HB130.html

31-46-1.
This chapter shall be known and may be cited as the 'Georgia Health Care Act.'

31-46-2.
(a) The General Assembly finds that the health care crisis in Georgia and in the United States so threatens the public health and welfare and undermines economic prosperity that state action is necessary. Reliance on a combination of private insurance and public coverage for personal health care has proved inequitable, grossly expensive, inefficient, and inadequate to meet the needs of the people. This chapter is enacted to provide comprehensive health care coverage for every Georgian and to maximize health care quality, freedom of choice, and cost effectiveness. These goals shall be achieved through creation of a publicly financed, single-payer, single-budget health insurance coverage system to replace the current mix of public and private payment methods.
(b) Georgians suffer poor health status. The infant mortality rate, a standard measure of overall quality of life, is now the worst among the states. The United States rate is higher than those of 20 other nations. Some rural counties have infant death rates that are higher than in developing countries. Citizens of 11 other countries live longer than people in the United States despite their often higher rates of smoking, alcohol consumption, and other health risks. Residents of 46 other states live longer than Georgians. Our child immunization rates are lower than in much of the rest of the world. Access to necessary health care is declining. People with serious conditions are seeing doctors less often than in previous years.
(c) Lack of health insurance is a major reason for this suffering. People without insurance are less likely to see doctors, more likely to be ill or to have debilitating conditions, more likely to miss work or school, more likely to get care only episodically in a hospital emergency room after a condition has become more expensive to treat, and more likely to die prematurely of treatable disorders. Added to the health risk from inability to get regular care is the threat of financial ruin in the event of illness or accident. Medical bills are the leading cause of personal bankruptcy.
(d) Over one million Georgians and 35 million people in the United States have no public or private insurance coverage. In Georgia, the risk of being uninsured crosses demographic and occupational categories. Among our uninsured people are children, families with only one parent at home, people in rural areas, urban dwellers, personal service workers, construction workers, those working in agriculture, and professionals. Many uninsured Georgians are in working families. More Americans are losing coverage daily. While people with low incomes are most likely to be uninsured, with over half of Georgians with incomes between 50 percent and 100 percent of the national poverty level lacking insurance, a growing number of people with higher incomes are losing their coverage. Of the 1.3 million Americans who lost insurance in 1991, almost 75 percent had incomes of over $25,000.00 and a third had incomes of over $50,000.00.
(e) Paradoxically, while many people suffer poor health, shortened life, and financial insecurity because of medical expenses, annual personal health spending for Georgians has now reached nearly $6,000.00 per family. Families pay 72 percent of this cost through insurance premiums, taxes, and out-of-pocket expenditures while businesses pay 28 percent through insurance, taxes, and other means. National health spending now exceeds $2,500.00 per person. We spend a third more per person than do Canadians and twice as much as do Japanese and Germans despite the fact that they cover virtually all of their citizens and experience better health. Health costs now exceed 13 percent of our gross national product and double digit annual health care inflation persists. Besides taking an unacceptable human toll, disproportionately high spending in the health industry also saps the country´s economic strength and contributes to trade deficits.
(f) The financing system is inefficient. With hundreds of different insurers and public programs making payments to health care providers, it is impossible to plan a budget using available funds to achieve specified goals as any family or business must do. Each insurer competes with the others to minimize costs and maximize earnings from premium income or simply to minimize expenditures while individual and institutional health care providers attempt to maximize revenues. The result is a shell game in which:
(1) Costs are shifted from one payor to another;
(2) Decisions by patients and their doctors are scrutinized and overridden by insurers;
(3) Benefits are uneven and unclear to patients, doctors, and hospitals, subject to cancellation or restriction, and may have exclusions or dollar maximums resulting in noncoverage of needed care;
(4) People are forced increasingly to use designated providers, which is not the case in Canada, Japan, or Germany;
(5) Employers wishing to avoid insurance premium increases or loss of coverage have an incentive to avoid hiring or to discharge otherwise valuable employees with health problems;
(6) Nearly a quarter of every health dollar is spent on coverage verification, utilization review, and billing related administration; and
(7) High technology care, although unquestionably beneficial when used appropriately, gets disproportionate emphasis because it is more profitable than primary care. Studies show that many expensive and dangerous procedures performed on well-insured people are unnecessary.
(g) Private health insurance provided through employers´ group plans and individual policies covers a decreasing share of health care costs. Nationally, private insurance pays for only 33 percent of personal health expenses today, down from 44 percent in 1975. The majority of such costs are paid by government and by patients out of pocket. Only about 23 percent of Georgians´ personal health bills are paid through employment based insurance, and these percentages include the employee´s share of premiums. Georgians pay more out of pocket than the national average. The number of Medicaid enrollees has also increased dramatically in the last year so that about 750,000 Georgians are now covered.
(h) A major reason for the declining role of private coverage is the erosion of the traditional basis of insurance: to spread risk over a large group so that no individual has to pay too much for protection. Increasingly, private insurers seek to avoid risk, rather than to spread it, by using underwriting and risk-rating procedures to deny coverage or charge prohibitively high premiums for people with conditions such as high blood pressure, asthma, cancer, AIDS, or birth defects. It is estimated that a third of the population has conditions that would now subject them to exclusion or high rates if they had to seek insurance outside of a large group. Increasingly sophisticated genetic testing will compound this problem. Thousands of Georgians also experience 'job lock' because they fear being unable to obtain new insurance.
(i) In addition, some private insurance may not be reliable because of financial instability of the companies. Nationally, liquidations of life or health insurers occurred at a rate of about 19 per year from 1984 to 1990, with a high of 43 in 1989, up from an average of five per year from 1975 to 1983. Georgia was fourth in the nation among states reporting dollar value of unpaid claims by multiple employer welfare associations from 1988 to 1990.
(j) Almost 60 percent of employment based health coverage is now provided through employers that self-insure. This is a dramatic increase from the 5 percent of companies that self-insured in 1970. Like private companies, self-insured plans may not provide security for a person who requires health services. Employers may cancel them, and courts have allowed such plans arbitrarily to reduce benefits based on the nature and expense of an enrollee´s condition.
(k) Although public subsidy of health care for low-income people figures prominently in a discussion of health care costs, 79 percent of all federal health care expenditures are for the nonpoor. Federal expenditures include medicare, the federal share of Medicaid, benefits for employees and public officials, veterans´ and other health programs, a tax benefit for employees whose employer paid health insurance premiums are not counted as taxable income to them, corporate tax deductions, and hospital tax exemptions. State and local governments provide similar benefits and tax subsidies. This variety of on-budget and off-budget revenue streams and the plethora of private insurers create a wasteful, inequitable health care payment system which defies any attempt to budget and plan rationally.
(l) Limited reorganization of health care financing under the rubric of 'managed competition' has been proposed. The United States Congressional Budget Office has testified that this approach will neither save money nor assure coverage of the population within five years.
(m) The United States General Accounting Office, on the other hand, has determined that administrative efficiencies achieved by combining dollars expended on personal health services from all sources and using them to devise a single-budget, single-payor plan would finance uniform coverage for the entire population and would allow reduction or elimination of copayments and deductibles. Current revenue sources include medicare, Medicaid, other government programs, private health insurance premiums paid by employers and individuals, tax subsidies, and out-of-pocket payments. A progressive tax system to replace what individuals now pay through current revenue streams would assure that payment is based on ability to pay throughout the life span, rather than penalizing people when they are ill.
(n) In light of the foregoing, the General Assembly rejects proposals such as tax credits, 'pay or play' employer plans, rationing schemes, managed competition, and other forced managed care systems that continue reliance on the fragmented public and private payment system because it finds that system to be inherently inequitable and inefficient. The General Assembly adopts the approach of this chapter in order to secure as a right equitable access to comprehensive, high-quality, cost-effective health care with freedom of choice for all Georgians.

