| SB 89 - Essential Rural Nonemergency Trans- portation Provider Access Act |
First Reader Summary
A bill to amend Article 7 of Chapter 4 of Title 49 of the
Official Code of Georgia Annotated, the "Georgia Medical
Assistance Act of 1977," so as to provide for legislative
findings and intent; to create a new Code section to be known as
the "Essential Rural Nonemergency Transportation Provider Access
Act"; to provide for definitions.
| Senate |
Action |
House |
| 1/29/99 |
Read 1st time |
|
SB 89 99 LC 11 9730
SENATE BILL 89
By: Senator Madden of the 47th
A BILL TO BE ENTITLED
AN ACT
1- 1 To amend Article 7 of Chapter 4 of Title 49 of the Official
1- 2 Code of Georgia Annotated, the "Georgia Medical Assistance
1- 3 Act of 1977," so as to provide for legislative findings and
1- 4 intent; to create a new Code section to be known as the
1- 5 "Essential Rural Nonemergency Transportation Provider Access
1- 6 Act"; to provide for definitions; to provide for the
1- 7 designation of essential rural health care providers; to
1- 8 impose requirements for qualifications as essential rural
1- 9 health care providers; to provide that certain essential
1-10 rural health care providers shall have the opportunity to
1-11 become participating providers in local nonemergency
1-12 transportation services and certain contracts; to provide
1-13 for good faith negotiations between providers and the
1-14 Department of Medical Assistance; to provide for conditions
1-15 for denial, rejection, or termination of an essential rural
1-16 health care provider as a participating provider and an
1-17 opportunity to cure any deficiency; to provide for hearing,
1-18 appeal, and confidentiality of information; to provide for
1-19 powers of certain hospitals; to provide for effective dates;
1-20 to repeal conflicting laws; and for other purposes.
1-21 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
1-22 SECTION 1.
1-23 It is the intent of the General Assembly to encourage the
1-24 continued existence and availability of certain health care
1-25 providers in rural areas of the state so as to promote and
1-26 preserve the provision of local nonemergency transportation
1-27 to the residents of such rural areas. The General Assembly
1-28 finds that a severe shortage of local nonemergency
1-29 transportation providers currently exists in many rural
1-30 areas, and those providers which do exist continue to do so
1-31 under financial hardship of state-wide brokerages. The
1-32 General Assembly further finds that rural health care
1-33 providers are being arbitrarily excluded from participating
1-34 in nonemergency transportation plans and that, should such
1-35 practice continue, these providers will be harmed and forced
-1-
2- 1 either to discontinue their services or relocate to urban
2- 2 areas thereby further exacerbating the shortage which
2- 3 already exists. The General Assembly therefore concludes
2- 4 that certain steps must be taken to promote the continued
2- 5 existence and expansion of local nonemergency transportation
2- 6 providers in order to preserve the availability of quality
2- 7 primary health care services to Georgia's rural citizens.
2- 8 SECTION 2.
2- 9 Article 7 of Chapter 4 of Title 49 of the Official Code of
2-10 Georgia Annotated, the "Georgia Medical Assistance Act of
2-11 1977," is amended by adding after Code Section 49-4-152.4 a
2-12 new Code section to read as follows:
2-13 "49-4-152.5.
2-14 (a) This Code section shall be known and may be cited as
2-15 the 'Essential Rural Nonemergency Transportation Provider
2-16 Access Act.'
2-17 (b) As used in this Code section, the term:
2-18 (1) 'Essential rural health care provider' means any
2-19 hospital, federally qualified health center, or rural
2-20 health clinic, as such terms are defined in this Code
2-21 section, or municipally or county owned emergency
2-22 medical services department which is located in a rural
2-23 area and which complies with the provisions of
2-24 subsection (c) of this Code section.
2-25 (2) 'Federally qualified health center' means, for the
2-26 purposes of this Code section, a facility which meets
2-27 the definition of a federally qualified health center as
2-28 described in Section 1395x(aa)(4) of Title 42 of the
2-29 United States Code Annotated and which is located in a
2-30 rural area.
2-31 (3) 'Hospital' means any building or facility licensed
2-32 by the Department of Human Resources as a hospital under
2-33 Chapter 7 of Title 31 which:
2-34 (A) Operates no more than 200 beds;
2-35 (B) Provides 24 hour emergency care as well as a range
2-36 of health care services sufficient to support the
2-37 practice of a primary care physician; and
2-38 (C) For at least one of the immediately preceding two
2-39 fiscal years, derived at least 40 percent of its
-2-
3- 1 patient revenues from medicare, Medicaid, or any
3- 2 combination of medicare and Medicaid.
