Senate Bill 461
By: Senators Tillery of the 19th, Robertson of the 29th, Walker III of the 20th and Watson
of the 1st
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 2 of Title 31 and Chapters 2 and 4 of Title 49 of the Official Code of
Georgia Annotated, relating to the Department of Community Health, Department of Human
Services, and public assistance, respectively, so as to provide for the Department of Human
Services to be the single state agency responsible for the administration of the state Medicaid
program; to transfer certain powers, functions, and duties from the Department of
Community Health to the Department of Human Services; to revise definitions; to provide
for transition; to provide for conforming changes; to provide for related matters; to provide
for a state plan amendment or waiver request; 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 2 of Title 31 of the Official Code of Georgia Annotated, relating to Department of
Community Health, is amended in Code Section 31-2-1, relating to legislative intent and
grant of authority, by revising paragraph (1) as follows:
"(1) Serve as the lead planning agency for all health issues in the state to remedy the
current situation wherein the responsibility for health care policy, purchasing, planning,
and regulation is spread among many different agencies <del>and achieve determinations of
Medicaid eligibility for inmates to attain services at long-term care facilities when he or
she is being considered for parole;"
</del> SECTION 2.
Said chapter is further amended in Code Section 31-2-4, relating to powers, duties, functions,
and responsibilities, divisions, directors, and contracts for health benefits, by adding a new
subsection to read as follows:
<ins>"(e) On and after July 1, 2027, the powers, functions, and duties of the Department of
Community Health relating to the administration of the state Medicaid program, including,
but not limited to, the requirements provided for in paragraphs (11) and (12) of
subsection (d) of this Code section, shall be performed and exercised by the Department
of Human Services."
</ins> SECTION 3.
Said chapter is further amended in Code Section 31-2-15, relating to streamlining and
expediting credentialing and billing processes for state medical plans, by revising subsection
(a) as follows:
"(a) As used in this Code section, the term 'state medical plan' means the state health
benefit plan under Article 1 of Chapter 18 of Title 45, <del>the medical assistance program
under Article 7 of Chapter 4 of Title 49,</del> the PeachCare for Kids Program under Article 13
of Chapter 5 of Title 49, and any other health benefit plan or policy administered by or on
behalf of the state."
SECTION 4.
Said chapter is further amended in Code Section 31-2-18, relating to reporting on state health
plans, by revising subsection (a) as follows:
"(a) As used in this Code section, the term 'state health plan' means:
(1) <del>The medical assistance program provided pursuant to Article 7 of Chapter 4 of
Title 49</del> <ins>Reserved;
</ins> (2) The PeachCare for Kids Program provided pursuant to Article 13 of Chapter 5 of
Title 49;
(3) The state employees' health insurance plan established pursuant to Article 1 of
Chapter 18 of Title 45;
(4) The health insurance plan for public school teachers established pursuant to Subpart
2 of Part 6 of Article 17 of Chapter 2 of Title 20; <del>and
</del> (5) The health insurance plan for public school employees established pursuant to
Subpart 3 of Part 6 of Article 17 of Chapter 2 of Title 20; <ins>and
(6) The health benefit plan established for members, employees, and retirees of the
Board of Regents of the University System of Georgia pursuant to Code Section 31-2-4."
</ins> SECTION 5.
Chapter 2 of Title 49 of the Official Code of Georgia Annotated, relating to the Department
of Human Services, is amended in Code Section 49-2-1, relating to department created,
transfer from Department of Human Resources, commissioner, and kinship care enforcement
administrator, by revising subsection (a) as follows:
"(a)(1) There is created a Department of Human Services. The powers, functions, and
duties of the Department of Human Resources as they existed on June 30, 2009, except
for those relating to the Division of Mental Health, Developmental Disabilities, and
Addictive Diseases, the Division of Public Health, and the Office of Regulatory Services,
unless specifically transferred or reassigned to the Department of Community Health or
the Department of Behavioral Health and Developmental Disabilities, are transferred to
the Department of Human Services effective July 1, 2009, and the Department of Human
Resources shall be reconstituted as the Department of Human Services effective July 1,
2009.