31-46-3.
As used in this chapter, the term:
(1) 'Board of governors' or 'board' means the Georgia health care corporation board of governors created under Code Section 31-46-4 or the successor body, if any.
(2) 'Consumer' means a person who is not employed by any health care facility or provider and who has no financial or fiduciary interest in any health care facility or provider.
(3) 'Critical health care services' means services identified through the process established in Code Section 31-46-10 and addressed in the improper queuing provisions set forth in Code Section 31-46-13.
(4) 'Enrollee' means any person who is a resident of Georgia and who is enrolled in the Georgia health plan.
(5) 'Executive officer' means the executive officer of the Georgia health care service corporation created under Code Section 31-46-4 or the successor body, if any.
(6) 'Georgia health care corporation' or 'corporation' means the public corporation established under Code Section 31-46-4.
(7) 'Georgia health plan,' 'health care plan,' 'health plan,' or 'plan' means the health plan provided under Code Section 31-46-4.
(8) 'Health care facility' or 'facility' means a hospital licensed under Chapter 7 of this title or other institutions licensed by the state under that chapter that the board of governors identify as appropriate to provide health care plan services.
(9) 'Health care provider,' 'provider,' or 'practitioner' means a physician licensed under Chapter 34 of Title 43 or other licensed health professionals regulated under Chapter 9, 11, 26, 28, 29, 30, 33, 35, 39, or 44 of Title 43 and whom the board of governors identify as appropriate to provide services through the health care plan.
(10) 'Health care services' means a set of comprehensive basic health care services defined under Code Section 31-46-10 and provided by the Georgia health plan.
(11) 'Improper queuing' means the waiting period to receive critical health care services in excess of acceptable standards and guidelines as established by the board of governors under Code Section 31-46-10.
(12) 'Insurer' means an accident and sickness insurer, a health care plan, a health maintenance organization, a fraternal benefit society, a nonprofit medical service corporation, or a nonprofit hospital service corporation authorized pursuant to Title 33 to sell accident and sickness insurance policies, subscriber certificates, or other contracts of insurance by whatever name called.
(13) 'Nonmedical services' means services that are not necessarily provided by a provider or facility but are deemed by the board of governors as critical for the efficient and effective delivery of health care services and may include, but are not limited to, transportation and language translation services.
(14) 'Resident' means a person who is domiciled in this state.
(15) 'State health care budget' or 'health care budget' means a budget that finances the total amount of health care services provided in the health care plan with funds enumerated in Code Section 31-46-7.

