reglab/housing_qa huggingface dataset:
GA Code § 49-4-151 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-151. Obtaining Information for Investigations and Audits

  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 authorized, personally or by his duly authorized representative, to administer oaths and to examine and copy books, papers, records (medical, business, or otherwise), or memoranda of a provider or of any other person possessed of information relating to reimbursable costs claimed by a provider or otherwise relating to the amount of medical assistance to which a provider is entitled. The commissioner may compel such examinations by means of subpoenas issued to require the custodian of such items to produce them for examination. A subpoena may be served by any sheriff, by his deputy, or by any other person not less than 18 years of age. Proof may be shown by return of certificate endorsed on a copy of the subpoena. Subpoenas may also be served by registered or certified mail or statutory overnight delivery, and the return receipt shall constitute prima-facie proof of service. If any person shall fail to obey a subpoena issued and served under this subsection, then upon application of the commissioner, the superior court of the county in which such custodian was required to appear may issue an order requiring such custodian to comply with the subpoena and to produce the subpoenaed documentation. Furthermore, if any provider shall fail to obey a subpoena issued and served under this subsection with respect to any matter concerning a claim for medical assistance, that claim for medical assistance shall not be reimbursed by the Department of Community Health; and, if already reimbursed, the amount of medical assistance reimbursed shall be deducted from any amount of medical assistance which may then be or thereafter become payable to such provider.   In the course of conducting investigations and audits, the Department of Community Health may request from any governmental department, board, commission, bureau, or agency information and assistance pertinent thereto. The Department of Community Health shall be entitled to have access to all such pertinent information which is within the custody of any governmental department, board, commission, bureau, or agency.    (Ga. L. 1977, p. 384, § 10; Ga. L. 1999, p. 296, § 24; Ga. L. 2000, p. 1589, § 3.)
GA Code § 49-4-151.1 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-151.1. Errors or Omissions in Reporting; Right to Hearing; Exclusion

  Any clerical or record-keeping error, including but not limited to a typographical error, scrivener's error, or computer error; any unintentional error or omission in billing, coding, or required documentation; or any isolated instances of incomplete documentation by a provider of medical assistance regarding reimbursement for medical assistance may not in and of itself constitute fraud or constitute a basis to recoup payment for medical assistance provided, so long as any such errors or instances do not result in an improper payment. An improper payment includes any payment that was made to an ineligible recipient, payment for noncovered services, duplicate payments, payments for services not received, payments that are for the incorrect amount, and instances when the department is unable to discern whether a payment was proper because of insufficient or lack of documentation. The department or its agents shall not recoup the cost of medical assistance if such error, omission, or incomplete documentation has been resolved in accordance with subsection (b) of this Code section; provided, however, that recoupment shall be allowed to the extent that the error, omission, or incomplete documentation resulted in an improper payment, though recoupment shall be limited to the amount improperly paid.   A provider of medical assistance shall be allowed 30 calendar days following receipt by the provider of a preliminary audit review report in which to submit records or documents to correct an error or omission or to complete documentation identified in such review report; provided, however, that the department or its agents, in the discretion of the department, may reject the submission of a corrected record or document if the submission would result in an improper payment, or the provider demonstrates a pattern of repeated errors, omissions, or incomplete documentation. The department shall be authorized to establish rules and regulations delineating what constitutes a pattern of repeated errors, omissions, or incomplete documentation taking into consideration the type of provider; frequency of audits; volume of claims submitted by a provider; type of error, omission, or incomplete documentation; and other pertinent factors.   A provider of medical assistance shall be afforded the right to a hearing in accordance with Code Section 49-4-153 for any attempted withholding of reimbursement or recoupment by the department or its agents relating to an error, omission, incomplete documentation, or improper payment relating to the provision of medical assistance.   This Code section shall not apply to criminal or civil investigations which involve fraud, willful misrepresentation, reckless disregard, or abuse conducted by the Attorney General's Medicaid Fraud Control Unit or other law enforcement agencies.     (Code 1981, §49-4-151.1, enacted by Ga. L. 2017, p. 219, § 2/HB 206.)
GA Code § 49-4-152 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-152. Research and Demonstration Projects; Pilot Projects to Provide Health Care Coverage and Essential Health Care Services; Pharmacy Assistance Programs

