Ga. Comp. R. & Regs. R. 125-4-4-.01 - Responsibility

Current through Rules and Regulations filed through April 4, 2022

When a person is committed to a correctional institution it becomes the responsibility of the correctional authorities to provide the necessary health care for the inmate. Medical and hospital care as required shall be provided for all inmates assigned. In no instance shall an inmate, his family or other individual be required to pay any portion of the fee or expenses for the inmate's medical or dental treatment, except as otherwise provided by law.

(a) Definitions:
1. Medical Emergency: A medical emergency is any condition which, in the judgment of a health care provider, poses an immediate threat to life or limb.
2. Chronic illness: An illness requiring care and treatment over an extended period of time. Chronic illness includes, but is not limited to, hypertension, diabetes, pulmonary illness, a seizure disorder, acquired immune deficiency syndrome, cancer, tuberculosis B, hepatitis C, rheumatoid arthritis, a autoimmune disorder, and renal disease.
(b) The Commissioner may establish procedures for a reasonable deduction from money credited to the money account of a prisoner to defray the costs paid by the Department or its contractor for medical care and/or prescription medication for a prisoner.
1. If the prisoner is incarcerated in a state prison or facility operated by a contractor of the state it shall be the responsibility of the state or its contractor to render any needed medical or hospital care.
2. The Department and its contractors are authorized to make reasonable deductions from money credited to the money account of a prisoner to defray the costs paid by the state or its contractors for:
(i) Medical treatment for a prisoner when the request for medical treatment has been initiated by the prisoner; and
(ii) Medication prescribed for treatment of a medical condition unrelated to pregnancy or a chronic illness.
3. The Department and its contractors are authorized to make reasonable deductions from money credited to the money account of a prisoner to repay the Department or its contractors for the cost of medical treatment and prescription medication for injuries inflicted by the prisoner upon himself or herself or others unless the inmate has a severe mental health designation as determined by the department.
4. The amount to be charged by the Department on individual prisoner accounts shall be established by Department policy and operating procedure. However, the Department will not deduct a medical charge amount from a prisoner's account when the account balance on the date medical care is provided is less than ten dollars ($10.00) until such time that further deposits to the account raise the balance above ten dollars ($10.00). Individual prisoner money accounts shall be frozen until all medical charges incurred by the individual prisoner have been fully paid.
5. Nothing in this rule shall be construed to relieve the governing authority, governmental unit, subdivision, or agency having the physical custody of a prisoner from its responsibility first to provide and initially pay for any needed medical and hospital care rendered to such prisoner.
(c) If the state prisoner is incarcerated in a county facility and requires emergency medical or hospital care, the Department or its contractor shall bear the costs of direct medical services required for emergency medical conditions posing an immediate threat to life or limb if the inmate cannot be placed in a state institution for the receipt of this care. The responsibility for payment will commence when the costs for direct medical services exceed $1,000.00. The Department will pay only the balance in excess of this amount. The Commissioner shall establish regulations relative to payment of such medical and hospital costs by the Department.
1. The Department of Corrections shall bear the cost of any reasonable and necessary emergency medical and hospital care which is provided to any prisoner eligible for transfer to the Department but remaining in the physical custody of a county jail. The Department shall also bear the cost of any reasonable and necessary follow-up medical or hospital care rendered to any such prisoner as a result of the initial emergency care and treatment.
2. When admission of a prisoner to a hospital becomes necessary, for any reason, the Department will be notified by the authority having physical custody of the prisoner. Such notification should be made at the time of admission to the hospital.
3. Claims received by the Department for payment under the terms of this rule will be subject to medical review. This review will address the following issues: Appropriateness of the services provided and verification of charges as being within the range of usual or customary rates for comparable services.
4. All claims for reimbursement must be submitted in accordance with instructions established by the Department of Corrections, Health Services Division. The Department will provide for the payment of medical bills by reimbursing each county on a monthly basis for expenditures incurred. The Department will not make direct payment to an individual doctor or hospital.
5. Payment will be made for medical and hospital care provided to any prisoner alter receipt by the Department of the following documents: Certified copy of sentence, certified copy of indictment, certificate of revocation (when applicable), affidavit of custodian, and personal history.

Notes

Ga. Comp. R. & Regs. R. 125-4-4-.01
Ga. Constitution 1982, 1983, Art. XI, Sec. 1, Par. I, (b): O.C.G.A. Secs. 31-2-1, 34-9-150, 42-2-1, 42-2-4, 42-2-11, 42-5-2, 42-5-51 to 42-5-53, 42-5-55, 42-5-59, 42-10-2.
Rule entitled "Responsibility" adopted as R. 415-4-4-.01. F. Nov. 14, 1984; eff. Dec. 4, 1984, renumbered as R. 125-4-4-.01. F. June 28, 1985; eff. July 20, 1985, as specified by the Agency. Amended: ER. 125-4-4-0.1-.01 adopted. F. Apr. 7, 1986; eff. Apr. 3, 1986, the date of adoption. Amended: Permanent Rule adopted. F. July 16, 1986; eff. August 5, 1986. Amended: F. Oct. 23, 1990; eff. Nov. 12, 1990. Amended: F. Dec. 11, 1995; eff. Dec. 31, 1995. Amended: F. Oct. 7, 1996; eff. Oct. 27, 1996. Amended: F. Nov. 6, 1998; eff. Nov. 26, 1998. Amended: F. June 4, 2009; eff. June 24, 2009.

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