3- 3 (4) 'Nonemergency transportation' means nonemergency
3- 4 transportation services rendered by an essential rural
3- 5 health care provider for patients to, between, and from
3- 6 providers of health care services and other department
3- 7 authorized nonemergency transportation within the scope
3- 8 of such provider's license or legal authorization.
3- 9 (5) 'Rural area' means any county having a population of
3-10 less than 35,000 according to the United States
3-11 decennial census of 1990 or any future such census.
3-12 (6) 'Rural health clinic' means a facility which is
3-13 located in a rural area and which meets the definition
3-14 of a rural health clinic as described in Section
3-15 1395x(aa)(2) of Title 42 of the United States Code
3-16 Annotated.
3-17 (7) 'Transportation contract' means any agreement with
3-18 the department to provide nonemergency transportation to
3-19 recipients of medical assistance.
3-20 (c) Any essential rural health care provider shall have
3-21 the opportunity to become a participating provider of
3-22 nonemergency transportation to recipients of medical
3-23 assistance under transportation contracts with the
3-24 department if such provider meets all of the following
3-25 conditions:
3-26 (1) Participates in the medicare and Medicaid programs;
3-27 (2) Is licensed, where required under law, and qualified
3-28 to render the services required under the transportation
3-29 contract;
3-30 (3) Agrees to payment terms which are either:
3-31 (A) The same payment terms applicable to other similar
3-32 participating providers in the transportation
3-33 contract; or
3-34 (B) Such payment terms as may be mutually agreed upon
3-35 by such provider and the department; and
3-36 (4) Meets the reasonable and nondiscriminatory
3-37 qualifications and standards established by the
3-38 transportation contract, which standards must comply
3-39 with all applicable laws and regulations, but such
3-40 qualifications and standards may not discriminate
-3-
4- 1 against essential rural health care providers on the
4- 2 basis of geographic proximity to other participating
4- 3 providers or corporate status.
4- 4 (d) All essential rural health care providers within a
4- 5 defined service area that meet the conditions established
4- 6 in subsection (c) of this Code section shall be given the
4- 7 opportunity to apply to become a participating
4- 8 nonemergency transportation provider under the
4- 9 transportation contract. Provisions within a
4-10 transportation contract applicable to providers thereunder
4-11 shall be applied by the department in a uniform and
4-12 consistent manner to similarly situated providers. In the
4-13 event an essential rural health care provider requests the
4-14 opportunity to become a participating provider under a
4-15 transportation contract, the department shall conduct
4-16 reasonable and good faith negotiations with such essential
4-17 rural health care provider to determine whether it meets
4-18 the applicable qualifications and standards established
4-19 for the transportation contract in accordance with all
4-20 applicable laws, rules, and regulations as promulgated by
4-21 the commissioner.
4-22 (e) Nonemergency transportation plans shall include
4-23 sufficient and reasonable numbers of qualified and trained
4-24 attendants located in rural areas.
4-25 (f) To deny, reject, or terminate an essential rural
4-26 health care provider from serving as a participating
4-27 provider under a transportation contract, the department
4-28 shall:
4-29 (1) Inform the essential rural health care provider in
4-30 writing of the basis for such denial, rejection, or
4-31 termination, including a reference to any specific
4-32 qualification or standard established under the
4-33 transportation contract in accordance with all
4-34 applicable laws and regulations which the provider
4-35 failed to meet; and
4-36 (2) Where possible, afford the essential rural health
4-37 care provider a reasonable opportunity to cure the
4-38 deficiency which is the basis for such denial,
4-39 rejection, or termination.
4-40 (g) Any essential rural health care provider which is
4-41 denied, rejected, or terminated from serving as a
4-42 participating provider under the transportation contract
4-43 shall have the right of hearing and appeal under
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5- 1 subsection (c) and paragraph (3) of subsection (b) of Code
5- 2 Section 49-4-153. To the extent proprietary materials,
5- 3 trade secrets, rate data, or other materials not generally
5- 4 known to the public are presented at a hearing or an
5- 5 appeal, such information shall be admissible but shall be
5- 6 sealed and held as confidential and shall not be subject
5- 7 to Article 4 of Chapter 18 of Title 50.
5- 8 (h) A hospital which is an essential rural health care
5- 9 provider owned or operated by a hospital authority created
5-10 under Article 4 of Chapter 7 of Title 31, the 'Hospital
5-11 Authorities Law,' is authorized to provide nonemergency
5-12 transportation under a transportation contract."
5-13 SECTION 3.
5-14 This Act shall become effective upon approval of the
5-15 Governor or upon its becoming law without such approval.
5-16 SECTION 4.
5-17 All laws and parts of laws in conflict with this Act are
5-18 repealed.
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Secretary of the Senate
Frank Eldridge, Jr., Secretary
Last Updated on 05/15/00
