SB461: SB461 Department of Human Services; the single state agency responsible for the administration of the state Medicaid program; provide

26 LC 52 0974 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 of1 Georgia Annotated, relating to the Department of Community Health, Department of Human2 Services, and public assistance, respectively, so as to provide for the Department of Human3 Services to be the single state agency responsible for the administration of the state Medicaid4 program; to transfer certain powers, functions, and duties from the Department of5 Community Health to the Department of Human Services; to revise definitions; to provide6 for transition; to provide for conforming changes; to provide for related matters; to provide7 for a state plan amendment or waiver request; to provide for an effective date; to repeal8 conflicting laws; and for other purposes.9 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:10 SECTION 1.11 Chapter 2 of Title 31 of the Official Code of Georgia Annotated, relating to Department of12 Community Health, is amended in Code Section 31-2-1, relating t o legislative intent and13 grant of authority, by revising paragraph (1) as follows:14 "(1) Serve as the lead planning agency for all health issues in the state to remedy the15 current situation wherein the responsibility for health care policy, purchasing, planning,16 S. B. 461 - 1 - 26 LC 52 0974 and regulation is spread among many different agencies and achieve determinations of17 Medicaid eligibility for inmates to attain services at long-term care facilities when he or18 she is being considered for parole;"19 SECTION 2.20 Said chapter is further amended in Code Section 31-2-4, relating to powers, duties, functions,21 and responsibilities, divisions, directors, and contracts for health benefits, by adding a new22 subsection to read as follows:23 "(e) On and after July 1, 2027, the powers, functions, and duti es of the Department of24 Community Health relating to the administration of the state Medicaid program, including,25 but not limited to, the requirements provided for in paragraphs (11) and (12) of26 subsection (d) of this Code section, shall be performed and exercised by the Department27 of Human Services."28 SECTION 3.29 Said chapter is further amended in Code Section 31-2-15, relati ng to streamlining and30 expediting credentialing and billing processes for state medical plans, by revising subsection31 (a) as follows:32 "(a) As used in this Code section, the term 'state medical plan ' means the state health33 benefit plan under Article 1 of Chapter 18 of Title 45, the med ical assistance program34 under Article 7 of Chapter 4 of Title 49, the PeachCare for Kids Program under Article 1335 of Chapter 5 of Title 49, and any other health benefit plan or policy administered by or on36 behalf of the state."37 SECTION 4.38 Said chapter is further amended in Code Section 31-2-18, relating to reporting on state health39 plans, by revising subsection (a) as follows:40 S. B. 461 - 2 - 26 LC 52 0974 "(a) As used in this Code section, the term 'state health plan' means:41 (1) The medical assistance program provided pursuant to Articl e 7 of Chapter 4 of42 Title 49 Reserved;43 (2) The PeachCare for Kids Program provided pursuant to Articl e 13 of Chapter 5 of44 Title 49;45 (3) The state employees' health insurance plan established pur suant to Article 1 of46 Chapter 18 of Title 45;47 (4) The health insurance plan for public school teachers established pursuant to Subpart48 2 of Part 6 of Article 17 of Chapter 2 of Title 20; and49 (5) The health insurance plan for public school employees esta blished pursuant to50 Subpart 3 of Part 6 of Article 17 of Chapter 2 of Title 20; and51 (6) The health benefit plan established for members, employees , and retirees of the52 Board of Regents of the University System of Georgia pursuant to Code Section 31-2-4."53 SECTION 5.54 Chapter 2 of Title 49 of the Official Code of Georgia Annotated, relating to the Department55 of Human Services, is amended in Code Section 49-2-1, relating to department created,56 transfer from Department of Human Resources, commissioner, and kinship care enforcement57 administrator, by revising subsection (a) as follows:58 "(a)(1) There is created a Department of Human Services. The powers, functions, and59 duties of the Department of Human Resources as they existed on June 30, 2009, except60 for those relating to the Division of Mental Health, Developmen tal Disabilities, and61 Addictive Diseases, the Division of Public Health, and the Office of Regulatory Services,62 unless specifically transferred or reassigned to the Department of Community Health or63 the Department of Behavioral Health and Developmental Disabilities, are transferred to64 the Department of Human Services effective July 1, 2009, and the Department of Human65 S. B. 461 - 3 - 26 LC 52 0974 Resources shall be reconstituted as the Department of Human Services effective July 1,66 2009.67 (2) On and after July 1, 2027, the powers, functions, and duti es of the Department of68 Community Health relating to the Medicaid program shall be performed and exercised69 by the Department of Human Services."70 SECTION 6.71 Said chapter is further amended in Code Section 49-2-11, relati ng to acceptance and72 disbursement of federal aid, compliance with conditions, and us e of appropriations for73 matching funds, by revising subsection (f) as follows:74 "(f) Notwithstanding subsections (a) through (e) of this Code section, the Department of75 Community Health On and after July 1, 