05 LC 34
0188
Senate
Bill 128
By: Senators Miles of the 43rd, Butler of the 55th, Fort of the 39th, Seay of the 34th, Henson of the 41st and others
By: Senators Miles of the 43rd, Butler of the 55th, Fort of the 39th, Seay of the 34th, Henson of the 41st and others
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Article 2 of Chapter 8 of Title 31 of the Official Code of Georgia
Annotated, relating to hospital care for nonresident indigents, so as to provide
further legislative findings; to provide for alternative procedures and sources
of funding for reimbursing hospitals; to provide for related matters; to provide
an effective date; to repeal conflicting laws; and for other
purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Article
2 of Chapter 8 of Title 31 of the Official Code of Georgia Annotated, relating
to hospital care for nonresident indigents, is amended by striking Code Section
31_8_30, relating to legislative findings, and inserting in lieu thereof the
following:
"31_8_30.
The
General Assembly finds that there is an inequitable distribution of the public
costs incurred in providing health care for indigent persons who receive such
care outside their counties of residence.
While some
hospitals receive significant financial support from their counties for the
provision of indigent care, other hospitals, often those with the greatest need,
receive no financial support from their counties. This results in a disparity
of treatment and inequitable access to hospital and health care services among
the state´s indigent population, forcing many indigent persons to seek such
services in other counties. Those
The
publicly supported hospitals
in other
counties providing such health care
services to
nonresident indigent persons are
frequently not reimbursed for the costs thereby incurred, which either
unfairly
increases the tax burden of citizens
supporting
such hospitals
residing in
such other counties or
unfairly
increases the charges made to paying patients
of such
hospitals or causes a combination of both
types of such increases. It is the purpose of this article to recognize and
provide for the state´s
and
counties´ responsibility to assist in
the payment of cost of care for nonresident indigent patients by providing
procedures for the reimbursement of such costs from state
or
county
funds."
SECTION
2.
Said
article is further amended by striking paragraph (5) of Code Section 31_8_31,
relating to the definitions, and inserting in lieu thereof the
following:
"(5)
'Health care' means the following services for nonresident inpatients and
outpatients:
(A)
Emergency care or treatment;
(B)
Treatment for conditions of pregnancy and treatment of the newborn infant from
the time of birth until the time of discharge from the hospital;
(C)
Treatment for a potentially disabling illness or injury
when
treatment for such illness or injury is not available for indigent patients in
the county of residence of the patient;
and
(D)
Treatment for any combination of the
foregoing."
SECTION
3.
Said
article is further amended by striking subsections (c) through (f) of Code
Section 31_8_32, relating to the determination of indigency, and inserting in
lieu thereof the following:
"(c)(1)
When a nonresident patient receives health care from a hospital and when such
patient claims inability to pay cost of care because of indigency, the chief
administrative officer of the hospital
or his or her
designee shall notify, in writing, the
health care advisory officer of the county of residence of the patient. Such
notification shall request a determination of indigency of the patient. As soon
as practicable after receiving such notification but not later than 30 days
thereafter, the health care advisory officer of the county shall notify the
chief administrative officer of the hospital of his
or
her determination.
(2)
If the health care advisory officer determines that the patient is indigent,
such notification shall constitute a certification of such indigency, and the
expenditures
for cost of care of such nonresident
indigent patient shall be
paid to the
hospital in the manner provided in this article and shall
be maintained on the records of the
hospital for the purposes of Code Section 31_8_34.
(3)
If the health care advisory officer determines the patient is not indigent
according to the standards promulgated pursuant to subsection (a) of this Code
section, the hospital submitting the request may appeal such determination to
the commissioner, providing the commissioner with all appropriate documentation
supporting its request. The commissioner shall notify the chief administrator
of the hospital of his or her determination on appeal as soon as practicable
after receiving such appeal request but not later than 30 days thereafter. If
the commissioner determines on appeal that the patient is indigent, the cost of
care of such nonresident indigent patient shall be paid to the hospital in the
manner provided in this article.
(d)
If the health care advisory officer of a county fails to respond to a request
for a determination of indigency from a hospital providing health care for such
patient within the time limitation provided by subsection (c) of this Code
section, the county of residence of the patient shall be liable for the payment
of cost of care of such patient. In such event, the hospital providing health
care for the nonresident patient may bill the county of residence of the patient
for the amount of his
or
her cost of care, and it shall be the duty
of the governing authority of such county to pay the hospital the amount billed
within 30 days
of the county´s receipt of such bill. If the county fails to make such
payment within 30 days of receipt, interest shall accrue on any unpaid amount at
the legal rate of interest provided in Code Section
7_4_2.
