TITLE 31 HEALTH

Section 8. Care and Protection of Indigent and Elderly Patients, 31-8-1 through 31-8-306.

ARTICLE 2A HOSPITAL CARE FOR PREGNANT WOMEN

31-8-43. Determination of indigency; payment of services provided under Code Section 31-8-42 for indigent patients by county; records; administration.

The commissioner of community health shall adopt state-wide standards to determine indigency for the purposes of this article, which standards shall be based upon and consistent with 125 percent of the federal poverty level as it exists on May 1, 1985. These standards shall further provide for legal liability, based upon ability to pay some reasonable percentage of cost of care, for patients and other persons legally liable for the patients' cost of care if those patients or other persons do not meet the indigency standards based upon less than 100 percent of the federal poverty level but do meet those standards based upon between 100 and 125 percent of the federal poverty level, as such level exists on May 1, 1985.
Within 30 days after receiving the standards provided by the commissioner pursuant to subsection (a) of this Code section, the governing authority of each county, by resolution, shall designate a person, to be known as the health care advisory officer of the county, to make a determination of indigency for the residents of the county in accordance with the standards promulgated pursuant to subsection (a) of this Code section. The health care advisory officer shall carry out such additional duties as may be assigned to him by the governing authority of the county. It shall be the duty of the governing authority of each county to mail a copy of such resolution to the commissioner or the commissioner's designee within 15 days after its adoption. The governing authority of any county may change the person designated as the health care advisory officer, but any such change shall be accomplished by resolution of the governing authority, and a copy of the resolution making such change shall be mailed to the commissioner or the commissioner's designee within 15 days after its adoption. If a county fails or refuses either to designate a health care advisory officer or to provide to the commissioner or the commissioner's designee the required notification of the county's designation of such officer, the county governing authority shall be deemed to be such officer for purposes of this article.
When a patient receives health care from a hospital or physician, which care that hospital is required to provide the patient under Code Section 31-8-42, and when such patient claims indigency, the chief administrative officer of the hospital shall determine whether any portion of the cost of services may be paid by the medical assistance program for the needy under Title XIX of the Social Security Act, by insurance, or by any other governmental or public agency pursuant to any federal, state, or local program and provide written notification of such determination to the health care advisory officer of the county of residence of the patient. Such notification shall include a certification by the chief administrative officer of the hospital that an appropriate investigation has been made and that it has been determined that no portion of the cost of services may be paid by the medical assistance program for the needy under Title XIX of the Social Security Act, by insurance, or by any other governmental or public agency pursuant to any federal, state, or local program or a certification that an appropriate investigation has been made and that a portion of the cost of services may be paid from such sources. If it is determined that a portion of the cost of services may be paid from such sources, then the notification shall include a certification of the amount which may be so paid. Such notification shall also request a determination of indigency of the patient. As soon as practicable after receiving such notification but not later than 60 days thereafter, the health care advisory officer of the county shall notify the chief administrative officer of the hospital of his determination. If the health care advisory officer determines that the patient meets the indigency standards or 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 this subsection, the county of residence of the patient shall be liable for the payment of cost of care of such patient in each hospital rendering the emergency services. In such event, each hospital and physician providing the emergency health care for the patient may bill the county of residence of the patient for the amount of the patient's cost of care. It shall be the duty of the governing authority of such county to pay the hospital and physician that billed amount plus, if that billed amount is not paid by the county within 120 days after the mailing of a request for a determination of indigency, interest on the billed amount at the rate specified in Code Section 48-2-40 for unpaid taxes.
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 whom that officer has determined to be indigent.
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.
To the extent practicable and consistent with appropriate health care, the commissioner and the health care advisory officer shall encourage the use of hospitals located in the county of residence of the pregnant woman.

(Code 1981, §31-8-43, enacted by Ga. L. 1984, p. 1389, § 1; Ga. L. 1985, p. 829, § 3; Ga. L. 1991, p. 94, § 31; Ga. L. 1992, p. 6, § 31; Ga. L. 2009, p. 453, § 1-6/HB 228.)

JUDICIAL DECISIONS

Constitutionality.

- When a county argued that O.C.G.A. § 31-8-43 was violative of Ga. Const. 1983, Art. IX, Sec. II, Para. III(b)(1), which prohibits a county from exercising certain enumerated powers inside the boundaries of any municipality or other county except by contract with the entity affected, since the county had no contract with the political subdivision within which a hospital seeking reimbursement under subsection (c) of O.C.G.A. § 31-8-43 was located, it could not constitutionally pay the claims of the hospital, it was held that the words "unless otherwise provided by law," prefacing the constitutional prohibition apply to a general law such as O.C.G.A. § 31-8-43. Terrell County v. Albany/Dougherty Hosp. Auth., 256 Ga. 627, 352 S.E.2d 378 (1987).

Claims presentation requirements of

§ 36-11-1 inapplicable. - Requirements of O.C.G.A. § 36-11-1 on presenting claims against a county apply to claims arising from contract and do not apply to a claim when the right to and amount of the claim is fixed by law as when a hospital furnishes emergency services to pregnant indigent residents of the county under O.C.G.A. Art. 2A, Ch. 8, T. 31. Terrell County v. Albany/Dougherty Hosp. Auth., 256 Ga. 627, 352 S.E.2d 378 (1987).

Reasonableness of indigency standards.

- Statewide standards of indigency adopted by the Commissioner of Human Resources are not arbitrary, capricious, or otherwise unreasonable. Terrell County v. Albany/Dougherty Hosp. Auth., 256 Ga. 627, 352 S.E.2d 378 (1987).

Indigency not waived by patients' execution of promissory notes.

- Although patients signed and delivered promissory notes to the hospital, the execution of the notes by the patients did not amount to a waiver of indigency on the patients' part nor indirectly amount to a waiver on the part of the hospital nor did the execution of the notes in any way satisfy the obligation of the county to provide medical service for indigent persons. Terrell County v. Albany/Dougherty Hosp. Auth., 256 Ga. 627, 352 S.E.2d 378 (1987).

Validity of rules and regulations.

- Argument that the regulations adopted by the Commissioner of Human Resources under O.C.G.A. § 31-8-43 are invalid because the Commissioner expanded the scope of the act by including intra partum and post partum care of the mother and a pediatric examination of the newborn is invalid. The General Assembly may delegate to administrative offices or agencies the authority to make rules and regulations necessary to effectuate statutes of the General Assembly. Terrell County v. Albany/Dougherty Hosp. Auth., 256 Ga. 627, 352 S.E.2d 378 (1987).

Syfert Injury Law Firm

2018 Georgia Code 31-8-43 | Car Wreck Lawyer