31-46-4.
(a) The Georgia health care corporation is created as a public corporation in this state to implement and administer the Georgia health plan. The corporation shall be governed by a board of governors composed of 19 members, 15 of whom shall be appointed by the Governor with the advice and consent of the Senate and four of whom shall be the following voting ex officio members who shall serve on the board during the time they hold the following offices: the commissioner of the Department of Human Resources, the Commissioner of Insurance, the commissioner of community health, and the state revenue commissioner. Of the 15 appointed members, ten members shall represent consumers, including representatives of individuals with special health care needs and access problems, and five shall represent providers and facilities.
(b) Of the initial appointments made by the Governor, three shall be for a term ending July 1, 2006; three shall be for a term ending July 1, 2007; three shall be for a term ending July 1, 2008; three shall be for a term ending July 1, 2009; and three shall be for a term ending July 1, 2010. Thereafter, terms of office shall be for five years, each term ending on the first day of July.
(c) Each appointed member shall hold office from the date of that person´s appointment until the end of the term for which the person was appointed. Any member appointed to fill a vacancy occurring prior to the expiration of the term for which that person´s predecessor was appointed shall hold office for the remainder of that term. Each member shall continue in office subsequent to the expiration date of that person´s term until that person´s successor takes office or until a period of 60 days has elapsed, whichever occurs first.
(d) The Governor annually shall appoint the chairperson, vice chairperson, and secretary of the board from among the membership of the board.
(e) Meetings shall be held upon the call of the chairperson and as may be provided by procedures prescribed by the board.
(f) Ten members of the board constitute a quorum and the affirmative vote of ten members shall be necessary for any action to be taken by the board.
(g) The Governor, at any time after notice and opportunity for hearing, may remove for cause any member appointed by the Governor.
(h) The members of the board shall serve without compensation but shall be reimbursed for their expenses incurred while engaged in the business of the board. Appointed members of the board shall receive the expenses and allowances authorized for legislative members of interim legislative committees. Members of the board who are officers or employees of the state shall receive no compensation for their services on the board, but they shall be reimbursed for expenses incurred by them in the performance of their duties as members of the board in the same manner as they are reimbursed for expenses incurred in the performance of their duties as officers or employees of the state. The funds necessary for the reimbursement of the expenses of any such state officer or employee shall come from funds appropriated to or otherwise available to the respective department of that officer or employee. All other funds necessary to carry out the provisions of this resolution shall come equally from the funds appropriated to the Georgia health care service corporation.