 Subject to the availability of funds, the Department of Community Health is authorized to enter into agreements with and submit applications to departments and agencies of the government of the United States for purposes of accepting grants, receiving matching funds, and administering such grants and funds for research and demonstration projects pursuant to Title XI, XVIII, XIX, or XXI of the federal Social Security Act of 1935, as amended, or any other provision of federal law, without regard to the factor of state wideness and such other factors as may be required to be waived by the terms of the federal grant. Notwithstanding any other provision of law and subject to the availability of funds, the department is authorized to establish pilot projects to provide health care coverage and access to essential health care services or benefits to the uninsured and underinsured, including but not limited to pharmacy assistance programs.   (Ga. L. 1977, p. 384, § 11; Ga. L. 1999, p. 296, § 24; Ga. L. 2001, p. 1240, § 9.)   Code Commission notes.   - Pursuant to Code Section 28-9-5, in 1986, a hyphen between "state" and "wideness" was deleted in the first sentence.   Pursuant to Code Section 28-9-5, in 2001, "Title" was substituted for "Titles" in the first sentence of this Code section.   U.S. Code.   - Titles XI, XVIII, XIX, and XXI of the federal Social Security Act of 1935, referred to in this Code section, are codified at 42 U.S.C. §§ 1320d et seq., 42 U.S.C. § 1395, 42 U.S.C. § 1396 (XIX and XXI), respectively.
GA Code § 49-4-152.2 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-152.2. Rebates for Sole-Source and Multiple-Source Drugs Included in Controlled Medical Assistance Drug List

  The department is authorized to negotiate and enter into agreements directly with manufacturers and distributors whose prescription drug products are sold in the state for sole-source and multiple-source drugs to be paid for under the state plan for eligible recipients under this article.Such agreements shall provide for a periodic rebate of a negotiated percentage of the total product cost to be paid by the manufacturer or distributor of a specific product covered under the state plan.   Prescription drug products shall be included in the Controlled Medical Assistance Drug List only upon satisfaction and completion of the application and approval process established by the department.Those products for which a rebate has been successfully negotiated shall automatically be included in the Controlled Medical Assistance Drug List for a period of time conterminous with the negotiated rebate.   If there has been a failure to negotiate or renew a rebate agreement for a specific prescription drug product, the pharmaceutical manufacturer or distributor of that product shall disclose to the department its most favorable pricing arrangements available to state and nonstate government purchasers of such products.If the department determines that the product needs to be included in the Controlled Medical Assistance Drug List, the department shall establish the amount of the rebate for such product based upon the price information provided by the manufacturer or distributor.The determination as to whether a product should be included in the Controlled Medical Assistance Drug List shall be based upon the product's efficacy, cost, medical necessity, and safety.   The provisions of this Code section shall be construed in conformity with Code Section 49-4-157.     (Code 1981, §49-4-152.2, enacted by Ga. L. 1990, p. 1808, § 2; Ga. L. 2013, p. 141, § 49/HB 79.)    The 2013 amendment,  effective April 24, 2013, part of an Act to revise, modernize, and correct the Code, revised language in the last sentence of subsection (b).
GA Code § 49-4-152.3 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-152.3. Reuse of Unit Dosage Drugs

  As used in this Code section, the term:   "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.   "Unit dosage drug" means any dangerous drug regulated under Chapter 13 of Title 16 which is individually packaged to contain only one dosage of such drug and which includes on such packaging the brand or generic name, strength, lot number, and expiration date of such drug.     Unit dosage drugs may be returned to the dispensing pharmacy for reuse. The department and the State Board of Pharmacy shall promulgate regulations which permit the reuse of prescribed but unused unit dosage drugs for a resident of a long-term care facility other than the resident for whom the drug was originally prescribed, but only when:   The cost of those drugs has been paid for or reimbursed under this article; and   The drugs are unused because the resident for whom the drugs were originally prescribed:   Has died;   Has had such resident's prescription changed so as no longer to require those drugs; or   Otherwise no longer needs those drugs.  The consent of the resident for whom the unused drugs were originally prescribed shall not be required for such reuse of prescribed unit doses. Such reuse shall only be authorized by a resident of a long-term care facility for whom the specific dosage of that unused drug has been prescribed when payment or reimbursement for that drug for that resident is otherwise permitted under this article. Nothing in this Code section shall require a pharmaceutical manufacturer to provide a rebate based on the reuse of any unused unit dosage drug.          (Code 1981, §49-4-152.3, enacted by Ga. L. 1997, p. 939, § 1; Ga. L. 2009, p. 453, § 1-4/HB 228.)
GA Code § 49-4-152.4 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-152.4. Department Contracts to Require Refund of Prescription Drug Rebates

