Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-3 - MEDICAL ASSISTANCE › Subject 111-3-9 - HOSPITAL PROVIDER PAYMENT PROGRAM › Rule 111-3-9-.02 - Payments to the Segregated Account

Current through Rules and Regulations filed through June 27, 2024
(1) There is established within the Trust
				Fund a Segregated Account for revenues raised through the imposition of the
				Provider Payment. Any Provider Payment assessed pursuant to this Chapter shall
				be deposited into the Segregated Account. No other funds shall be deposited
				into the Segregated Account. All funds shall be invested in the same manner as
				authorized for investing other moneys in the state treasury.
(2) Each Hospital shall be assessed a
				Provider Payment in the amount of 1.45 percent of the Net Patient Revenue of
				the Hospital; provided, however, that Trauma Centers shall be assessed a
				Provider Payment in the amount of 1.40 percent of the Net Patient Revenue of
				the Trauma Center.
(3) The Provider
				Payment shall be paid quarterly by each Hospital to the Department. The
				assessment shall be based on the Department's annual Hospital Financial Survey.
				Payment of the Provider Payment shall be due on the last day of the last month
				of each calendar quarter; the first payment shall be due on September 30, 2013
				or 30 calendar days after the receipt of State Plan Amendment approval,
				whichever is later.
(4) The
				Department shall prepare and distribute a form on which each Hospital shall
				submit information to comply with this Chapter.
(5) Each Hospital shall keep and preserve for
				a period of seven (7) years such books and records as may be necessary to
				determine the amount for which it is liable under this Chapter. The Department
				shall have the authority to inspect and copy the records of a Hospital for
				purposes of auditing the calculation of the Provider Payment. All information
				obtained by the Department pursuant to this Chapter shall be confidential and
				shall not constitute a public record.
(6) The Department shall impose a penalty of
				up to six percent (6%) for any Hospital that fails to pay a Provider Payment
				within the time required by the Department for each month or fraction thereof
				that the Provider Payment is overdue. If a required Provider Payment has not
				been received by the Department by the last day of the last month of the
				calendar quarter, the Department shall withhold an amount equal to the Provider
				Payment and penalty owed from any medical assistance payment due such Hospital
				under the Medicaid program. Any Provider Payment assessed pursuant to this
				Chapter 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 Chapter. Any penalty that accrues pursuant to this Rule shall be credited
				to the Segregated Account.
(7) In
				the event the Department determines that a Hospital has underpaid the Provider
				Payment, the Department shall notify the Hospital of the balance of the
				Provider Payment that is due. Such payment shall be due within thirty (30) days
				of the Department's notice.
(8) The
				Provider Payment imposed under this Chapter shall be recognized by the
				Department as a form of expenditure for indigent or charity care under any
				agreement by a Hospital to provide a specified amount of clinical health
				services to indigent patients pursuant to subsection (c) of O.C.G.A. §
									31-6-40.1 and may be considered a
				community benefit for purposes of any required or voluntary community benefit
				report filed or prepared by a Hospital; provided, however, that the Provider
				Payment shall not be considered charity or indigent care for purposes of
				calculating Net Patient Revenue pursuant to this Chapter.
Act I of the 2013
				  Session of the Georgia General Assembly.