05 LC 33
0691/AP
House
Bill 392 (AS PASSED HOUSE AND SENATE)
By:
Representatives Brown of the
69th,
Harbin of the
118th,
Keen of the
179th,
and Cooper of the
41st
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Chapter 8 of Title 31 of the Official Code of Georgia, relating to
indigent and elderly patients, so as to provide for a quality assessment fee on
care management organizations to be used to obtain federal financial
participation for medical assistance payments; to provide for authority; to
provide for definitions; to establish a segregated account within the Indigent
Care Trust Fund for the deposit of assessment fees; to provide for a method for
calculating and collecting the assessment fees; to authorize the Department of
Community Health to inspect records of care management organizations; to provide
for penalties for failure to pay an assessment fee; to provide for the
collection of assessment fees by civil action and tax liens; to provide for the
appropriation of funds in the segregated account for medical assistance
payments; to provide for application of the "Georgia Medical Assistance Act of
1977"; to provide for related matters; to provide for an effective date; to
repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Chapter
8 of Title 31 of the Official Code of Georgia Annotated, relating to indigent
and elderly patients, is amended by adding a new Article 6B to read as
follows:
"ARTICLE
6B
31-8-170.
This
article is passed pursuant to the authority of Article III, Section IX,
Paragraph VI(i) of the Constitution.
31-8-171.
As
used in this article, the term:
(1)
'Care management organization' means an entity granted a certificate of
authority under Chapter 21 of Title 33 of the Official Code of Georgia Annotated
and which meets the definition found in 42 U.S.C. Sec. 1396b(w)(7)(A)(viii) as
it now exists or as it may be amended in the future.
(2)
'Department' means the Department of Community Health created by Chapter 5A of
this title.
(3)
'Gross direct premium' shall have the meaning that the term has in Chapter 8 of
Title 33 of the Official Code of Georgia Annotated.
(4)
'Quality assessment fee' means the fee imposed pursuant to this article for the
privilege of operating a care management organization.
(5)
'Segregated account' means an account for the dedication and deposit of provider
fees which is established within the Indigent Care Trust Fund created pursuant
to Code Section 31-8-152.
(6)
'Trust fund' means the Indigent Care Trust Fund created pursuant to Code Section
31-8-152.
31-8-172.
There
is established within the trust fund a segregated account for revenues raised
through the imposition of the quality assessment fee. All revenues raised
through such fees shall be credited to the segregated account within the trust
fund and shall be invested in the same manner as authorized for investing other
moneys in the state treasury. Contributions and transfers to the trust fund
pursuant to Code Sections 31-8-153 and 31-8-153.1 shall not be deposited into
the segregated account.
31-8-173.
(a)
Each care management organization shall be assessed a quality assessment fee, in
an amount to be determined by the department based on anticipated revenue
estimates included in the state budget report, with respect to its gross direct
premiums for the preceding quarter. The quality assessment fee shall be assessed
uniformly upon all care management organizations. The aggregate quality
assessment fees imposed under this article shall not exceed the maximum amount
that may be assessed pursuant to the 6 percent indirect guarantee threshold set
forth in 42 C.F.R. Section 433.68(f)(3)(i).
(b)
The quality assessment fee shall be paid quarterly by each care management
organization to the department. A care management organization shall calculate
and report its gross direct premiums upon a form prepared by the department and
submit therewith payment of the quality assessment fee no later than the
thirtieth day following the end of each calendar quarter. The initial quality
assessment fee report shall be filed and the initial payment of the quality
assessment fee shall be submitted no later than April 30, 2006. A care
management organization shall calculate and report the initial quality
assessment fee using information about its gross direct premiums for the quarter
ending March 31, 2006.
31-8-174.
(a)
The department shall collect the quality assessment fees imposed pursuant to
Code Section 31-8-173. All revenues raised pursuant to this article shall be
deposited into the segregated account. Such funds shall be dedicated and used
for the sole purpose of obtaining federal financial participation for medical
assistance payments to one or more providers pursuant to Article 7 of Chapter 4
of Title 49 or for purposes as authorized for expenditures from the trust
fund.
(b)
The department shall prepare and distribute a form upon which a care management
organization shall calculate and report to the department the quality assessment
fee.
(c)
Each care management organization shall keep and preserve for a period of five
years such books and records as may be necessary to determine the amount for
which it is liable under this article. The department shall have the authority
to inspect and copy the records of a care management organization for purposes
of auditing the calculation of the quality assessment fee. All information
obtained by the department pursuant to this article shall be confidential and
shall not constitute a public record; provided, however, that information
otherwise available to the public shall not become confidential solely because
it has been obtained by the department.
(d)
In the event that the department determines that a care management organization
has underpaid or overpaid the quality assessment fee, the department shall
notify the care management organization of the balance of the quality assessment
fee or refund that is due. Such payment or refund shall be due within 30 days of
the
department́s
notice.
(e)
Any care management organization that fails to pay the quality assessment fee
pursuant to this article within the time required by this article shall pay, in
addition to the outstanding quality assessment fee, a 6 percent penalty for each
month or fraction thereof that the payment is overdue. If a quality assessment
fee has not been received by the department by the last day of the month, the
department shall withhold an amount equal to the quality assessment fee and
penalty owed from any medical assistance or other payment due such care
management organization under the Medicaid program. The quality assessment fee
levied by this article shall constitute a debt due the state and may be
collected by civil action and the filing of tax liens in addition to such
methods provided for in this article. Any penalty that accrues pursuant to this
subsection shall be credited to the segregated account.
31-8-175.
(a)
Notwithstanding any other provision of this chapter, the General Assembly is
authorized to appropriate as state funds to the department for use in any fiscal
year all revenues dedicated and deposited into the segregated account. Such
appropriations shall be made for the sole purpose of obtaining federal financial
participation in the provision of health care services pursuant to Article 7 of
Chapter 4 of Title 49 or for purposes as authorized for expenditures from the
trust fund. Any appropriation from the segregated account for any purpose other
than medical assistance payments shall be void.
(b)
Revenues appropriated to the department pursuant to this Code section shall be
used to match federal funds that are available for the purpose for which such
trust funds have been appropriated.
(c)
Appropriations from the segregated account to the department shall not lapse to
the general fund at the end of the fiscal year.
31-8-176.
The
department shall report annually to the General Assembly on its use of revenues
deposited into the segregated account and appropriated to the department
pursuant to this article.
31-8-177.
Except
where inconsistent with this article, the provisions of Article 7 of Chapter 4
of Title 49, the 'Georgia Medical Assistance Act of 1977,' shall apply to the
department in carrying out the purposes of this
article."
SECTION
2.
This
Act shall become effective on July 1, 2005.
SECTION
3.
All
laws and parts of laws in conflict with this Act are repealed.