2027, the department shall be the single state76 agency for the administration of the state medical assistance plan."77 SECTION 7.78 Chapter 4 of said title is amended in Code Section 49-4-141, re lating to definitions, by79 revising paragraphs (2), (3), and (4) as follows:80 "(2) 'Board' means the Board of Community Health established un der Chapter 2 of81 Title 31 Human Services.82 (3) 'Commissioner' means the commissioner of the department human services.83 (4) 'Department' means the Department of Community Health esta blished under84 Chapter 2 of Title 31 Human Services."85 SECTION 8.86 Said chapter is further amended in Code Section 49-4-142, relat ing to Department of87 Community Health established, adoption, administration, modific ation of state plan, drug88 S. B. 461 - 4 - 26 LC 52 0974 application fees, and personal needs allowance, by revising subsection (a) and adding a new89 subsection to read as follows:90 "(a) The Until June 30, 2027, the Department of Community Health established under91 Chapter 2 of Title 31 is authorized to adopt and administer a s tate plan for medical92 assistance in accordance with Title XIX of the federal Social S ecurity Act, as amended93 (Act of July 30, 1965, P.L. 89-97, 79 Stat. 343, as amended), p rovided such state plan is94 administered within the appropriations made available to the department. On and after July95 1, 2027, the department is authorized to adopt and administer such state plan for medical96 assistance, provided such state plan is administered within the appropriations made97 available to the department. The department is authorized to establish the amount,98 duration, scope, and terms and c onditions of eligibility for an d receipt of such medical99 assistance as it may elect to authorize pursuant to this article. Further, the department is100 authorized to establish such rules and regulations as may be necessary or desirable in order101 to execute the state plan and to receive the maximum amount of federal financial102 participation available in expenditures made pursuant to the state plan; provided, however,103 that the department shall establish reasonable procedures for notice to interested parties and104 an opportunity to be heard prior to the adoption, amendment, or repeal of any such rule or105 regulation. The department is authorized to enter into such re ciprocal and cooperative106 arrangements with other states, persons, and institutions, public and private, as it may deem107 necessary or desirable in order to execute the state plan."108 "(e) The department, in cooperation with the Department of Community Health, shall take109 all necessary steps to implement and facilitate the transition of the administration of the110 Medicaid program from the Department of Community Health to the department in111 accordance with the provisions of this Code section."112 S. B. 461 - 5 - 26 LC 52 0974 SECTION 9.113 Said chapter is further amended by revising Code Section 49-4-1 43, relating to power of114 Board of Community Health and Board of Medical Assistance abolished, as follows:115 "49-4-143.116 The Board of Community Health established under Chapter 2 of Ti tle 31 board i s117 empowered to establish the general policy to be followed by the department. The Board118 of Medical Assistance which existed June 30, 1999, is abolished July 1, 1999, and no119 person shall be appointed to such board on or after July 1, 1999."120 SECTION 10.121 Said chapter is further amended by revising Code Section 49-4-1 44, relating to chief122 administrative officer and powers and duties, as follows:123 "49-4-144.124 The commissioner of community health established under Chapter 2 of Title 31 shall be125 the chief administrative officer of the department and, subject to the general policy126 established by the board, shall supervise, direct, account for, organize, plan, administer, and127 execute the functions vested in the department."128 SECTION 11.129 Said chapter is further amended by revising Code Section 49-4-1 46, relating to time for130 action on claim, as follows:131 "49-4-146.132 The Until June 30, 2027, the Department of Community Health, within three months of133 receiving a claim submitted on or after July 1, 1978, shall pay or deny the claim. The134 department, within three months of receiving a claim submitted on or after July 1, 2027,135 shall pay or deny the claim."136 S. B. 461 - 6 - 26 LC 52 0974 SECTION 12.137 Said chapter is further amended in Code Section 49-4-147.2, rel ating to Department of138 Community Health not eligible to obtain nor liable for interest on orders, judgments, and139 liquidated or unliquidated amounts and exceptions, by revising subsection (a) as follows:140 "(a) Notwithstanding the provisions of Code Section 49-4-141, as used in this Code section141 the term 'department' means the Department of Community Health Human Services or its142 officers, agents, or employees solely in their capacity as such o f f i c e r s , a g e n t s , o r143 employees."144 SECTION 13.145 Said chapter is further amended in Code Section 49-4-154, relat ing to powers and duties146 retained by Department of Human Resources (Department of Commun ity Health), by147 revising subsection (b) and adding a new subsection to read as follows:148 "(b) The Until June 30, 2027, the Department of Human Resources (now known as the149 Department of Community Health for these purposes) shall retain , in accordance with150 terms of the state plan, the functions, and all tangible things and employees relating thereto,151 of: 152 (1) Establishing and maintaining