05 LC 33
0635
House
Bill 317
By:
Representatives Gardner of the
57th,
Ashe of the
56th,
Orrock of the
58th,
and Sinkfield of the
60th
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Article 2 of Chapter 8 of Title 31 of the Official Code of Georgia
Annotated, relating to hospital care for nonresident indigents, so as to provide
further legislative findings; to provide for alternative procedures and sources
of funding for reimbursing hospitals; to provide for related matters; to provide
an effective date; to repeal conflicting laws; and for other
purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Article
2 of Chapter 8 of Title 31 of the Official Code of Georgia Annotated, relating
to hospital care for nonresident indigents, is amended by striking Code Section
31-8-30, relating to legislative findings, and inserting in lieu thereof the
following:
"31-8-30.
The
General Assembly finds that there is an inequitable distribution of the public
costs incurred in providing health care for indigent persons who receive such
care outside their counties of residence.
While some
hospitals receive significant financial support from their counties for the
provision of indigent care, other hospitals, often those with the greatest need,
receive no financial support from their counties. This results in a disparity
of treatment and inequitable access to hospital and health care services among
the
statés
indigent population, forcing many indigent persons to seek such services in
other counties. Those
The
publicly supported hospitals
in other
counties providing such health care
services to
nonresident indigent persons are
frequently not reimbursed for the costs thereby incurred, which either
unfairly
increases the tax burden of citizens
supporting
such hospitals
residing in
such other counties or
unfairly
increases the charges made to paying patients
of such
hospitals or causes a combination of both
types of such increases. It is the purpose of this article to recognize and
provide for the
statés
and
countieś
responsibility to assist in the payment of cost of care for nonresident indigent
patients by providing procedures for the reimbursement of such costs from state
or
county
funds."
SECTION
2.
Said
article is further amended by striking paragraph (5) of Code Section 31-8-31,
relating to the definitions, and inserting in lieu thereof the
following:
"(5)
'Health care' means the following services for nonresident inpatients and
outpatients:
(A)
Emergency care or treatment;
(B)
Treatment for conditions of pregnancy and treatment of the newborn infant from
the time of birth until the time of discharge from the hospital;
(C)
Treatment for a potentially disabling illness or injury
when
treatment for such illness or injury is not available for indigent patients in
the county of residence of the patient;
and
(D)
Treatment for any combination of the
foregoing."
SECTION
3.
Said
article is further amended by striking subsections (c) through (f) of Code
Section 31-8-32, relating to the determination of indigency, and inserting in
lieu thereof the following:
"(c)(1)
When a nonresident patient receives health care from a hospital and when such
patient claims inability to pay cost of care because of indigency, the chief
administrative officer of the hospital
or his or her
designee shall notify, in writing, the
health care advisory officer of the county of residence of the patient. Such
notification shall request a determination of indigency of the patient. As soon
as practicable after receiving such notification but not later than 30 days
thereafter, the health care advisory officer of the county shall notify the
chief administrative officer of the hospital of his
or
her determination.
(2)
If the health care advisory officer determines that the patient is indigent,
such notification shall constitute a certification of such indigency, and the
expenditures
for cost of care of such nonresident
indigent patient shall be
paid to the
hospital in the manner provided in this article and shall
be maintained on the records of the
hospital for the purposes of Code Section 31-8-34.
(3)
If the health care advisory officer determines the patient is not indigent
according to the standards promulgated pursuant to subsection (a) of this Code
section, the hospital submitting the request may appeal such determination to
the commissioner, providing the commissioner with all appropriate documentation
supporting its request. The commissioner shall notify the chief administrator
of the hospital of his or her determination on appeal as soon as practicable
after receiving such appeal request but not later than 30 days thereafter. If
the commissioner determines on appeal that the patient is indigent, the cost of
care of such nonresident indigent patient shall be paid to the hospital in the
manner provided in this article.
(d)
If the health care advisory officer of a county fails to respond to a request
for a determination of indigency from a hospital providing health care for such
patient within the time limitation provided by subsection (c) of this Code
section, the county of residence of the patient shall be liable for the payment
of cost of care of such patient. In such event, the hospital providing health
care for the nonresident patient may bill the county of residence of the patient
for the amount of his
or
her cost of care, and it shall be the duty
of the governing authority of such county to pay the hospital the amount billed
within 30 days
of the
countýs
receipt of such bill. If the county fails to make such payment within 30 days
of receipt, interest shall accrue on any unpaid amount at the legal rate of
interest provided in Code Section
7-4-2.
