Annual report, 1992

Georgia Department of Medical Assistance
ANNUAL REPORT
1992

Table of Contents Commissioner's Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i.
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1. Highlights of Fiscal Year 1992. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2. Board of Medical Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3. Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5. Recipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8. . Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 2.
Appendix: Tables and Charts
History of Medicaid Benefits Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 FY 92 Administrative Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.6 FY92MedicarePremiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.6 Collections and Measurable Cost Avoidance. FY 89-92 . . . . . . . . . . . . . . . . . . . . . .27 Benefits Paid by Aid Category by Type of Service. FY 92 . . . . . . . . . . . . . . . . . . . .28 Recipients by Aid Category by Type of Service. FY 92 . . . . . . . . . . . . . . . . . . . . . . 29
Percentage of Expenditures. Percentage of Recipients. and Average
Yearly Payment per Recipient by Aid Category. FY 92 . . . . . . . . . . . . . . . . . . . .30 Number of Visits and Prescriptions by Aid Category. FY 92 . . . . . . . . . . . . . . . . .30 Percentage of Total Recipients Utilizing Each Service. FY 89.92 . . . . . . . . . . . . . .31 Average Payment for Services per Recipient. FY 89-92 . . . . . . . . . . . . . . . . . . . . . .32 Percentage of Total Expenditures for Each Category of Service. FY 89-92 . . . . . 33 Providers with Paid Claims by Category of Service. FY 89.92 . . . . . . . . . . . . . . . .34 Comparison of Eligibles. Recipients. and Expenditures. FY 89.92 . . . . . . . . . . . . 35 Analysis of Recipients and Expenditures by Recipient's County. FY 92 . . . . . . . 36 Medical Assistance Advisory Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0

Russell B. Toal Commissioner

State of Georgia
Department of ~ e d i c aAl ssistance Floyd Veterans Memorial Bldg. - West Tower
2 Martin Luther King, Jr. Drive, S.E. Atlanka, Georgia 30334

The Honorable Zell Miller Governor of Georgia
Members of the General Assembly of Georgia Citizens of the State of Georgia
Ladies and Gentlemen:
I am submitting for your review the Annual Report of the Department of Medical Assistance. This report summarizes agency activity through the fiscal year ending June 30,1992.
In State Fiscal Year 1992, the number of Medicaid recipients continued to climb rapidly, increasing by 15.6 percent over the previous year, largely because of economic conditions. During the year, we made health care a reality for more than 848,000 people in our state.
On behalf of the Department, I wish to express my appreciation for your support and assistance. You may be certain of our continued commitment to making appropriate health care accessible to every eligible Georgian in the most cost effective manner possible.

Commissioner

An Equal Opportunity Employer

Abstract
Covered Services

The Georgia Department of Medical Assistance (DMA)is the state agency responsible for operating the Medicaid program. Funded by state and federal dollars, Medicaid pays for health care services for individuals or families with low income and limited resources.

Medicaid reimburses health care providers for services given to eligible individuals. Persons who are eligible for Medicaid receive a card each month to use for obtaining health care services from participating providers.

~
I Total FY 92 Expenditures
Benefits Indigent Care Trust Fund Medicare premiums Administration Nurse aide training

$ 2,090,163,405 $ 249,939,533 $ 78,265,028 $ 74,429,475 $ 3,748,289

$ 2,496,545,730

Average yearly benefit per recipient

$

2,465

Unduplicated count of recipients

I

Categorically Needy

Medically Needy

Right From the Start Medicaid

Qualified Medicare Beneficiaries

678,805 7,147
152,430
9,647

848,029

Average number of monthly eligibles

726,014

Ii Enrolled providers (as of June 30,1992) Providers with paid claims

34,052 18,686

L Number of- Medic. aid claims processed

- --

33,443,832

Ambulance Services Ambulatory Surgical and Birthing Center Services Diagnostic, Screening and Preventive Services (Health Departments) Dental Services Dialysis Services Durable Medical Equipment Services Early and Periodic Screening, Diagnosis and Treatment Services Family Planning Services Home Health Services Hospice Services Inpatient and Outpatient Hospital Services Intermediate Care for the Mentally Retarded Facility Services Laboratory and Radiological Services Mental Health Clinic Services Non-Emergency Transportation Services Nurse Midwifery Services Nurse Practitioner Services Nursing Facility Services Orthotic and Prosthetic Services Physician Services Podiatric Services Pregnancy-Related Services Prescribed Drugs Psychological Services Rural Health Clinic/Community Health Center Services Swing Bed Services Targeted Case Management Services
Early Intervention Chronically Mentally I11 Perinatal Vision Care Services Waiver Services Community Care Independent Care Mental Retardation Model Waiver for Oxygen or Ventilator-Dependent Children Pregnant /Substance Abuse Day Treatment

