Ga. Comp. R. & Regs. R. 111-3-8-.02 - Definitions
(1) "Authorized
representative" means a guardian or a person designated by the Member to act on
his or her behalf during the Member's life.
(2) "Creditor" means an entity (person or
institution) to whom an obligation is owed because a Member received something
of value in exchange.
(3) "Debt"
means a sum of money owed from one person to another, including the right of
the creditor to receive and enforce payment.
(4) "Department" means the Georgia Department
of Community Health, Division of Medical Assistance.
(5) "Discharge from the medical institution
and return home" means a qualifying discharge, which involves the Member's
dismissal from the nursing institution and/or facility for at least thirty (30)
days wherein the Member's personal effects and bed are released at the same
time of his or her discharge.
(6)
"Equity interest in the home" means value of the property in which the Member
holds legal interest beyond the amount owed on it in mortgages and
liens.
(7) "Estate" means all real
and personal property under the probate code, including real and personal
property passing by reason of joint tenancy, right of survivorship, life
estate, survivorship, trust, annuity, Individual Retirement Accounts, homestead
or any other arrangement. Estate also includes excess funds from a burial trust
or contract, promissory notes, cash, and personal property. Estates with a
gross value of $25,000 or less are exempt from estate recovery.
(8) "Hearing" means a formal proceeding
before an Administrative Law Judge or Probate Judge in which an aggrieved party
affected by an action or an intended action of the Department shall be allowed
to present testimony, documentary evidence, and argument as to why such action
should or should not be taken.
(9)
"Heirs" means heirs-at-law who are entitled under the statutes of intestate
succession to property of a decedent and beneficiaries who are entitled to
inherit the estate if there is a lawful will.
(10) "Lawfully residing" means permissive use
by the owner/power of attorney at the law.
(11) "Lien" means a claim, encumbrance or
charge against the Medicaid Member's real or personal property on account of
medical assistance paid to the Member correctly under the State Plan. A Lien
may be placed on the real property of a Member who is an inpatient of a nursing
facility, intermediate care facility for individuals with intellectual
disabilities, or other institution or a Lien may be placed on both real and
personal property of a Member after the Member's death.
(12) "Long-term care" means a service
provided in a long-term care facility or in the home, pursuant to federally
approved home and community based services, as an alternative to
institutionalization.
(13) "Medical
assistance" means payment by the State's program under Title XIX of the Social
Security Act or Medicaid program administered by the Department.
(14) "Member" means a person who has been
certified as Medicaid eligible, pursuant to the terms of the State Plan, to
have medical assistance paid on his or her behalf.
(15) "Member's home" means a true, fixed and
permanent domicile and principal establishment to which the Member has the
intention of returning to whenever absent.
(16) "Permanently institutionalized" means
residing in a nursing facility or intermediate care facility for individuals
with intellectual disabilities and developmentally disabled for six (6)
consecutive months or more.
(17)
"Personal representative" means an executor, administrator, guardian,
conservator, committee, trustee, fiduciary, or other person having a status
which by operation of law or written instrument confers upon such person a duty
of distributing property to Heirs.
(18) "On a continuous basis" means that the
qualifying relative lived with the Member in the Member's home at his or her
principal place of residence during an uninterrupted timeframe. An absence of
residence greater than six months is presumed to disrupt the continuity of
residence.
(19) "Residing in the
home for at least one or two years" means one is domiciled in the principal
place of residence.
(20) "State
Plan" means all documentation submitted by the Commissioner, on behalf of the
Department, to and for approval by the Secretary of Health and Human Services
pursuant to Title XIX of the federal Social Security Act of 1935, as
amended.
Notes
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