(e)(1)
In the event a hospital fails for any reason to receive payment for the cost of
care rendered to a nonresident indigent within 90 days of a
countýs
receipt of the
hospitaĺs
request for a determination of indigency or if the payment is disputed and said
payment is not received from either the fund or the county determined by the
hospital to be responsible for such payment within such 90 days, the hospital
shall certify to the Comptroller General the unpaid amount.
(2)
The Comptroller General shall have no longer than 45 days from the date of
receiving the
hospitaĺs
certified notice to forward the unpaid amount to the appropriate hospital from
any funds due to the county under any revenue-sharing or tax-sharing fund or
grant established, collected, distributed, or administered by the state
notwithstanding the statutory purposes designated for such fund or grant,
including but not limited to those grants and special revenue disbursements
authorized pursuant to Code Sections 48-14-1 and 48-14-2, those grants to
counties for construction and maintenance of county roads under Article 2 of
Chapter 17 of Title 36, funds payable under the county appraisal staff grant
program specified in Code Section 48-5-267, the public road grant program
specified in Code Section 48-14-3, the state grants or loans for storm-water
related projects specified in Code Section 12-5-582, and any fees, charges, or
taxes imposed on insurance companies on behalf of counties pursuant to Chapter 8
of Title 33, except as otherwise provided by the state Constitution. If the
Comptroller General fails to make such payment within such 45 days, interest
shall accrue on any unpaid amount at the legal rate of interest provided in Code
Section 7-4-2. The Comptroller General shall provide the Governor and the
Appropriations Committees in the House of Representatives and the Senate with a
quarterly accounting of the amounts certified by hospitals as owed by counties
and the amount paid to hospitals out of any revenue-sharing or tax-sharing funds
or grants due to the county.
(e)(f)
To the end that the certifications of indigency required by subsection (c) of
this Code section may be expedited, it shall be the duty of each county health
care advisory officer to establish and maintain files showing the names of
county residents determined to be indigent.
(f)(g)
It shall be the duty of the commissioner to devise such standard forms as may be
necessary or desirable to administer this Code section uniformly. It shall be
the duty of counties, health care advisory officers, and hospitals to use the
forms promulgated by the commissioner pursuant to this
subsection."
SECTION
4.
Said
article is further amended by striking Code Section 31-8-33, relating to the
Nonresident Indigent Health Care Fund, and inserting in lieu thereof the
following:
"31-8-33.
There
is created the Nonresident Indigent Health Care Fund for the purpose of making
payments therefrom to hospitals to reimburse such hospitals for the cost of care
of nonresident indigent patients. Such fund shall be made up of appropriations
made thereto by the General Assembly, as provided in this article.
To the extent
there are for any reason insufficient moneys in the fund to pay any of the
financial obligations created by this article, such obligations shall be paid by
the Comptroller General in the manner provided in subsection (e) of Code Section
31-8-32."
SECTION
5.
Said
article is further amended by inserting at the end thereof a new Code Section
31-8-38 to read as follows:
"31-8-38.
Any
countýs
total liability under this article for any year shall not exceed the amount
which could be derived by the county from a one mill ad valorem tax levy for
that year, regardless of whether that amount is actually derived from such tax
or any other tax. Amounts paid by a county for interest, penalties,
attorneyś
fees, or court costs arising under this article shall be excluded from any
calculation of a
countýs
total amount of liability. Notwithstanding the foregoing, the total liability
of a county under this article shall be reduced by an amount equal to the amount
of any payment made by such county during such year to any hospital located in
such county to support the services and facilities of such hospital, as well as
the proceeds of any ad valorem tax levied by such county pursuant to Code
Section 31-7-84 and paid to such hospital or hospital authority during such
year. Nothing in this Code section shall be construed to be a limitation upon a
countýs
authority to levy a tax or spend for any health care services in an amount
greater than that provided in this Code section. A county shall not satisfy its
liability under this article by making lump sum payments, aggregate payments, or
prepayments to any hospital located outside such county, nor by entering into an
exclusive contract with any such hospital, unless such hospital is owned or
operated by a hospital authority created in whole or part by the paying
county."
SECTION
6.
This
Act shall become effective upon its approval by the Governor or upon its
becoming law without such approval.
SECTION
7.
All
laws and parts of laws in conflict with this Act are repealed.