Georgia Code, Title 33, Chapter 21a - Medicaid Care Management Organizations

• § 33-21a-1 - Short Title
  This chapter shall be known and may be cited as the "Medicaid Care Management Organizations Act."
• § 33-21a-2 - Definitions
  As used in this chapter, the term: (1) "Care management organization" means an entity that is organized for the purpose of providing or arranging...
• § 33-21a-3 - Certificate of Authority Required; Setting of Rates; Authority of Commissioners
  (a) A care management organization shall be required to obtain a certificate of authority as a health maintenance organization pursuant to Chapter 21 of...
• § 33-21a-4 - Reimbursement for Emergency Health Care Services
  (a) In particular, but without limitation, a care management organization shall not: (1) Deny or inappropriately reduce payment to a provider of emergency health...
• § 33-21a-5 - Requirements Relating to Critical Access Hospitals
  (a) A critical access hospital must provide notice to a care management organization and the Department of Community Health of any alleged breaches in...
• § 33-21a-6 - Coverage for Newborn Infants Until Discharged From Inpatient Care
  (a) Each care management organization shall pay for health care services provided to a newborn infant who is born to a mother who is...
• § 33-21a-7 - Bundling of Provider Complaints and Appeals
  (a) In reviewing provider complaints or appeals related to denial of claims, a care management organization shall allow providers to consolidate complaints or appeals...
• § 33-21a-8 - Participation by Dentists
  (a) Except as provided in subsection (b) of this Code section, no care management organization or agent of such care management organization shall deny...
• § 33-21a-9 - Submission and Payment of Claims
  (a) If a provider submits a claim to a responsible health organization for services rendered within 72 hours after the provider verifies the eligibility...
• § 33-21a-10 - New and Renewal Agreements With Care Management Organizations and Health Care Providers
  (a) On and after May 13, 2008, the Department of Community Health shall include provisions in all new or renewal agreements with a care...
• § 33-21a-11 - Hospital Statistical and Reimbursement Reports From Care Management Organizations; Penalty
  Upon request by a hospital provider related to a specific fiscal year, a care management organization shall, within 30 days of the request, provide...
• § 33-21a-12 - Federal Law, Rule and Regulations Control
  To the extent any provision in this chapter is inconsistent with applicable federal law, rule, or regulation, the applicable federal law, rule, or regulation...

Last modified: October 14, 2016