Title 49 — Title 49
0 chapters · 292 sections in this title.
O.C.G.A. § 49-4-1 Social assistance register, §49-4-19
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Social security. Public assistance. Provisions construed with federal social security act, §49-4-18. Subpoenas. Financial records. Alleged fraud, §49-4-15.1. Temporary assistance for needy families, §§49-4-180 to 49-4-193. Transportation. Elderly and disabled persons, §49-1-7. Fi…
O.C.G.A. § 49-4-10 Physical examination of applicant
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With respect to applicants for any category of public assistance authorized under Code Section 49-4-3, the department may require physical examinations of any applicant and may require the results thereof to be recorded by the examining physician on a form furnished by the depart…
O.C.G.A. § 49-4-11 Award and payment of public assistance
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(a) Upon the completion of the investigation under Code Section 49-4-9, the county department shall decide whether the applicant is eligible for assistance under this article and determine, in accordance with the rules and regulations of the Board of Human Services, the amount an…
O.C.G.A. § 49-4-13 Hearings; appeal
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(a) Except as provided in subsection (b) of this Code section, an applicant for or recipient of public assistance who is aggrieved by the action or inaction of the department, including any county department of family and children services, shall be entitled to a hearing. Each ap…
O.C.G.A. § 49-4-14 Regulations as to records; use or disclosure of information; penalty
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(a) The board is directed to prescribe regulations governing the custody, use, and preservation of the records, papers, files, and communications of the Department of Human Services, including the county departments, relating to public assistance. Except as otherwise provided in t…
O.C.G.A. § 49-4-140 Short title
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The short title for this article shall be the “Georgia Medical Assistance Act of 1977.” History. Ga. L. 1977, p. 384, § 2.
O.C.G.A. § 49-4-141 Definitions
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As used in this article, the term: (1) “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 acte…
O.C.G.A. § 49-4-142.1 Legislative notification of request for waiver
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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 95 …
O.C.G.A. § 49-4-142.2 COUNTY TAX COLLECTORS
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Credit card payment, §50-1-6. Payment of taxes. Credit card payment, §50-1-6. COSTS. Medicaid, false claims. Actions by private person, §49-4-168.2. Civil penalties, §49-4-168.1. COUNTY TAX RECEIVERS. Credit card payment, §50-1-6. Payment of taxes. Credit card payment, §50-1-6. C…
O.C.G.A. § 49-4-142.5 Waiver request allowing Medicaid reimbursement
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(a) 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 rei…
O.C.G.A. § 49-4-143 Power of Board of Community Health; Board of Medical Assistance abolished
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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 bo…
O.C.G.A. § 49-4-144 Chief administrative officer; powers and duties
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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 …
O.C.G.A. § 49-4-146 Time for action on claim
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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.
O.C.G.A. § 49-4-146.3 Medical assistance, §49-4-141
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Medical institutions. Aid to the blind, §49-4-51. Aid to the disabled, §49-4-80. Old-age assistance, §49-4-31. Medically necessary services. Therapy services for children with disabilities, §49-4-169.1. Medical model. Licenses for adult day care centers, §49-6-82. Members at larg…
O.C.G.A. § 49-4-147 Audits
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Obtaining information for audit, §49-4-151. Biomarker testing for Medicaid recipients, §49-4-159.3. Board of community health. Compensation of members, §49-4-143. Creation, §49-4-143. Definition of board, §49-4-141. Members, §49-4-143. Quorum, §49-4-143. Records. Regulations as to…
O.C.G.A. § 49-4-147.2 Duties, §49-4-154
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Family supplementation of medicaid payments. Submission of plan upon federal removal of restrictions, §49-4-149.1. Interest.