31-46-5.
The board shall have all the powers necessary or convenient to carry out and effectuate the purposes and provisions of this chapter, including, but without limiting the generality of the foregoing, the following powers:
(1) To sue and be sued;
(2) To have a seal and alter the same;
(3) To make and execute contracts and other instruments necessary to exercise the powers of the board;
(4) To acquire, accept, or retain equitable interests, security interests, or other interests in any property, real or personal, by mortgage, assignment, security agreement, pledge, conveyance, contract, lien, loan agreement, or other consensual transfer in order to secure the repayment of any moneys loaned or credit extended by the board;
(5) To accept gifts, grants, or devises of any property;
(6) To exchange, transfer, assign, pledge, mortgage, or dispose of any real or personal property or interest therein;
(7) To mortgage, pledge, or assign any revenue, income, tolls, charges, or fees received by the board;
(8) To borrow money for any corporate purpose;
(9) To appoint officers, agents, and employees; and
(10) To make use of any facilities afforded by the federal government or any agency or instrumentality thereof.

31-46-6.
(a) Notwithstanding other provisions of law, it is the responsibility of the board of governors to implement the provisions of this chapter so that all residents shall be enrolled in the health care plan by July 1, 2008. The plan shall incorporate the following elements:
(1) All residents of Georgia shall have the right to participate in the Georgia health care plan regardless of age, sex, marital status, ethnicity, race, health condition, geographic location, employment, or economic status;
(2) A uniform set of appropriate health care services, developed under Code Section 31-46-10, that adhere to the principles set forth in Code Section 31-46-2 shall be available to all enrollees. Such health care services shall be provided in an efficient and timely manner;
(3) The Georgia health care corporation shall be developed based on the concept of a unified administrative organizational structure having complete operational control over all aspects of the health plan, including budgeting, health plan benefit design, data collection, negotiation, contracting, and payment. The board of governors may, but is not required to, contract with insuring entities or other appropriate organizations to act as regional administrative entities or provide other administrative services;
(4) A state health care budget, as defined in Code Section 31-46-3, derived from sources identified in Code Section 31-46-7 shall be established;
(5) Health care facilities that provide health care services through the plan shall be funded by an annual health care facility operating budget negotiated by the executive officer, reflecting the total cost of health care services provided through the plan, which is based on data adjusted for patient characteristics and other factors, updated at least annually, and considers regional variations, if any. Capital expenditures and health care provider education costs shall be paid separately by the plan;
(6) Each health care provider shall have the option of payment that is negotiated on the basis of fee for service, annual budget, or capitation. Payments shall be set within each specialty or scope of practice in the manner prescribed by the board of governors. These fees shall be computed taking into consideration the principles set forth in the federal resource based relative value scale, incentives to provide wellness services, and the least intrusive procedures appropriate for the prevention or treatment of illnesses or injuries. The board may establish incentives to ensure that needed providers are available in traditionally underserved areas. Except for regional variations authorized under Code Section 31-46-8 or other actuarially based variations, capitation rates shall be uniformly based on the number of enrollees served by the provider. If such provider chooses to be reimbursed through an annual budget, the amount shall be determined in a manner similar to a health care facility annual budget. The board of governors shall develop incentives for health care providers to participate in service organizations that are cost effective;
(7) The board of governors may contract directly with local health departments or districts, public or private not-for-profit health centers, health care facilities, or other appropriate governmental agencies to provide health plan services;
(8) No health care facility, health care provider, or insurer may charge any additional fees or balance bills for services included in the health plan that are provided to enrollees;
(9) The plan shall include necessary nonmedical services to eliminate barriers to needed health care services;
(10) The plan shall include portability provisions whereby an enrollee traveling out of state continues to be covered under the plan. The board shall establish a payment schedule for payment of out-of-state services. The board shall also endeavor to ensure that enrollees do not use out-of-state health care providers as regular sources of health care services but may permit reasonable exceptions; and
(11) The plan shall provide for an explicit grievance and complaint procedure whereby an enrollee may file a complaint or grievance regarding any aspect of the plan and the filing shall be addressed expeditiously.
(b) As of July 1, 2008, no insurer may independently insure, contract for, or provide those health care services provided through the Georgia health plan. Nothing in this chapter shall preclude such an insurer from insuring, providing, or contracting for health services not included in the health plan nor restrict the right of an employer to offer, or employee representative from negotiating for, services not included in the plan. Facilities and practitioners may offer enhanced benefits not included in the plan if, through organizational and administrative efficiencies, plan services can be provided for less than the contracted amount. However, additional payment shall not be required of nor permitted by an enrollee receiving such enhanced service.
(c) Initially, any benefits for health care services provided under any policy of workers´ compensation insurance or a self-insured workers´ compensation program, state and federal veterans health care program, and the civilian health and medical program of the uniformed services (CHAMPUS) of the United States Department of Defense shall not be included in the health plan but shall be studied for future inclusion.
(d) The board shall develop payment schedules for persons from out of state who receive services through the plan. Such schedules shall reflect the total cost of the health care service provided.
(e) In developing the plan, the board of governors should consider the likelihood of the establishment of a national health care plan adopted by the federal government and its implications.
(f) The board shall consider implementing a publicly operated liability insurance plan for providers who provide Georgia health plan services. The board shall report, as necessary, its determination as to the necessity or desirability of such plan to the General Assembly by December 1, 2005.