certain standards for certain institutions and agencies153 seeking to become or remain providers and shall finally determi ne and certify whether154 such institutions and agencies meet such standards; 155 (2) Determining and certifying the eligibility of certain applicants for and recipients of156 medical assistance; and157 (3) Prescribing regulations to require that applicants for medical assistance be given clear158 and easily understandable notice that all books, papers, records, and memoranda of the159 provider relating to the provision of medical assistance to the applicant will be made160 available, upon request, to the commissioner of medical assistance or his representative161 and that, by accepting medical assistance, the applicant thereby consents to the providing162 S. B. 461 - 7 - 26 LC 52 0974 of such books, papers, records, and memoranda to the commission er of medical163 assistance or his representative. 164 (c) On and after July 1, 2027, the department shall assume, in accordance with the terms165 of the state plan, the powers, functions, and duties, and all tangible things and employees166 relating to the administration of the medical assistance progra m, as provided in167 paragraphs (1) through (3) of subsection (b) of this Code section."168 SECTION 14.169 Said chapter is further amended by revising Code Section 49-4-155, relating to Department170 of Community Health to succeed to existing rules, regulations, policies, procedures, and171 administrative orders, as follows:172 "49-4-155.173 (a) Beginning July 1, 2027, the department shall succeed to al l the rules, regulations,174 policies, procedures, and administrative orders of the Departme nt of Community Health175 that relate to the administration of the Medicaid program and a re in effect on June 30,176 2027, and shall further succeed to any rights, privileges, enti tlements, obligations, and177 duties of the Department of Community Health that relate to the administration of the178 Medicaid program and are in effect on June 30, 2027.179 (b) The Department of Community Health shall succeed to all the r ules, regulations,180 policies, procedures, and administrative orders of the Departme nt of Human Resources181 (now known as the Department of Human Services) transferred to the Department of182 Medical Assistance pursuant to the previously existing provisions of this Code section and183 that are in effect on June 30, 1999, and shall further succeed to any rights, privileges,184 entitlements, obligations, and duties of the Department of Human Resources (now known185 as the Department of Human Services) that are in effect on June 30, 1999, to which the186 Department of Medical Assistance succeeded pursuant to the previously existing provisions187 of Code Section 49-4-156."188 S. B. 461 - 8 - 26 LC 52 0974 SECTION 15.189 Said chapter is further amended by replacing "Department of Com munity Health" with190 "department" where such term occurs in:191 (1) Code Section 49-4-147, relating to enforcement of liens, c laims, or offsets against192 assistance;193 (2) Code Section 49-4-148, relating to recovery of assistance from third party liable for194 sickness, injury, disease, or disability;195 (3) Code Section 49-4-149, relating to lien of Department of Community Health against196 third parties, subrogation to recipients' insurance claims, and assignment of recipients'197 claims;198 (4) Code Section 49-4-149.1, relating to plan for family suppl ementation of Medicaid199 payments upon federal removal of restrictions or waiver;200 (5) Code Section 49-4-150, relating to regulations as to maint enance and use of records201 and use of information;202 (6) Code Section 49-4-151, relating to obtaining information for investigations and audits;203 (7) Code Section 49-4-152, relating to research and demonstration projects, pilot projects204 to provide health care coverage and essential health care services, and pharmacy assistance205 programs; and206 (8) Code Section 49-4-153, relating to hearings and appeals and judicial review.207 SECTION 16.208 Said chapter is further amended by replacing "commissioner of c ommunity health" with209 "commissioner" where such term occurs in:210 (1) Code Section 49-4-147, relating to enforcement of liens, c laims, or offsets against211 assistance;212 (2) Code Section 49-4-148, relating to recovery of assistance from third party liable for213 sickness, injury, disease, or disability;214 S. B. 461 - 9 - 26 LC 52 0974 (3) Code Section 49-4-150, relating to regulations as to maint enance and use of records215 and use of information; and216 (4) Code Section 49-4-153, relating to hearings and appeals and judicial review.217 SECTION 17.218 Said chapter is further amended by replacing "Board of Communit y Health" with "board"219 where such term occurs in:220 (1) Code Section 49-4-150, relating to regulations as to maint enance and use of records221 and use of information; and222 (2) Code Section 49-4-153, relating to hearings and appeals and judicial review.223 SECTION 18.224 If necessary to implement the provisions of this Act, the Department of Human Services shall225 submit a Medicaid state plan amendment or waiver request to the Centers for Medicare and226 Medicaid Services of the United States Department of Health and Human Services.227 SECTION 19.228 This Act shall become effective upon its approval by the Governor or upon its becoming law229 without such approval.230 SECTION 20.231 All laws and parts of laws in conflict with this Act are repealed.232 S. 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