Compilation of Rules and Regulations of the State of Georgia
Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE
Chapter 350-2 - PROCEDURES FOR ADOPTION, AMENDMENT, AND REPEAL OF RULES AND FOR PUBLIC NOTICE OF CHANGES IN METHODS AND STANDARDS FOR SETTING PAYMENT RATES
Rule 350-2-.08 - Procedure for Public Notice of Changes in Statewide Methods and Standards for Setting Payment Rates

Universal Citation: GA Rules and Regs r 350-2-.08

Current through Rules and Regulations filed through September 23, 2024

(1) Except as specified in paragraph (2) of this section, the agency shall provide public notice of any proposed change in its methods and standards for setting payment rates for services whenever such change is expected, based on the most recent report of Department data obtained prior to the decision to make such proposed change, to:

(a) increase or decrease gross Department expenditures, for the category of service for which the change is proposed, during the 12 months following the effective date of the change by more than two percent (2.0%), or

(b) affect more than two percent (2.0%) of the providers enrolled at the time of the decision to make such change for the category of service for which the change is proposed.

(2) Notice is not required if:

(a) the change is required by court order; or

(b) the change is based on changes in wholesalers' or manufacturers' prices of drugs or materials, if the agency's reimbursement system is based on material cost plus a professional fee.

(3) The notice must:

(a) describe the proposed change in methods and standards;

(b) give an estimate of any expected increase or decrease in annual aggregate expenditures;

(c) explain why the agency is changing its methods and standards;

(d) identify a local agency in each county where copies of the proposed changes are available for public review;

(e) give an address where written comments may be sent and reviewed by the public; and

(f) give the location, date, and time for a public hearing on the proposed change or tell how this information may be obtained.

(4) The notice shall appear at least 30 days before the proposed effective date of the change in the newspaper of widest circulation in each city with a population of 50,000 or more.

(5) A copy of the notice and of the proposed changes shall be transmitted to the legislative counsel at least 30 days prior to the proposed effective date.

O.C.G.A. Sec. 49-4-142(a).

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