IMPORTANT NOTICE REGARDING HB1234

What is HB1234?

HB1234, also known as the Medicaid Managed Care Bill was sponsored in the Georgia Legislature by Senator Greg Goggans and signed into law on May 12, 2008 by Governor Sonny Perdue. It affects all CMOs and Medicaid Fee for Service Plan and all three Plans and DCH are collaborating on its implementation. Rules for HB1234 will be applied retroactively to allow for implementation and system configuration and testing. The bill provides guidance on standardizing the administration of Georgia Medicaid benefits administered by Care Management Organizations. This bill is to be enacted on July 1, 2008.

How will it affect providers?

Since HB1234 offers guidance on the administration of Georgia Medicaid benefits administered by Care Management Organizations, providers will also be affected. The bill incorporates the following elements:

Appeals Processes and Procedures

Provider directories

Web Portals

Time Frames

All plans and vendors must comply with DCH time frames listed below. These time frames cover claims with dates of service beginning July 1, 2008.

Contracting

Eligibility and Claims Payment

Who do I call if I have questions or need additional information regarding these changes?

For further information regarding HB1234 and how it will affect your relationship with or your administration of any plans administered by Avesis, please contact our Provider Service department at (800) 522-0258.