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
| (1) |
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). |
| (2) |
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. |
| (3) |
Upon the Board's approval of the proposed draft, but prior to the adoption, amendment, or repeal of any such rule, the Department shall:
| (a) |
give at least thirty (30) days notice of its intended action by mail to:
| 1. |
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 |
| 2. |
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 |
|
| (b) |
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 |
| (c) |
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. |
|
| (1) |
Any interested person may petition the Department
requesting the adoption, amendment, or repeal of any rule. |
| (2) |
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. |
| (3) |
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. |
| (4) |
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. |
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.
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.
| (1) |
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. |
| (2) |
The 20-day filing period is subject to the following exceptions:
| (a) |
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 |
| (b) |
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. |
|
| (1) |
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. |
| (2) |
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. |
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.
| (1) |
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:
| (a) |
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 |
| (b) |
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. |
|
| (2) |
Notice is not required if:
| (a) |
the change is required by court order; or |
| (b) |
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. |
|
| (3) |
The notice must:
| (a) |
describe the proposed change in methods and
standards; |
| (b) |
give an estimate of any expected increase or decrease in
annual aggregate expenditures; |
| (c) |
explain why the agency is changing its methods and
standards; |
| (d) |
identify a local agency in each county where copies of the
proposed changes are available for public review; |
| (e) |
give an address where written comments may be sent and
reviewed by the public; and |
| (f) |
give the location, date, and time for a public hearing on
the proposed change or tell how this information may be obtained. |
|
| (4) |
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. |
| (5) |
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. |