 The department shall provide that any department contract with a provider of medical assistance which is renewed or executed on or after July 1, 1997, shall require a refund to the department of any prescription drug rebate, as established in this article or in federal law in Section 1927 of Title XIX of the Social Security Act, as amended, obtained by the provider for prescription drugs furnished to recipients of medical assistance pursuant to that contract.    (Code 1981, §49-4-152.4, enacted by Ga. L. 1997, p. 1385, § 1.)   Code Commission notes.   - Pursuant to Code Section 28-9-5, in 1997, this Code section, enacted as Code Section 49-4-152.3, was redesignated as Code Section 49-4-152.4.   U.S. Code.   - Section 1927 of Title XIX of the Social Security Act, referred to in this Code section, is codified at 42 U.S.C. § 1396r-8.
GA Code § 49-4-152.5 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-152.5. Restocking Fees

 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 Chapter 8 of Title 31.    (Code 1981, §49-4-152.5, enacted by Ga. L. 2006, p. 152, § 2/HB 1178; Ga. L. 2009, p. 8, § 49/SB 46; Ga. L. 2016, p. 524, § 3/HB 897.)    The 2016 amendment,  effective July 1, 2016, substituted "unused over- the-counter and prescription drugs pursuant to Article 10 of Chapter 8 of Title 31" for "prescription drugs pursuant to Article 11 of Chapter 4 of Title 26, the 'Utilization of Unused Prescription Drugs Act'" at the end of this Code section.   Law reviews.   - For article on 2006 enactment of this Code section, see 23 Ga. St. U.L. Rev. 197 (2006).
GA Code § 49-4-154 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-154. Powers and Duties Retained by Department of Human Resources (Department of Community Health)

  The status, position, and rights of persons transferred from the Department of Human Resources (now known as the Department of Community Health for these purposes) to the Department of Medical Assistance pursuant to Ga. L. 1977, p. 384 shall not be affected by the transfer, in and of itself; and such persons shall retain, inter alia, all rights of rank or grade; rights to vacation, sick pay, and leave; rights under any retirement plan; and any other rights under any law or administrative policy.   The Department of Human Resources (now known as the Department of Community Health for these purposes) shall retain, in accordance with terms of the state plan, the functions, and all tangible things and employees relating thereto, of:   Establishing and maintaining certain standards for certain institutions and agencies seeking to become or remain providers and shall finally determine and certify whether such institutions and agencies meet such standards;   Determining and certifying the eligibility of certain applicants for and recipients of medical assistance; and   Prescribing regulations to require that applicants for medical assistance be given clear and easily understandable notice that all books, papers, records, and memoranda of the provider relating to the provision of medical assistance to the applicant will be made available, upon request, to the commissioner of medical assistance or his representative and that, by accepting medical assistance, the applicant thereby consents to the providing of such books, papers, records, and memoranda to the commissioner of medical assistance or his representative.      (Ga. L. 1977, p. 384, § 13; Ga. L. 1994, p. 97, § 49; Ga. L. 2009, p. 453, § 1-54/HB 228.)
GA Code § 49-4-155 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-155. Department of Community Health to Succeed to Existing Rules, Regulations, Policies, Procedures, and Administrative Orders

 The Department of Community Health shall succeed to all the rules, regulations, policies, procedures, and administrative orders of the Department of Human Resources (now known as the Department of Human Services) transferred to the Department of Medical Assistance pursuant to the previously existing provisions of this Code section and that are in effect on June 30, 1999, and shall further succeed to any rights, privileges, entitlements, obligations, and duties of the Department of Human Resources (now known as the Department of Human Services) that are in effect on June 30, 1999, to which the Department of Medical Assistance succeeded pursuant to the previously existing provisions of Code Section 49-4-156.   (Ga. L. 1977, p. 384, § 14; Ga. L. 1999, p. 296, § 20; Ga. L. 2009, p. 453, § 1-55/HB 228.)
GA Code § 49-4-156 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-156. Tax Exemption for Health Maintenance Organizations With Respect to Contracts Pursuant to This Article

 Reserved. Repealed by Ga. L. 2010, p. 125, § 1, effective July 1, 2010.   Editor's notes.   - This Code section was based on Code 1981, § 49-4-156, enacted by Ga. L. 2005, p. 1438, § 3/SB 140.
GA Code § 49-4-156.1 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-156.1. Reimbursement for Services Rendered Under Article 5 of Chapter 6 of This Title