31-46-7.
(a) The state health care budget shall reflect the total expenditure of the plan. The board of governors shall develop the state health care budget based on state economic and revenue indicators and other forecasting methods. The state health care budget shall be comprised of the sources identified in subsection (b) of this Code section. The board of governors shall submit the state care health budget, which shall include estimated amounts of each trust fund account as set forth in Code Section 31-46-11, as part of the Governor´s annual budget request. The General Assembly may adopt, reject, or reduce the budget so submitted and advise the board regarding individual amounts in each trust fund account.
(b) The state health care budget shall include funds to be obtained from the following sources:
(1) Medicare, Parts A and B, Title XVIII of the federal Social Security Act, as amended;
(2) Medicaid, Title XIX of the federal Social Security Act, as amended;
(3) Such other federal funds as may be made available;
(4) Gifts, grants, or donations from private sources; and
(5) State appropriations for the plan derived from progressive personal and corporate income taxes and such other revenue sources as the General Assembly authorizes.
(c) Health care budget funds shall be deposited in the Georgia health care trust fund created in Code Section 31-46-11.

31-46-8.
The board of governors may create Georgia health care regions upon the determination that differences in demographics, geography, population density, cost of living, economic status, availability of health care facilities and health care providers, or other relevant factors require some variation in the administration and service delivery of the Georgia health plan. In such case, the board of governors shall designate regional boundaries that best reflect the differences and may appoint a regional administrative entity to operate the plan within the designated region. All organizational and service delivery variations must be consistent with the Georgia health plan elements set forth in Code Section 31-46-6.

