Compilation of Rules and Regulations of the State of Georgia
Department 350 - DEPARTMENT OF MEDICAL ASSISTANCE
Chapter 350-7 - INDIGENT CARE TRUST FUND - NURSING HOME PROVIDER FEE
Rule 350-7-.02 - Payments to the Segregated Account
Current through Rules and Regulations filed through September 23, 2024
(1) There is established within the Indigent Care Trust Fund a segregated account for revenues raised through imposition of the provider fee. All revenues raised through the nursing home provider fees shall be credited to the segregated account. All said revenues raised shall be dedicated and used for the sole purpose of obtaining federal financial participation for medical assistance payments to nursing homes that disproportionately serve the medically indigent. Payments to the segregated nursing home provider fee account shall be made by any nursing home required to do so pursuant to O.C.G.A. Section 31-8-164. Such payments to the segregated account shall be irrevocable and shall not include any limitation upon use of such contributions except as permitted in this article or by the Department. Payments shall only be used for the purposes contained in O.C.G.A. Section 31-8-165. Contributions and transfers to the Indigent Care Trust Fund pursuant to O.C.G.A. Section 31-8-153 and 31-8-153.1 shall not be deposited into the segregated account.
(2) Each nursing home shall be assessed a provider fee with respect to each patient day for the preceding quarter, excluding Medicare program patient days. The provider fee shall be assessed uniformly upon all nursing homes except with respect to the waiver to be applied for pursuant to O.C.G.A. Section 31-8-168. The aggregate provider fees imposed shall not exceed the maximum amount that may be assessed pursuant to the 6 percent indirect guarantee threshold set forth in 42 C.F.R. Section 433.68(f)(3)(i). Such provider fee payments may be deposited to the segregated account by means of electronic funds transfer, when pre-authorized by the Department.
(3) The provider fee shall be paid quarterly by each nursing home to the Department. A nursing home shall calculate and report the provider fee due upon a form prepared and distributed by the Department. The payments shall be submitted no later than the thirtieth day following the end of each calendar quarter. The initial provider fee report shall be filed and the initial provider fee payment shall be submitted no later than July 30, 2003. The initial provider fee payment for July 30, 2003 shall be calculated using the patient day information for the calendar quarter ending June 30, 2003.
(4) Each nursing home shall keep and preserve for a period of three years such books and records as may be necessary to determine the amount for which it is liable for a provider fee pursuant to these rules. The Department shall have the authority to inspect and copy the records of a nursing home for purposes of auditing the calculation of the provider fee. All information obtained by the Department for this purpose shall be confidential and shall not constitute a public record.
(5) In the event the Department determines that a nursing home has underpaid or overpaid the provider fee, the Department shall notify the nursing home of the balance of the provider fee or refund that is due. Such payment or refund shall be due within 30 days of the Department's notice to the nursing home.
(6) Any nursing home that fails to pay the provider fee pursuant to these rules within the time periods specified by these rules shall pay, in addition to the outstanding provider fee, a 6 percent penalty for each month or fraction thereof that the payment is overdue. If a provider fee has not been received by the Department by the last day of the month, the Department shall withhold an amount equal to the provider fee and penalty owed from any Medicaid payment due the nursing home in question. The provider fee levied by this article 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 by these rules. Any penalty that accrues as a result of late payments shall be credited to the segregated account.
O.C.G.A. Sec. 31-8-5.