Highlights of Fiscal Year 1992

The Medicaid program provided health care to about one in seven Georgians, or 12.6 percent of the state's population. The number of recipients increased by 15.6percent, with the largest actual increase among pregnant women and children.
The number of providers enrolled in the Medicaid program increased by 6,699 in FY 92, up almost 25 percent over the previous year. Providers filed 33.4 million claims during the year. Almost 75 percent were paid in less than seven days. Nearly 97 percent were paid in less than 20 days.
DMA successfullycompleted 16major enhancements to the Medicaid Management Information System within contractual requirements. Some of the changes were implemented in April, with the balance effective July 1,1992. In FY 92, the Department also transferred to the fiscal agent responsibility for provider telephone inquiry, prior approval receipt and tracking, prepayment review of multiple surgery claims and third party liability file maintenance and pended claim resolution.
DMA continued its participation in the Family Connection,Governor Miller's multi-agency initiative to decrease the number of Georgia students dropping out of school. During the year, the Department helped the 15project sites access available Medicaid services. Three of the participating school systems began targeted case management to link students with medical, educational and socialservicesthey need to stay in school. DMA amended its state plan to enable community mental health workers to provide servicesin clinicslocated at the project sites.
In May 1992, the Department began the Independent Care program, designed to help a limited number of adult Medicaid recipients with disabilities live in their own homes or in the community rather than in institutional settings. The program coversan array of services including case management, home modification, skilled nursing, transportation, companion services, medical equipment and supplies, occupational therapy, counseling and personal emergency response systems. Operating under a federal waiver, the program is availableto recipientsin the metropolitan areas of Albany,Atlanta, Augusta,Columbusand Savannah.
May 1992 also marked the beginning of Medicaid coverage of substance abuse day treatment services for pregnant women. At the end of the year, the program was available in three areas of the state: Atlanta, Brunswick and Statesboro.
The Indigent Care Trust Fund totaled $249.9 million in FY 92. Using $95.6 million in voluntary contributions from 68 hospitals serving a disproportionate share of low-income patients, the state received $154.3million in matching federal dollars. The largest share of the trust fund was used to help participating hospitals recover a portion of the cost of providing servicesto patients unable to afford care. Hospitals used at least 15percent of the dollars they received from the fund to establish and expand primary care services in their communities.
Rebate agreements with pharmaceutical manufacturers saved the state an estimated $22.4 million in FY 92.
The Department took actionto curtail growth and contain costsby reducing its FY 92budget by $37 million in state funds as directed by the Governor and the General Assembly.
Cost avoidance measures, investigations and collections saved almost $618 million.
Administrative costs accounted for only three percent of total DMA expenditures.
In April,the Department adopted Medicare's Resource-BasedRelativeValueScale(RBRVS) for the reimbursement of physician, podiatry, nurse midwife, psychology, nurse practitioner, vision care and health department services. This nationally-recognized payment system is designed to allow for more equitable reimbursement based on work value, cognitive skill, practice expense, malpractice insurance cost and geographic location. Adoption of RBRVS also was intended to eliminate the confusion surrounding the differences between the Medicare and Medicaid payment systems.

Board of Medical Assistance

The Board of Medical Assistance is the policy-making authority for the Department. The Board is composed of five members appointed by the Governor and confirmed by the Senate for four-year terms of office. Board meetings are held monthly.
Members of the Board as of June 30,1992, were:
Ann McKee Parker, Ph.D., Chairperson Atlanta, Georgia
Joseph H. Patterson, M.D., Secretary Atlanta, Georgia
Beauty P. Baldwin Lawrenceville, Georgia
Carol Fullerton Albany, Georgia
Norman B. Pursley, M.D. Lincolnton, Georgia

DEPARTMENT OF MEDICAL ASSISTANCE ORGANIZATIONAL CHART

- - - - - Board of Medical Assistance II

-1

Commissioner's Off ice
I

Advisory Commit tee

Deputy omm missioner's
Office
Assistant Commissioner of Operations
4 Personnel Services

FLegal Services 1 Division of
Systems Management

1-1

Division of Community Services

Division of Institutional Policy & Reimbursement

Division of Program Compliance

Division of Professional
Services

Division of Maternal & Child

Program

Overview of the Department

Responsibility for Medicaid services is split among four divisions: Institutional Policy and Reimbursement,ProfessionalServices,Maternal and Child Health, and CommunityServices.
The Division of Institutional Policy and Reimbursement administers the nursing facility, hospital, hospice, swing-bed, laboratory, dialysis, birthing and ambulatory surgical center, and rural and community health center programs.
The Division of Professional Services administers the physician, pharmacy, podiatry, nurse midwifery, nurse practitioner, psychology, vision care, dental, and diagnostic, screening and preventive services programs.
The Division of Maternal and Child Health is responsible for family planning, pregnancyrelated services, perinatal and early intervention case management, and the Early and Periodic Screening,Diagnosis and Treatment (EPSDT)program for children.
The Division of Community Servicesis responsible for durable medical equipment, transportation, mental health, home health care, orthotics and prosthetics, and waiver services.
DMA's other areas - Operations and the divisions of Program Compliance and Systems
Management - are responsible for the day-to-day management and monitoring of the program.
Operations is responsible for the budget, contracts, financial services, program evaluation, and support services.
The Division of Program Compliance is responsible for provider enrollment, recipient eligibility, recipient inquiry, quality control,investigations,utilization review and third party administration.
The Divisionof SystemsManagement is responsible for managing the fiscalagent contract for claims payment, Medicaid card control, and data base maintenance.