(e)(1)
In the event a hospital fails for any reason to receive payment for the cost of
care rendered to a nonresident indigent within 90 days of a county´s
receipt of the hospital´s request for a determination of indigency or if
the payment is disputed and said payment is not received from either the fund or
the county determined by the hospital to be responsible for such payment within
such 90 days, the hospital shall certify to the Comptroller General the unpaid
amount.
(2)
The Comptroller General shall have no longer than 45 days from the date of
receiving the hospital´s certified notice to forward the unpaid amount to
the appropriate hospital from any funds due to the county under any
revenue_sharing or tax_sharing fund or grant established, collected,
distributed, or administered by the state notwithstanding the statutory purposes
designated for such fund or grant, including but not limited to those grants and
special revenue disbursements authorized pursuant to Code Sections 48_14_1 and
48_14_2, those grants to counties for construction and maintenance of county
roads under Article 2 of Chapter 17 of Title 36, funds payable under the county
appraisal staff grant program specified in Code Section 48_5_267, the public
road grant program specified in Code Section 48_14_3, the state grants or loans
for storm_water related projects specified in Code Section 12_5_582, and any
fees, charges, or taxes imposed on insurance companies on behalf of counties
pursuant to Chapter 8 of Title 33, except as otherwise provided by the state
Constitution. If the Comptroller General fails to make such payment within such
45 days, interest shall accrue on any unpaid amount at the legal rate of
interest provided in Code Section 7_4_2. The Comptroller General shall provide
the Governor and the Appropriations Committees in the House of Representatives
and the Senate with a quarterly accounting of the amounts certified by hospitals
as owed by counties and the amount paid to hospitals out of any revenue_sharing
or tax_sharing funds or grants due to the county.
(e)(f)
To the end that the certifications of indigency required by subsection (c) of
this Code section may be expedited, it shall be the duty of each county health
care advisory officer to establish and maintain files showing the names of
county residents determined to be indigent.
(f)(g)
It shall be the duty of the commissioner to devise such standard forms as may be
necessary or desirable to administer this Code section uniformly. It shall be
the duty of counties, health care advisory officers, and hospitals to use the
forms promulgated by the commissioner pursuant to this
subsection."
SECTION
4.
Said
article is further amended by striking Code Section 31_8_33, relating to the
Nonresident Indigent Health Care Fund, and inserting in lieu thereof the
following:
"31_8_33.
There
is created the Nonresident Indigent Health Care Fund for the purpose of making
payments therefrom to hospitals to reimburse such hospitals for the cost of care
of nonresident indigent patients. Such fund shall be made up of appropriations
made thereto by the General Assembly, as provided in this article.
To the extent
there are for any reason insufficient moneys in the fund to pay any of the
financial obligations created by this article, such obligations shall be paid by
the Comptroller General in the manner provided in subsection (e) of Code Section
31_8_32."
SECTION
5.
Said
article is further amended by inserting at the end thereof a new Code Section
31_8_38 to read as follows:
"31_8_38.
Any
county´s total liability under this article for any year shall not exceed
the amount which could be derived by the county from a one mill ad valorem tax
levy for that year, regardless of whether that amount is actually derived from
such tax or any other tax. Amounts paid by a county for interest, penalties,
attorneys´ fees, or court costs arising under this article shall be
excluded from any calculation of a county´s total amount of liability.
Notwithstanding the foregoing, the total liability of a county under this
article shall be reduced by an amount equal to the amount of any payment made by
such county during such year to any hospital located in such county to support
the services and facilities of such hospital, as well as the proceeds of any ad
valorem tax levied by such county pursuant to Code Section 31_7_84 and paid to
such hospital or hospital authority during such year. Nothing in this Code
section shall be construed to be a limitation upon a county´s authority to
levy a tax or spend for any health care services in an amount greater than that
provided in this Code section. A county shall not satisfy its liability under
this article by making lump sum payments, aggregate payments, or prepayments to
any hospital located outside such county, nor by entering into an exclusive
contract with any such hospital, unless such hospital is owned or operated by a
hospital authority created in whole or part by the paying
county."
SECTION
6.
This
Act shall become effective upon its approval by the Governor or upon its
becoming law without such approval.
SECTION
7.
All
laws and parts of laws in conflict with this Act are repealed.