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

(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.