Compilation of Rules and Regulations of the State of Georgia Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE
Here is a comprehensive overview of the Rules and Regulations of the State of Georgia β Department 350: Department of Medical Assistance, effective through early 2025:
ποΈ Administrative Structure
Department 350 administers Georgiaβs Medicaid program, known as the State Plan for Medical Assistance, under the authority of O.C.G.A. Β§β―49β4β142.
The Department of Medical Assistance (DMA) was established by the Georgia General Assembly in 1977 to oversee medical assistance programs, including setting eligibility, reimbursement rates, and provider standards.
π Key Chapters & Rules
Chapter 350β1: Administration
Rule 350β1β.01 β Definitions: Defines terms such as "Medical Assistance," "Provider," and "State Plan" .
Rule 350β1β.02 β Department of Medical Assistance: Details the Department's authority to administer the State Plan, establish rules, and enter into cooperative arrangements .
Rule 350β1β.03 β Commissioner of Medical Assistance: Outlines the responsibilities of the Commissioner as the chief administrative officer of the Department .
Rule 350β1β.04 β Board of Medical Assistance: Describes the composition and functions of the Board, which sets general policy for the Department .
Rule 350β1β.05 β Practice of Non-Discrimination: Affirms the Department's commitment to non-discrimination in accordance with federal civil rights laws .
Chapter 350β2: Procedures for Adoption, Amendment, and Repeal of Rules and for Public Notice of Changes in Methods and Standards for Setting Payment Rates
Establishes the process for adopting, amending, or repealing rules and for providing public notice of changes in payment methods and standards .
Chapter 350β3: Sanctions for Nursing Facilities
Rule 350β3β.01 β Definitions: Provides definitions specific to nursing facility sanctions .
Rule 350β3β.02 β Remedies: Lists potential remedies the Department may impose if a facility fails to meet program requirements .
Rule 350β3β.03 β Imposition of Remedies: Details the procedures for imposing remedies .
Rule 350β3β.04 β Civil Monetary Penalties: Specifies conditions under which civil monetary penalties may be assessed .
Rule 350β3β.05 β Temporary Management: Describes the appointment of temporary management in certain situations .
Rule 350β3β.06 β Monitoring: Outlines monitoring requirements for facilities under sanction .
Rule 350β3β.07 β Notice: Specifies notice requirements for facilities facing sanctions .
Rule 350β3β.08 β Administrative Review: Details the process for administrative review of sanctions .
Rule 350β3β.09 β Administrative Hearing: Describes the procedures for administrative hearings related to sanctions .
Chapter 350β4: Administrative Review, Hearings, and Appeals
Rule 350β4β.01 β Hearings Conducted by the Department of Medical Assistance: Outlines the procedures for hearings conducted by the Department .
Rule 350β4β.02 β Hearings Conducted by the Department of Human Resources: Specifies procedures for hearings conducted by the Department of Human Resources .
Rule 350β4β.03 β Right to Representation: Details the rights of parties to be represented in hearings .
Rule 350β4β.04 β Administrative Review: Describes the process for administrative review of decisions .
Rule 350β4β.05 β Hearing Requests: Specifies the procedures for requesting a hearing .
Rule 350β4β.06 β Dismissal of Hearing Requests: Outlines conditions under which hearing requests may be dismissed .
Rule 350β4β.07 β Informal Disposition; Settlement: Provides guidelines for informal resolution and settlement of disputes .
Rule 350β4β.08 β The Administrative Law Judge: Defines the role and responsibilities of the Administrative Law Judge .
Rule 350β4β.09 β Disqualification of the Administrative Law Judge: Specifies grounds for disqualification of the Administrative Law Judge .
Rule 350β4β.10 β Ex Parte Communications: Addresses prohibitions on ex parte communications .
Rule 350β4β.11 β Notice of Hearing: Details requirements for providing notice of hearings .
Rule 350β4β.12 β Pre-Hearing Conferences: Describes the use of pre-hearing conferences .
Rule 350β4β.13 β Time and Place of Hearing: Specifies the time and location for hearings .
Rule 350β4β.14 β Continued and Reopened Hearings: Outlines procedures for continuing and reopening hearings .
Rule 350β4β.15 β Default; Abandonment: Addresses issues of default and abandonment in hearings .
Rule 350β4β.16 β Discovery: Specifies rules regarding discovery in hearings .
Rule 350β4β.17 β Subpoenas: Details the issuance and enforcement of subpoenas .
Rule 350β4β.18 β Depositions: Outlines procedures for depositions .
Rule 350β4β.19 β Pleadings and Amendments; Automatic Filings: Specifies requirements for pleadings and amendments .
Rule 350β4β.20 β Rules of Evidence; Official Notice: Addresses rules of evidence and official notice .
Rule 350β4β.21 β Substitution of Parties; Intervention: Details procedures for substitution of parties and intervention .
Rule 350β4β.22 β Consolidation and Severance: Specifies rules for consolidation and severance of cases .
Rule 350β4β.23 β Service: Outlines requirements for service of documents .
Rule 350β4β.24 β The Hearing: Describes the conduct of the hearing .
Rule 350β4β.25 β Motions: Specifies procedures for filing and ruling on motions .
Rule 350β4β.26 β Summary Determination: Addresses procedures for summary determinations .
Rule 350β4β.27 β The Hearing Record: Details requirements for maintaining the hearing record .
Rule 350β4β.28 β Decision of the Administrative Law Judge: Specifies requirements for the decision of the Administrative Law Judge .
Rule 350β4β.29 β Appeal of Administrative Law Judge's Decision: Outlines procedures for appealing the Administrative Law Judge's decision .
Rule 350β4β.30 β Appeal of the Commissioner's Decision: Specifies procedures for appealing the Commissioner's decision .
Chapter 350β5: Disclosure of Information on Medicaid Applicants, Recipients, and Providers
Rule 350β5β.01 β Types of Applicant and Recipient Information to be Safeguarded: Identifies types of information that must be protected .
Rule 350β5β.02 β Use of Applicant and Recipient Information: Specifies permissible uses of protected information .
Rule 350β5β.03 β Access to Applicant and Recipient Information: Details who may access protected information .
Rule 350β5β.04 β Disclosure of Provider Information: Addresses the disclosure of provider information
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