Rule 511-7-1-.05. Patient Selection and Referral

1. (1) The Department may, in its discretion, delegate the responsibility for determining the applicant's financial eligibility process to a Health Care Provider. In the event that the Department makes such a designation, the Health Care Provider shall make the financial eligibility determinations and patient referrals in accordance with Rule 511-7-1.06 and shall only utilize Volunteers in the manner prescribed in Rule 511-7-1-.04 for making financial eligibility determinations and patient referrals.
2. (2) Health Care Providers shall be required to accept all referrals unless the Contract between the Department and the Health Care Provider(s) authorizes a specific limit on the number of Patients that may be referred to a Health Care Provider.
3. (3) Neither the Department nor its designees may refer a Patient to a Health Care Provider unless a determination has been made that the Patient is eligible to participate in the Program.
4. (4) If a Patient has been referred by the Department, neither the Health Care Provider nor the facility in which the Health Care is rendered shall be permitted to charge the Patient.

Authority: O.C.G.A. Secs. 31-2A-6, 31-8-200.

History. Original Rule entitled "Patient Selection and Referral" adopted. F. Sep. 20, 2013; eff. Oct. 10, 2013.