31-46-9.
The Georgia health plan shall be implemented in developmental phases as follows:
(1) By March 1, 2005, the director of the Office of Planning and Budget shall establish a transitional team composed of staff of the commissioners of the Department of Community Health, Department of Human Resources, Department of Revenue, and Department of Insurance. The director may request participation of the appropriate legislative committee staff. The transitional team shall conduct analyses and identify:
(A) The necessary transfer and consolidation of responsibilities among state agencies to implement fully this chapter;
(B) State and federal laws that would need to be repealed, amended, or waived to implement this chapter; and
(C) Appropriate guidelines for the administrative cost of the plan.
The transitional team shall report its findings to the director and board by October 1, 2005, and on that date be disbanded;
(2) By July 1, 2005, the board of governors shall be appointed. As soon as possible thereafter, the board shall:
(A) Appoint the executive officer;
(B) Hire the necessary staff;
(C) Develop necessary data sources; and
(D) Develop the necessary methods to establish the state health care budget;
(3) By December 1, 2005, the board of governors shall submit to the appropriate committees of the General Assembly an agency transfer and consolidation report, which shall address staffing, equipment, facilities, and funds, along with drafts of any necessary legislation. It shall also recommend appropriate cost guidelines for the administration of the plan;
(4) By December 1, 2005, the board shall:
(A) Report to the Governor and the appropriate committees of the General Assembly the extent that statutory revisions are needed;
(B) Report its recommendations regarding medical malpractice as required in subsection (f) of Code Section 31-46-6; and
(C) Submit requests for necessary federal waivers to implement this chapter;
(5) By July 1, 2006, the board shall report to the Governor and the appropriate committees of the General Assembly, if necessary, regarding implementation of the plan without federal waivers;
(6) By September 1, 2006, the board shall have:
(A) Established health care regions if deemed necessary;
(B) Determined plan benefits;
(C) Identified strategies addressing improper queuing;
(D) Developed procedures regarding enrollment and facility and provider negotiations and payments; and
(E) Defined a list of critical health care services;
(7) By October 1, 2006, consistent with the executive budget process, the board of governors shall submit the first proposed state health care budget to the Governor;
(8) During its 2007 session, the General Assembly should consider the material submitted to it pursuant to this Code section in an expeditious manner; and
(9) By July 1, 2008, consistent with specific appropriations, all provisions of this chapter shall be in full effect of law.

31-46-10.
(a) The board of governors shall define the health care plan benefits which shall include those health care and related services which promote and maintain the highest attainable health and quality of life for all Georgians at a reasonable cost achieved through system efficiencies and appropriate care.
(b) The health plan shall include, at least, the following categories of coverage:
(1) Clinical and community based primary and preventive health care;
(2) Health care practitioner services;
(3) Inpatient and outpatient hospital services;
(4) Testing and diagnostic services;
(5) Prescription drugs;
(6) Dental services;
(7) Mental health services;
(8) Long-term services, including attendant services, assistive technology, home and community based services and living alternatives, limited institutional beds, and respite care; and
(9) Certain auxiliary services, such as transportation necessary to facilitate use of health care services.
(c) Health plan benefits shall not include:
(1) Cosmetic surgery except medically necessary reconstructive surgery and related services; and
(2) Examinations associated with life insurance or legal proceedings.
(d) The health plan may include other coverage determined by the board of governors to be effective, necessary, and consistent with the principles set forth in Code Section 31-46-2.
(e) The specific schedule of health care services associated with the categories of coverage authorized by this Code section shall be developed by the board of governors under subsection (f) of this Code section.
(f)(1) The board of governors shall establish procedures to determine what specific schedule of health care services shall be covered in the plan and to assure that such services are provided in a timely and appropriate manner.
(2) The board of governors shall monitor developments in establishment of standards of care and standards for appropriate use of technology, including national practice guidelines, and shall incorporate into the health plan such standards and guidelines as the board deems appropriate.
(3) The board of governors shall develop a schedule of critical, high priority health care services and related time guidelines for delivery of such services or treatment. The schedules and guidelines shall be the basis for expending funds from the improper queuing reserve account established in Code Section 31-46-11.
(4) Recognizing that some providers have significant financial interests in major diagnostic equipment, surgical facilities, and laboratories through which their patients receive services and recognizing that such financial interests may create unusual incentives to order use of tests and treatment, the board of governors shall identify and monitor utilization of these services. The board shall conduct studies to determine if excess utilization is occurring and shall take appropriate steps to curb any excess utilization attributable to financial incentives.
(5) The board of governors shall monitor utilization generally to determine whether aspects of the payment system create incentives for underuse or overuse of certain services detrimental to cost-effective attainment of optimal health and functional ability for all Georgians and shall take appropriate steps to correct any adverse incentives.
(6) The board of governors shall develop and implement health care quality assurance programs.
(7) To carry out the requirements of this subsection, the board of governors shall periodically establish a health care service review panel, including consumers and providers, to review information on need, efficacy, and cost effectiveness of specific services and treatments and to recommend standards, guidelines, and methods. The board of governors shall also consult with the public and with appropriate professional and regulatory bodies and other state agencies in carrying out the requirements of this subsection.