<ins>(2) On and after July 1, 2027, the powers, functions, and duties of the Department of
Community Health relating to the Medicaid program shall be performed and exercised
by the Department of Human Services."
</ins> SECTION 6.
Said chapter is further amended in Code Section 49-2-11, relating to acceptance and
disbursement of federal aid, compliance with conditions, and use of appropriations for
matching funds, by revising subsection (f) as follows:
"(f) <del>Notwithstanding subsections (a) through (e) of this Code section, the Department of
Community Health</del> <ins>On and after July 1, 2027, the department</ins> shall be the single state
agency for the administration of the state medical assistance plan."
SECTION 7.
Chapter 4 of said title is amended in Code Section 49-4-141, relating to definitions, by
revising paragraphs (2), (3), and (4) as follows:
"(2) 'Board' means the Board of <del>Community Health established under Chapter 2 of
Title 31</del> <ins>Human Services.
</ins> (3) 'Commissioner' means the commissioner of <del>the department</del> <ins>human services.
</ins> (4) 'Department' means the Department of <del>Community Health established under
Chapter 2 of Title 31</del> <ins>Human Services."
</ins> SECTION 8.
Said chapter is further amended in Code Section 49-4-142, relating to Department of
Community Health established, adoption, administration, modification of state plan, drug
application fees, and personal needs allowance, by revising subsection (a) and adding a new
subsection to read as follows:
"(a) <del>The</del> <ins>Until June 30, 2027, the</ins> Department of Community Health established under
Chapter 2 of Title 31 is authorized to adopt and administer a state plan for medical
assistance in accordance with Title XIX of the federal Social Security Act, as amended
(Act of July 30, 1965, P.L. 89-97, 79 Stat. 343, as amended), provided such state plan is
administered within the appropriations made available to the department. <ins>On and after July
1, 2027, the department is authorized to adopt and administer such state plan for medical
assistance, provided such state plan is administered within the appropriations made
available to the department.</ins> The department is authorized to establish the amount,
duration, scope, and terms and conditions of eligibility for and receipt of such medical
assistance as it may elect to authorize pursuant to this article. Further, the department is
authorized to establish such rules and regulations as may be necessary or desirable in order
to execute the state plan and to receive the maximum amount of federal financial
participation available in expenditures made pursuant to the state plan; provided, however,
that the department shall establish reasonable procedures for notice to interested parties and
an opportunity to be heard prior to the adoption, amendment, or repeal of any such rule or
regulation. The department is authorized to enter into such reciprocal and cooperative
arrangements with other states, persons, and institutions, public and private, as it may deem
necessary or desirable in order to execute the state plan."
<ins>"(e) The department, in cooperation with the Department of Community Health, shall take
all necessary steps to implement and facilitate the transition of the administration of the
Medicaid program from the Department of Community Health to the department in
accordance with the provisions of this Code section."
</ins>
SECTION 9.
Said chapter is further amended by revising Code Section 49-4-143, relating to power of
Board of Community Health and Board of Medical Assistance abolished, as follows:
"49-4-143.
The <del>Board of Community Health established under Chapter 2 of Title 31</del> <ins>board</ins> is
empowered to establish the general policy to be followed by the department. The Board
of Medical Assistance which existed June 30, 1999, is abolished July 1, 1999, and no
person shall be appointed to such board on or after July 1, 1999."
SECTION 10.
Said chapter is further amended by revising Code Section 49-4-144, relating to chief
administrative officer and powers and duties, as follows:
"49-4-144.
The commissioner <del>of community health established under Chapter 2 of Title 31</del> shall be
the chief administrative officer of the department and, subject to the general policy
established by the board, shall supervise, direct, account for, organize, plan, administer, and
execute the functions vested in the department."
SECTION 11.
Said chapter is further amended by revising Code Section 49-4-146, relating to time for
action on claim, as follows:
"49-4-146.
<del>The</del> <ins>Until June 30, 2027, the</ins> Department of Community Health, within three months of
receiving a claim submitted on or after July 1, 1978, shall pay or deny the claim. <ins>The
department, within three months of receiving a claim submitted on or after July 1, 2027,
shall pay or deny the claim."
