Georgia
LLC
Website link to register:
https://sos.ga.gov/divisions/corporations
Naming conventions
Restricted words require state approval; name must reflect the business purpose for PLLCs. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLC designation applies to medical practices.
Licensing Requirements
Members must be licensed through the Georgia Composite Medical Board.
Malpractice insurance required. Specialized permits for diagnostic imaging may be needed.
Required documentation for medical practices
Articles of Organization, Diagnostic Facility Permits, Malpractice Insurance, Professional Licenses
Filing Fee: $100
Annual/Biennial Fee: $50
Additional Notes: Annual report due April 1.
Medicaid
Program Name: Georgia Medicaid
Official Website: https://medicaid.georgia.gov/
Legislation:Georgia passed SB 18, the “Direct Primary Care Act,” in 2019, defining DPC agreements as not being insurance and exempting them from state insurance laws.
Private Contracting
Explicitly permitted; DPC agreements are allowed and are not subject to state insurance laws.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
Georgia Medicaid provides health coverage to eligible low-income residents, including children.
Notification Requirements
Written notification must be provided to avoid misunderstandings.
Provider Enrollment Requirements
Providers must enroll with Georgia Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot be designated PCPs under Medicaid rules.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless pre-agreed terms exist.
CMS Guidance
CMS guidelines for state Medicaid programs include streamlined options for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or participate in state healthcare programs.
State-Specific Notes
Medicaid Managed Care Organizations in Georgia actively support primary care expansion initiatives.
Dispensing Medication
Board of Pharmacy Official Link: https://gbp.georgia.gov/
State Licensing
Physicians must obtain a dispensing license from the Georgia Composite Medical Board for controlled substances.
Scope of Practice
Physicians may dispense medications directly within their scope of practice, including controlled substances with proper licensing.
Inventory Management
Secure storage and detailed inventory tracking are required for all medications dispensed.
Record-Keeping
Comprehensive record-keeping is mandatory, and records must comply with state and HIPAA regulations.
Dispensing Standards
Labels must meet state requirements, including patient name, prescribing details, and dosage instructions.
Controlled Substances
DEA registration and reporting to Georgia’s PDMP are required for controlled substances.
Billing and Reimbursement
Physicians must comply with state-specific billing requirements and federal anti-kickback laws.
Federal Compliance
Adherence to federal guidelines, including FDA and DEA, is required for dispensing.
State Pharmacy Laws
Georgia state law requires compliance with Board of Pharmacy regulations for controlled substances dispensing.
Patient Consent
Informed consent is required before dispensing any medication.
Insurance and Liability
Liability insurance must explicitly cover medication dispensing activities.
Training Requirements
Continuing education for controlled substances is required under Georgia law.
Audits and Inspections
Inspections are conducted by the Georgia Composite Medical Board, with penalties for non-compliance.