O.C.G.A. § 49-4-148 Health care coverage pilot projects
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Authority to establish, §49-4-152. Home and community based services. Rates for provider reimbursement for home and community based services covered by certain programs. Comprehensive review, §49-4-142.4. Development of proposed rate models, §49-4-142.4. 941 INDEX MEDICAID —Cont’…
O.C.G.A. § 49-4-149 Interest
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Department of community health. Noneligibility to obtain or be liable for certain interest, §49-4-147.2. Interpretation and construction. Federal social security act. Construction of provisions with federal act, §49-4-157. Investigations. Department of community health. Violation…
O.C.G.A. § 49-4-149.1 Fees
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Drug application fees, §49-4-142. Forfeiture of property and proceeds. Medicaid fraud, §49-4-146.3. Fraud, §49-4-15. Errors or omissions in reporting by providers. Not, without more, to constitute fraud, §49-4-151.1. False claims, §§49-4-168 to 49-4-168.6. Financial records. Exam…
O.C.G.A. § 49-4-15.1 Examination of financial records in instances of alleged fraud
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The department may examine any books, papers, or memoranda reflecting the income of, or financial records bearing upon the determination of the eligibility of, recipients in instances of alleged fraud by recipients of food stamps and public assistance. This process may be implement…
O.C.G.A. § 49-4-150 State auditor
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Access by state auditor to confidential information, §50-6-29. Vocational rehabilitation services, §49-9-18. Welfare.
O.C.G.A. § 49-4-151 Obtaining information for investigations and audits
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(a) The commissioner, for the purposes of investigating the nature, amount, and extent of services provided to a recipient of medical assistance or auditing information submitted to the department concerning a provider’s entitlement to an amount of medical assistance, is authoriz…
O.C.G.A. § 49-4-152 Rules and regulations
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Succession to existing rules and regulations, §49-4-155. State plan. Adoption, administration and modification of plan, §49-4-142. Subrogation. Recipients’ insurance claims, §49-4-149. Third party liability as to payment of medical assistance, §49-4-148. Succession to existing rul…
O.C.G.A. § 49-4-152.3 Reuse of unit dosage drugs
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(a) As used in this Code section, the term: (1) “Long-term care facility” or “facility” means an intermediate care home, skilled nursing home, or intermingled home subject to regulation as such by the Department of Community Health. (2) “Unit dosage drug” means any dangerous drug…
O.C.G.A. § 49-4-152.4 Providers
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Defined, §49-4-146.1. Errors or omissions in reporting by providers. Fraud not found from errors or omissions not resulting in improper payment, §49-4-151.1. Rejection of correction, grounds, §49-4-151.1. Time to correct errors, §49-4-151.1. Withholding of payments. Hearing, §49-4…
O.C.G.A. § 49-4-152.5 Restocking fees
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In the provision of medical assistance pursuant to this article, the department shall allow for the payment and coverage of appropriate restocking fees incurred by a pharmacy which receives and dispenses unused over-the-counter and prescription drugs pursuant to Article 10 of Cha…
O.C.G.A. § 49-4-152.6 Medicaid coverage for mood disorders prescriptions
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(a) 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…
O.C.G.A. § 49-4-153 Hearings and appeals; judicial review
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(a) 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. (b)(1) Any applicant for medical assistance whose application is denied or is not acted upon wit…
O.C.G.A. § 49-4-155 Third parties
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Lien against third parties, §49-4-149. Violations of provisions.
O.C.G.A. § 49-4-156.1 Department of human services
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Annual progress report, §49-6-62. Rules and regulations, §49-6-64. Insurance. Volunteers. Coverage, §49-6-63. 869 INDEX AGED PERSONS —Cont’d Community care and services for the elderly —Cont’d Lead agency. Defined, §49-6-61. Duties, §§49-6-62, 49-6-63. Legislative declaration, §49…
O.C.G.A. § 49-4-157 Construction of this article with federal act
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It is the intention of the General Assembly that this article be construed consistently with Title XIX of the federal Social Security Act of 1935, as amended, and so as to authorize the Department of Community Health, within the appropriations provided to it, to administer the st…
O.C.G.A. § 49-4-158 Pregnancy
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Coverage for lactation and postpartum care, §49-4-159. Third party claims, §49-4-148. Time for action on claim, §49-4-146. Time limitations, §49-4-145. Unlawful acts, §49-4-146.1. Commissioner of community public health. Appointment, §49-4-144. Creation of position, §49-4-144. De…
O.C.G.A. § 49-4-159 Medicaid coverage for lactation and postpartum care
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(a) The department shall provide Medicaid coverage for: (1) Lactation care and services, as defined in paragraph (5) of Code Section 43-22A-3, to pregnant and lactating women and to children who are breastfeeding or receiving their mother’s milk; and 136 49-4-159.1 (2) Postpartum …
O.C.G.A. § 49-4-159.3 Biomarker testing for Medicaid recipients
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(a) As used in this Code section, the term: (1) “Biomarker” means a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention. Such term includes…
O.C.G.A. § 49-4-16 Aid to the blind, §49-4-52
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Aid to the disabled, §49-4-81. Disregarding of reserves, income and resources, §49-4-6. Old-age assistance, §49-4-32. Residence in state as affecting, §49-4-4. Residence sold by government action.