31-46-11.
(a) The health care trust fund is established in the state treasury. All funds enumerated in Code Section 31-46-7 shall be deposited in the health care trust fund and shall be expended in a manner consistent with rules adopted by the board of governors. The trust fund shall consist of five accounts:
(1) The health care account from which funds shall be expended for health plan services in accordance with rates, budgets, and contracts negotiated with health care facilities and health care practitioners; payments for remnant uncompensated care; and nonmedical services;
(2) The capital development account from which funds shall be expended, as determined necessary by the board in consultation with other affected agencies and the public, for expansion and improvement of health facilities and the acquisition of major medical equipment as defined by the board of governors by rule. The board shall establish categories of capital expenditures that do not require board approval;
(3) The public health account from which funds shall be expended for health promotion and illness and injury prevention services and other public health services in a manner that addresses priority health goals. Funds from this account shall be allocated to public and private entities in a manner prescribed by the board of governors by rule;
(4) The improper queuing reserve account from which funds shall be expended to reduce unacceptable delays in the delivery of critical health care services as set forth in Code Section 31-46-12; and
(5) The health professional education and research account from which funds shall be expended to:
(A) Train or retain needed health care providers;
(B) Conduct research relative to the operation of the plan consistent with the principles set forth in this chapter; and
(C) Compensate facilities for their costs in training or retraining providers.
(b) The board shall not expend or encumber for an ensuing year amounts exceeding 95 percent of the amount anticipated to accrue in the account during the year.

31-46-12.
It is the intent of the General Assembly that all enrollees receive necessary health care services in a timely manner and that every effort be made to avoid delays in service that could be detrimental to enrollee health. The board of governors shall develop strategies that will reduce or prevent improper queuing for critical health care services, as defined in Code Section 31-46-3. Upon the development of such strategies and the adoption of related rules, funds from the improper queuing reserve account of the Georgia health care trust fund may be used to implement such strategies.

31-46-13.
(a) The board of governors shall develop the health data sources necessary to implement and operate efficiently the Georgia health plan. The board of governors shall publish such data as is necessary to assure quality care and to promote public health and appropriate use of services. To the extent feasible, the board of governors shall use existing data systems and coordinate among existing agencies. The following sources shall be developed or made available:
(1) The board of governors shall coordinate with appropriate agencies to utilize data collected regarding health facilities and practitioners, rural health data, epidemiological data, ethnicity data, social and economic status data, and other data relevant to the board´s responsibilities;
(2) The board of governors, in coordination with appropriate agencies and academic institutions shall develop procedures to analyze clinical and other service outcome data and conduct other research necessary for the specific purpose of assisting in the design of the health plan benefits under Code Section 31-46-10; and
(3) The board of governors shall require each insurer, provider, and facility to provide the board with patient care and cost information, to include at least:
(A) Patient identifier, including date of birth, sex, and ethnicity;
(B) Provider identifier;
(C) Diagnosis;
(D) Health care services or procedures provided;
(E) Provider charges; and
(F) Amount paid.
(b) The board shall establish by rule confidentiality standards to safeguard the information from inappropriate use or release.

31-46-14.
The board of governors shall adopt rules consistent with this chapter for the administration of the plan. All rules shall be adopted in accordance with Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'

31-46-15.
The General Assembly reserves the right to amend or repeal all or any part of this chapter at any time and there shall be no vested private right of any kind against such amendment or repeal. All rights, privileges, or immunities conferred by this chapter on any act done pursuant thereto shall exist subject to the power of the General Assembly to amend or repeal this chapter at any time.

31-46-16.
The enactment of this chapter shall not terminate or modify any obligation or liability, civil or criminal, which was in effect when this chapter first becomes effective."