</ins>
SECTION 12.
Said chapter is further amended in Code Section 49-4-147.2, relating to Department of
Community Health not eligible to obtain nor liable for interest on orders, judgments, and
liquidated or unliquidated amounts and exceptions, by revising subsection (a) as follows:
"(a) Notwithstanding the provisions of Code Section 49-4-141, as used in this Code section
the term 'department' means the Department of <del>Community Health</del> <ins>Human Services</ins> or its
officers, agents, or employees solely in their capacity as such officers, agents, or
employees."
SECTION 13.
Said chapter is further amended in Code Section 49-4-154, relating to powers and duties
retained by Department of Human Resources (Department of Community Health), by
revising subsection (b) and adding a new subsection to read as follows:
"(b) <del>The</del> <ins>Until June 30, 2027, the</ins> 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:
(1) 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;
(2) Determining and certifying the eligibility of certain applicants for and recipients of
medical assistance; and
(3) 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.
<ins>(c) On and after July 1, 2027, the department shall assume, in accordance with the terms
of the state plan, the powers, functions, and duties, and all tangible things and employees
relating to the administration of the medical assistance program, as provided in
paragraphs (1) through (3) of subsection (b) of this Code section."
</ins> SECTION 14.
Said chapter is further amended by revising Code Section 49-4-155, relating to Department
of Community Health to succeed to existing rules, regulations, policies, procedures, and
administrative orders, as follows:
"49-4-155.
<ins>(a) Beginning July 1, 2027, the department shall succeed to all the rules, regulations,
policies, procedures, and administrative orders of the Department of Community Health
that relate to the administration of the Medicaid program and are in effect on June 30,
2027, and shall further succeed to any rights, privileges, entitlements, obligations, and
duties of the Department of Community Health that relate to the administration of the
Medicaid program and are in effect on June 30, 2027.
(b)</ins> 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."
SECTION 15.
Said chapter is further amended by replacing "Department of Community Health" with
"department" where such term occurs in:
(1) Code Section 49-4-147, relating to enforcement of liens, claims, or offsets against
assistance;
(2) Code Section 49-4-148, relating to recovery of assistance from third party liable for
sickness, injury, disease, or disability;
(3) Code Section 49-4-149, relating to lien of Department of Community Health against
third parties, subrogation to recipients' insurance claims, and assignment of recipients'
claims;
(4) Code Section 49-4-149.1, relating to plan for family supplementation of Medicaid
payments upon federal removal of restrictions or waiver;
(5) Code Section 49-4-150, relating to regulations as to maintenance and use of records
and use of information;
(6) Code Section 49-4-151, relating to obtaining information for investigations and audits;
(7) Code Section 49-4-152, relating to research and demonstration projects, pilot projects
to provide health care coverage and essential health care services, and pharmacy assistance
programs; and
(8) Code Section 49-4-153, relating to hearings and appeals and judicial review.
SECTION 16.
Said chapter is further amended by replacing "commissioner of community health" with
"commissioner" where such term occurs in:
(1) Code Section 49-4-147, relating to enforcement of liens, claims, or offsets against
assistance;
(2) Code Section 49-4-148, relating to recovery of assistance from third party liable for
sickness, injury, disease, or disability;
(3) Code Section 49-4-150, relating to regulations as to maintenance and use of records
and use of information; and
(4) Code Section 49-4-153, relating to hearings and appeals and judicial review.
SECTION 17.
Said chapter is further amended by replacing "Board of Community Health" with "board"
where such term occurs in:
(1) Code Section 49-4-150, relating to regulations as to maintenance and use of records
and use of information; and
(2) Code Section 49-4-153, relating to hearings and appeals and judicial review.
SECTION 18.
If necessary to implement the provisions of this Act, the Department of Human Services shall
submit a Medicaid state plan amendment or waiver request to the Centers for Medicare and
Medicaid Services of the United States Department of Health and Human Services.
SECTION 19.
This Act shall become effective upon its approval by the Governor or upon its becoming law
without such approval.
SECTION 20.
All laws and parts of laws in conflict with this Act are repealed.