350-2-.02(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any interested person may petition the Department requesting the adoption, amendment, or repeal of any rule.</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="350-2-.02(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> when the petition requests promulgation of a rule, the requested or proposed rule must be set out in full. The petition must also include all the reasons for the requested rule together with briefs containing any applicable law. Where the petition requests the amendment or repeal of a rule presently in effect, the rule or portion of the rule in question must be set out as well as the suggested amended form, if any. The petition must include all reasons for the requested amendment or repeal of the rule.</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="350-2-.02(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All petitions shall be considered by the Department. The Department may, at its discretion, order a hearing for the further consideration and discussion of the requested promulgation, amendment, repeal, or modification of any rule.</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="350-2-.02(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Within thirty (30) days after the submission of a petition, the Department shall formally consider the petition and shall within thirty (30) days thereafter either deny the petition in writing, stating the reasons for the denial, or initiate rule-making proceedings in accordance with Section .01 of this Chapter.</td> </tr> </table> <h2><a href="/GAC/350-2-.03" name="350-2-.03" title="350-2-.03">Rule 350-2-.03 Legislative Overview</a></h2> <P>In the event the chairperson of any standing committee of either House of the Georgia General Assembly to which a proposed rule relative to the Department of Medical Assistance is assigned notifies the agency that the committee objects to the adoption of such rule or has questions concerning the purpose, nature, or necessity of such rule, the Department will consult with the committee prior to the adoption of such rule.</P> <h2><a href="/GAC/350-2-.04" name="350-2-.04" title="350-2-.04">Rule 350-2-.04 Emergency Rules</a></h2> <P>If the Board finds that an imminent threat to the public health, safety, or welfare requires adoption of a rule upon fewer than thirty (30) days notice and states in writing the reasons therefor, the Commissioner, with the approval of the Chairperson, will proceed without prior notice of hearing or upon any abbreviated notice and hearing that the Board finds practicable. Such emergency rule shall be effective for a period of not longer than 120 days, but the adoption of an identical rule under Section .01 is not precluded.</P> <h2><a href="/GAC/350-2-.05" name="350-2-.05" title="350-2-.05">Rule 350-2-.05 Effective Dates of Rules</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="350-2-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each rule shall not become effective until the expiration of twenty (20) days after the original and two copies of the rule are filed in the office of the Secretary of State. Each rule so filed shall contain a citation of authority pursuant to which it was adopted and, if an amendment, shall clearly identify the original rule.</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="350-2-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The 20-day filing period is subject to the following exceptions: <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="350-2-.05(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> where a statute or the terms of the rule require a date which is later than the 20-day period, then the later date is the effective date; 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="350-2-.05(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> an emergency rule may become effective immediately upon adoption or within a period of less than twenty (20) days. The emergency rule shall be filed with the office of the Secretary of State within four (4) business days after its adoption.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/350-2-.06" name="350-2-.06" title="350-2-.06">Rule 350-2-.06 Promulgation of Rules</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="350-2-.06(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Immediately following the adoption of any rule the Department shall forward a copy to all persons who have requested in writing that they be placed upon a mailing list, which shall be maintained by the Department for this purpose, and who have tendered the actual cost of such mailing as from time to time estimated by 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="350-2-.06(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department shall maintain a book containing a copy of each rule, orderly arranged and properly indexed. This book shall be available for review by any person during regular business hours of the Department.</td> </tr> </table> <h2><a href="/GAC/350-2-.07" name="350-2-.07" title="350-2-.07">Rule 350-2-.07 Incorporation of Existing State Rules and Regulations</a></h2> <P>Adoption of the Rules of the Department of Medical Assistance is not intended to be exclusive of any presently existing rules and regulations of the State of Georgia pertaining to the Act, and adoption is made without prejudice to any rules and regulations of the Department of Human Resources which may have applicability to the administration of the State Plan. All such rules and regulations are incorporated herein, to the extent that they do not conflict with these Rules. All Rules of the Department of Medical Assistance heretofore adopted are hereby repealed.</P> <h2><a href="/GAC/350-2-.08" name="350-2-.08" title="350-2-.08">Rule 350-2-.08 Procedure for Public Notice of Changes in Statewide Methods and Standards for Setting Payment Rates</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="350-2-.08(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Except as specified in paragraph (2) of this section, the agency shall provide public notice of any proposed change in its methods and standards for setting payment rates for services whenever such change is expected, based on the most recent report of Department data obtained prior to the decision to make such proposed change, 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="350-2-.08(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> increase or decrease gross Department expenditures, for the category of service for which the change is proposed, during the 12 months following the effective date of the change by more than two percent (2.0%), 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="350-2-.08(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> affect more than two percent (2.0%) of the providers enrolled at the time of the decision to make such change for the category of service for which the change is proposed.</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="350-2-.08(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Notice is not required if: <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="350-2-.08(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the change is required by court order; 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="350-2-.08(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the change is based on changes in wholesalers' or manufacturers' prices of drugs or materials, if the agency's reimbursement system is based on material cost plus a professional fee.</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="350-2-.08(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The notice must: <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="350-2-.08(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> describe the proposed change in methods and standards;</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="350-2-.08(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> give an estimate of any expected increase or decrease in annual aggregate expenditures;</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="350-2-.08(3)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> explain why the agency is changing its methods and standards;</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="350-2-.08(3)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> identify a local agency in each county where copies of the proposed changes are available for public review;</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="350-2-.08(3)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> give an address where written comments may be sent and reviewed by the public; 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="350-2-.08(3)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> give the location, date, and time for a public hearing on the proposed change or tell how this information may be obtained.</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="350-2-.08(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The notice shall appear at least 30 days before the proposed effective date of the change in the newspaper of widest circulation in each city with a population of 50,000 or more.</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="350-2-.08(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A copy of the notice and of the proposed changes shall be transmitted to the legislative counsel at least 30 days prior to the proposed effective date.</td> </tr> </table> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/350-2-.01" name="350-2-.01" title="350-2-.01">Rule 350-2-.01 Adoption, Amendment, and Repeal of Rules</a></li><li><a href="/GAC/350-2-.02" name="350-2-.02" title="350-2-.02">Rule 350-2-.02 Petitions for Adoption, Amendment, or Repeal</a></li><li><a href="/GAC/350-2-.03" name="350-2-.03" title="350-2-.03">Rule 350-2-.03 Legislative Overview</a></li><li><a href="/GAC/350-2-.04" name="350-2-.04" title="350-2-.04">Rule 350-2-.04 Emergency Rules</a></li><li><a href="/GAC/350-2-.05" name="350-2-.05" title="350-2-.05">Rule 350-2-.05 Effective Dates of Rules</a></li><li><a href="/GAC/350-2-.06" name="350-2-.06" title="350-2-.06">Rule 350-2-.06 Promulgation of Rules</a></li><li><a href="/GAC/350-2-.07" name="350-2-.07" title="350-2-.07">Rule 350-2-.07 Incorporation of Existing State Rules and Regulations</a></li><li><a href="/GAC/350-2-.08" name="350-2-.08" title="350-2-.08">Rule 350-2-.08 Procedure for Public Notice of Changes in Statewide Methods and Standards for Setting Payment Rates</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 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