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Care Coordination/Care Management in Georgia

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Care Coordination/Care Management in Georgia

Subtopic Statute/Regulation Description
Licensure laws requiring or recommending care coordination or care management activities (Cross reference with private insurance/Medicaid/Medicare data requirements) Agreement for Assignment System, Ga. Code Ann. § 33-29A-3 Agreement for Assignment System
Assignment of Eligible Individuals to Managed Care Organizations, Ga. Code Ann. § 33-29A-5 Assignment of Eligible Individuals to Managed Care Organizations
Coverage Options through HMOs, Ga. Code Ann. § 33-21-29 Coverage Options through HMOs
Coverage Options, Ga. Code Ann. § 33-30-15 Coverage Options
Establishment of Health Maintenance Organizations, Ga. Code Ann. § 33-21-2 Establishment of Health Maintenance Organizations
Health Reimbursement Arrangements, Ga. Code Ann. § 33-51-7 Health Reimbursement Arrangements
Home Health Agencies Scope of Services, Ga. Comp. R. & Regs. 111-8-31-.08 Home Health Agencies Scope of Services
Home Health Agencies Standards for Patient Care, Ga. Comp. R. & Regs. 111-8-31-.09 Home Health Agencies Standards for Patient Care
Hospice Home Care, Ga. Comp. R. & Regs. 111-8-37-.16 Hospice Home Care
Hospital Inspections and Required Reports to the Department, Ga. Comp. R. & Regs. 111-8-40-.07 Hospital Inspections and Required Reports to the Department
Hospital Medical Records, Ga. Comp. R. & Regs. 111-8-40-.18 Hospital Medical Records
Hospital Patient Assessment and Treatment, Ga. Comp. R. & Regs. 111-8-40-.19 Hospital Patient Assessment and Treatment
Insurance Coverage for Bone Marrow Transplants, Ga. Code Ann. § 33-29-3.3 Insurance Coverage for Bone Marrow Transplants
Insurance Coverage for Breast Cancer Care, Ga. Code Ann. § 33-24-72 Insurance coverage for breast cancer care.   
Insurance Coverage for Children Services, Ga. Code Ann. § 33-29-3.4 Insurance Coverage for Children Services
Insurance Coverage for Human Heart Transplants, Ga. Code Ann. § 33-29-3.1 Insurance coverage for human heart transplants.   
Insurance Coverage for Mammograms, Pap Smears, and Prostate Tests, Ga. Code Ann. § 33-29-3.2 Insurance Coverage for Mammograms, Pap Smears, and Prostate Tests
Insurance Optional Policy Provisions, Ga. Code Ann. § 33-29-4 Insurance Optional Policy Provisions
Long Term Care Regulations, Ga. Code Ann. § 33-42-6 Long Term Care Regulations
Medicaid Certificate of Authority, Ga. Code Ann. § 33-21A-3 Medicaid Certificate of Authority
Medicaid Services for Newborn Infants, Ga. Code Ann. § 33-21A-6 Medicaid Services for Newborn Infants
Medical records under the Department of Community Health regulations - GA. COMP. R. & REGS. § 111-8-40-.18 Hospitals must retain patient records for 5 years. In the case of a minor patient, medical records must be retained 5 years after a patient turns 18...
Medicare Disclosure Standards, Ga. Code Ann. § 33-43-5 Medicare Disclosure Standards
Medicare Standards for Policy Provisions, Ga. Code Ann. § 33-43-3 Medicare Standards for Policy Provisions
Patient's Right to Request Indepdendent Review, Ga. Comp. R. & Regs. 111-2-3-.04 Patient's Right to Request Indepdendent Review
Public Health Tuberculosis Hospitalization of Committed Patients, Ga. Comp. R. & Regs. 511-2-3-.04 Public Health Tuberculosis Hospitalization of Committed Patients
Required Provisions of Managed Care Plans, Ga. Code Ann. § 33-20A-9 Required Provisions of Managed Care Plans
Resident Care and Treatment, Ga. Comp. R. & Regs. 111-8-50-.07 Resident Care and Treatment
Disease management Conditions of Anti Cancer Drug Coverage, Ga. Code Ann. § 33-53-2 Conditions of Anti Cancer Drug Coverage
Confinement of Patients For Tuberculosis, Ga. Code Ann. § 31-14-8 Confinement of Patients For Tuberculosis
Examination and Control of Venereal Diseases, Ga. Code Ann. § 31-17-3 Examination and Control of Venereal Diseases
Taking Into Custody Person Leaving Hospital Without Authority, Ga. Code Ann. § 31-14-11 Taking Into Custody Person Leaving Hospital Without Authority
Informed consent requirements (If the information is going beyond the patient and provider Consent of Minor for Treatment of Venereal Diseases, Ga. Code Ann. § 31-17-7 Consent of Minor for Treatment of Venereal Diseases
HIV Testing Refusal to Consent, Ga. Code Ann. § 31-17A-2 HIV Testing Refusal to Consent
Mental Health Record Confidentiality - Ga. Stat. Ann. § 37-3-166 Records and information relating to the mental health of an individual are confidential and privileged to the patient, and may only be disclosed in...
Information sharing across providers (including communication with other providers, across state lines, patient transfer) Disclosure Authorization Forms, Ga. Code Ann. § 33-39-7 Disclosure Authorization Forms
Disclosure of Information for Insurance Transactions, Ga. Code Ann. § 33-39-14 Disclosure of Information for Insurance Transactions
Group Policy Issues In Another State, Ga. Code Ann. § 33-42-5 Group Policy Issues In Another State
Individual Accident and Sickness Insurance Policies from Other States, Ga. Code Ann. § 33-29A-32 Individual Accident and Sickness Insurance Policies from Other States
Notice of Information Practices, Ga. Code Ann. § 33-39-5 Notice of Information Practices
Regulations for Pharmaceutical Services, Ga. Code Ann. § 33-20-4.3 Regulations for Pharmaceutical Services
Patient authorization requirements (to provide health information to another individual) HMO Confidentiality of Medical Information, Ga. Code Ann. § 33-21-23 HMO Confidentiality of Medical Information
Mental Health Facility Examination of Patient Records, Ga. Code Ann. § 37-3-167 Mental Health Facility Examination of Patient Records
Mental Health Facility Quality of Care and Treatment, Ga. Code Ann. § 37-3-162 Mental Health Facility Quality of Care and Treatment
Treatment planning when using interdisciplinary team (including assessments, plan of care, discharge/transfer planning Home Care Service Plans, Ga. Comp. R. & Regs. 111-8-65-.11 Home Care Service Plans
Hospice Assessment and Plan of Care, Ga. Comp. R. & Regs. 111-8-37-.15 Hospice Assessment and Plan of Care
Plan of Evaluation or Outpatient Treatment, Ga. Code Ann. § 31-14-13 Plan of Evaluation or Outpatient Treatment
Standards to Determine the Necessity of Treatment, Ga. Code Ann. § 33-20A-40 Standards to Determine the Necessity of Treatment
Termination of a Physician's Contract, Ga. Code Ann. § 33-20A-61 Termination of a Physician's Contract
Payment reform initiatives Prohibited Practices for Coverage, Ga. Code Ann. § 33-20A-62 Prohibited Practices for Coverage
New coordinated systems of care (ACOs, Patient Centered Medical Homes/Health homes) (Cross reference with Quality Measurement) Restraints and Abuses, Ga. Code Ann. § 37-4-124 Restraints and Abuses
Click on the individual state law in the table above to see our summary of the individual law.


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