 It is the intention of the General Assembly that the Department of Community Health be authorized to take those actions necessary to provide reimbursement under this article for services rendered under Article 5 of Chapter 6 of this title, relating to community care for the elderly.    (Ga. L. 1982, p. 2248, § 2; Code 1981, §49-4-156.1, enacted by Ga. L. 1982, p. 2248, § 3; Ga. L. 1999, p. 296, § 24.)   Code Commission notes.   - Pursuant to Code Section 28-9-5, in 1986, "this title" was substituted for "Title 49".
GA Code § 49-4-157 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-157. Construction of This Article With Federal Act

 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 state plan in a manner so as to receive the maximum amount of federal financial participation available in expenditures made under the state plan.   (Ga. L. 1977, p. 384, § 16; Ga. L. 1999, p. 296, § 24.)   OPINIONS OF THE ATTORNEY GENERAL   Limited use of state funds to pay for abortions to assure maximum federal financial participation.    - State funds may not be expended for any abortions except those in pregnancies wherein the life of the mother would be endangered if the fetus were carried to term, especially given the fact that it is the intention of the General Assembly that Ga. L. 1977, p. 384, § 1 et seq. (see O.C.G.A. § 49-4-140 et seq.) be construed so as to accomplish maximum federal financial participation. If the state plan were to be administered so as to assure payment for abortions other than those where the life of the mother would be threatened if the fetus were carried to term, no federal funds would be available for that purpose. 1977 Op. Att'y Gen. No. 77-64.
GA Code § 49-4-159 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-159. Medicaid Coverage for Lactation and Postpartum Care

  The department shall provide Medicaid coverage for:   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   Postpartum care for mothers for a period of six months following the date the woman gives birth.     If necessary to implement the provisions of this Code section, the department shall submit a Medicaid state plan amendment or waiver request to the United States Department of Health and Human Services.     (Code 1981, §49-4-159, enacted by Ga. L. 2020, p. 224, § 1/HB 1114.)   Cross references.   - Newborn Baby and Mother Protection Act, § 33-24-58.2.    Lactation Consultant Practice, § 43-22A-1 et seq.   Editor's notes.   - Ga. L. 2020, p. 224, § 2/HB 1114, not codified by the General Assembly, provided that the enactment of this Code section was contingent upon a specific appropriation of funds for purposes of this Act. Funding was appropriated in 2020.
GA Code § 49-4-159.1 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7 - Medical Assistance Generally|§ 49-4-159.1. State Plan Amendment to Implement Express Lane Eligibility in Medicaid and the Peachcare for Kids Program; Enrollment and Renewal

  No later than June 30, 2022, the department shall submit a state plan amendment to the federal Department of Health and Human Services to implement express lane eligibility in accordance with section 1902(e)(13) of the federal Social Security Act to determine whether a child meets one or more of the eligibility criteria for and enroll the child in Medicaid and the PeachCare for Kids Program. Such state plan amendment shall include, but not be limited to, reliance on a finding made by the Division of Family and Children Services of the Department of Human Services in determining eligibility of applicants for the federal Supplemental Nutrition Assistance Program and other programs as identified by the department and the Division of Family and Children Services of the Department of Human Services.   Upon approval of a state plan amendment, the Division of Family and Children Services of the Department of Human Services shall employ express lane eligibility by evaluating data received from applicants for the federal Supplemental Nutrition Assistance Program and other programs, as identified by the department and the Division of Family and Children Services of the Department of Human Services, to determine eligibility for Medicaid and the PeachCare for Kids Program and to provide for automatic enrollment and renewal of eligible children in Medicaid and the PeachCare for Kids Program.     (Code 1981, §49-4-159.1, enacted by Ga. L. 2021, p. 345, § 1/HB 163.)
GA Code § 49-4-160 (2021)
2021 Georgia Code|Title 49 - Social Services|Chapter 4 - Public Assistance|Article 7A - Long-Term Care Partnership Program|§ 49-4-160. Short Title

 This article shall be known and may be cited as the "Georgia Long-term Care Partnership Program Act."    (Code 1981, §49-4-160, enacted by Ga. L. 2005, p. 823, § 1/HB 643; Ga. L. 2006, p. 72, § 49/SB 465.)   Cross references.   - Long-term care insurance, § 33-42-1 et seq.   RESEARCH REFERENCES   C.J.S.   - 67 C.J.S., Officers and Public Employees, § 423.