Compilation of Rules and Regulations of the State of Georgia
Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH
Chapter 111-3 - MEDICAL ASSISTANCE
Subject 111-3-12 - RULES AND REGULATIONS FOR HOSPITAL CARE FOR THE INDIGENT
Rule 111-3-12-.08 - General Provisions

Universal Citation: GA Rules and Regs r 111-3-12-.08

Current through Rules and Regulations filed through September 23, 2024

(1) Definition of Terms. The following words, terms, or phrases when used in these Rules and Regulations, shall have the meaning ascribed to them in this section, except when the context clearly indicates a different meaning:

(a) "Program" means the Hospital Care for the Indigent Program, established by Act No. 397, Georgia Laws, 1957;

(b) "Physician" means a doctor of medicine duly licensed to practice medicine in Georgia in accordance with Section 84-901, et seq., Georgia Code Annotated.

(c) "Indigent Person" or "indigent" means any person who is ill or injured and who from his own resources or from resources of those upon whom he is legally dependent is financially unable to meet the full cost of hospital care as prescribed or ordered by a physician.

(d) "financially unable" means an economic status in which a person, who because of his level of income, property, or intrafamily assistance, is not able to pay for the cost of needed hospital care without depriving himself or his dependents of necessary food, shelter, clothing, and the other minimum necessities of life within specified limits of an economic inventory.

(e) "full cost" means the total cost of an entire period of hospitalization wherein the ill or injured person is or becomes indigent in reference to a portion of the hospital cost.

(f) "hospital care needed" means the hospital care as prescribed or ordered by a physician.

(g) "resident" means any person who is in the county for other than temporary or transitory purposes and who has lived continuously in Georgia for a period of not less than six months. The six months residency requirement may be waived when a physician certifies that the illness or injury constitutes an emergency which requires immediate hospital care.

(h) "Applicant" means a resident indigent ill or injured person who makes applications for service under this Program, according to prescribed rules and regulations.

(i) "ill or injured" means indisposed for a medical reason which requires, in the professional judgment of a physician, intensive care normally provided by a hospital, and there is a likelihood of material benefit from hospitalization.

(j) "Participating County" means a county, the governing authority of which by appropriate action has agreed to participate in the Program, has adopted the rules and regulations set forth for the administration of the Program, and is current with its prorated share of funds necessary for the hospital care of county residents.

(k) "County" means the governing or taxing authority of a county.

(l) "Participating Hospital," "Participating Hospitals," or "participating hospital" means hospitals that have agreed to cooperate with the Program and have been certified as eligible according to the eligibility criteria set forth in the Rules and Regulations.

(m) "County Board of Health" means a County Board of Health created under and by virtue of an Act of the General Assembly of Georgia (Acts of 1914, page 124-125 as amended) codified as Section 88-201 et. seq., Georgia Code Annotated; or the agency designated under the provision of 111-3-12-.02(c) of these Rules and Regulations.

(2) Appeal Procedure:

(a) An applicant, a physician, or a Participating Hospital may appeal to the County Board of Health wherein the applicant resides, if the application is not acted upon within a reasonable length of time or if the application is denied, in whole or in part, by seemingly arbitrary action.

(b) The governing authority of the county, the Count Board of Health, a Participating Hospital, or the local medical society have the right to appeal by a written request and to be granted a fair hearing by the Georgia Department of Public Health on administrative matters pertaining to local policies, procedures, or methods.

(c) The governing authority of a Participating County, or the County Board of Health have the right to ap peal by a written request and to be granted a fair hearing by the State Board of Health relative to administrative procedures and decisions of the Georgia Department of Community Health.

(3) Revision of Rules and Regulations. Within the framework and intent of the Act, these Rules and Regulations may be revised or modified from time to time by the Department of Community Health after consultation with the Hospital Care Advisory Council.

Ga. L. 1933, p. 7; O.C.G.A. § 31-8-1 et seq.

Disclaimer: These regulations may not be the most recent version. Georgia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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