O.C.G.A. § 49-4-160 Short title
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This article shall be known and may be cited as the “Georgia Long-term Care Partnership Program Act.” History. Code 1981, § 49-4-160, enacted by Ga. L. 2005, p. 823, § 1/HB 643; Ga. L. 2006, p. 72, § 49/SB 465.
O.C.G.A. § 49-4-161 Definitions
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As used in this article, the term: (1) “Asset disregard” means, with regard to state Medicaid benefits, the disregard of any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a qualified …
O.C.G.A. § 49-4-164 Martin Luther King, Jr
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advisory council. Reports. Duties of council, §50-8-241. Medicaid. Remote maternal health clinical services, §49-4-159.2. Metropolitan area planning and development commissions. Annual report, §50-8-100. Minors. Children and adolescents with severe emotional problems. Commissione…
O.C.G.A. § 49-4-165 Notice to consumers
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(a) 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. 144 49-4-168 (b) The notice to the consumer under subsection (a) of this Code section shal…
O.C.G.A. § 49-4-168 Definitions
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As used in this article, the term: (1) “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 progra…
O.C.G.A. § 49-4-168.2 CONFLICTS OF LAW
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Child abuse and neglect. Records. Confidentiality. Provisions not to conflict with federal law, §49-5-43. CONTRABAND. Juvenile justice. Guard lines. Crossing with prohibited items, §49-4A-16. Possession of prohibited items by juvenile detainee, §49-4A-18. Taking prohibited items in…
O.C.G.A. § 49-4-168.3 Standard of proof; procedure; intervention by Attorney General
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(a) 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. (b) Except as otherwise provided in …
O.C.G.A. § 49-4-168.4 Filing claims for assistance, §49-4-148
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LIMITED LIABILITY COMPANIES. Unmarried persons. Benefits, rights or privileges provided to married persons. Election to contractually provide such benefits, §50-1-8. LIVE OAK. State tree, §50-3-55. LOANS. Metropolitan area planning and development commissions. Authorization to acce…
O.C.G.A. § 49-4-168.5 Statute of limitations
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All civil actions under this article shall be filed pursuant to Code Section 49-4-168.2 within six years after the date the violation was committed, or four years after the date when facts material to the right of civil action are known or reasonably should have been known by the …
O.C.G.A. § 49-4-168.6 Venue
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All civil actions brought against natural persons under this article shall be brought in the county where the defendant or, in the case of multiple defendants or of defendants who are not residents of the State of Georgia, in any county where any one defendant resides, can be fou…
O.C.G.A. § 49-4-169 Legislative findings and intent
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The General Assembly finds that changes in the approval process of certain health care programs have made it difficult for children with disabilities who are eligible for medical assistance pursuant to Article 7 of this chapter to receive the services to which they are entitled wi…
O.C.G.A. § 49-4-169.1 Definitions
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As used in this article, the term: (1) “Correct or ameliorate” means to improve or maintain a child’s health in the best condition possible, compensate for a health problem, prevent it from worsening, prevent the development of additional health problems, or improve or maintain a…
O.C.G.A. § 49-4-169.2 Eligibility
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Expansion through increase in income threshold, §49-4-142.2. Express lane eligibility. State plan amendment to implement, §49-4-159.1. Errors or omissions in reporting by providers. Fraud not found from errors not resulting in improper payments, §49-4-151.1. Rejection of correcti…
O.C.G.A. § 49-4-169.3 State plan
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Defined, §49-4-141. Department of community health. Adoption, administration and modification of plan, §49-4-142. Subpoenas. Information for investigations and audits, §49-4-151. Subrogation. Department of community health. Subrogation to recipients’ insurance claims, §49-4-149. Th…
O.C.G.A. § 49-4-17 Short title
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Definitions. Establishment of categories of public assistance; powers and duties in administration of article. Residency requirements for public assistance. Determining amount of public assistance. Reserves, income, and resources to be disregarded. Receipt of compensation for resi…