Where the Medicaid
. Dollar Comes From..

Medicaid is funded by state and federal dollars. In FY 92, DMA's budget comprised about 10 percent of the total state budget.
The largest share of Medicaid costs is paid by the federal government. Georgia's Medicaid program receives various levels of federal reimbursement for different servicesand functions. For example, the federal government pays 90 percent of the cost of family planning services and 61.7percent for most other benefits. Computer costs are 75percent federally funded, and most other administrative costs receive 50 percent federal funding.

Total Benefits, Premiums and Administration FY 92

Total: $2,496,545,730 (Includes Indigent Cave Trust Fund amount of $249,939,533.)

And Where It Goes ...

Benefitspayments and the Indigent Care Trust Fund comprised almost 94 percent of all FY92
expenditures -administrative costs represented only three percent of total expenditures. The Department's contracts with the Department of Human Resources and the fiscal agent accounted for almost three-fourths of administrative costs.

The Department pays Medicare premiums for certain individuals entitled to Medicare benefits. Payment of the premiums ensures that Medicare pays for services before Medicaid is billed.

Total Expenditures FY 92

Medicare Premiums 3.1% Nurse Aide Training 0.2%

Activity

In M 92, payments for services for Medicaid recipients totaled $2,090,163,405. While per-
recipient costs increased by only 4.5 percent, total benefits payments rose by 21 percent as economic conditions and federal mandates brought more people into the program. Details about benefits and administrative expenditures for FY 92 and previous years appear in the Appendix of this report.

Benefits by Category of Service FY 92
Drugs 9.0Y~

Nursing Facility Care 29.3%

Other Care 13.0%

Just under 300 employees comprise the DMA staff. While the number of employees has remained virtually the same over the past five years, the program has doubled in size.
A sample of activity in FY 92:
DMA's Office of Legal Services handled 247 requests for hearings by providers, recipients and applicants.
The Provider Enrollment Section responded to 65,000 phone and 130,000 written inquiries, sent information to over 5,000 potential participants and enrolled more than 6,000 providers.
The Recipient Inquiry Unit responded to over 105,000 telephone calls, 3,300 letters and 190 visits.
The Recipient Card Control Unit resolved 195,000 provider inquiries and answered 148,000 requests for changes or emergency eligibility cards.

Claims Payment

Some 219,900 new client records were added to the Medicaid Management Information System (MMIS). The system processed 8,879,000 recipient updates.
Nursing Home Inquiry Staff responded to 6,575 requests from providers.
Over 610,000 checks to providers were processed
Utilization Review staff audited 248 providers and identified approximately $1.3 million to be returned to Medicaid.
Investigations and Compliance conducted 271 investigations of providers, resulting in 24 fraud investigations and 10convictions. The unit identified $2.4 million in provider overpayments, terminated the enrollment of 125providers and suspended eight others.
The Department evaluated the clinical records of 1,826 recipients of community care services, visited 1,116 recipients and reviewed 152 providers.
Staff reviewed 1,571 prior approval requests for office visits, surgeries and optometric services.
Third Party Administration staff identified other health insurance coverage for 50,880 recipients.
TheProvider Inquiry Unit responded to over 52,000 inquiriesfrom individual practitioners.
Under contract with the Department, the Georgia Pharmacy Foundation responded to 76,165 requests for pharmacy prior approval and received 20,000 calls and almost 13,000 written inquiries regarding pharmacy.
Benefits recovery staff collected over $11,000,000 in voluntary refunds from providers and funds identified by other Department units through audits, investigations and other recovery efforts.
Prepayment reviews were conducted on approximately 62,400 claims.
Almost 135,000 precertification requests were received and evaluated by the Georgia Medical Care Foundation under contract with the Department.
Electronic Data Systems (EDS)is the fiscal agent for the Georgia Medicaid program. While DMA is responsible for the administration of the program, EDS processes claims and maintains reporting systems which enable the Department to monitor the program and enforce its policies and procedures. Working with EDS, the Department processed 33.4
million claims during M 92. Approximately 75 percent of all claims were filed electronically.
Claims Processed by Type of Service FY 92
Nursing Facilities 3.0%

Recipients

In FY 92, Medicaid paid for health care services for 848,029 individuals. Payments for services totaled $2,090,163,405 or approximately $2,465 per recipient. The number of recipients increased by 15.6percent from FY 91. Since FY 88, the number of recipients has risen 62.8 percent, largely due to eligibility expansions mandated by the federal government.
Growth in Recipients FY 88 - 92

Thousands
7

15.6%

Qualifications for Medicaid Eligibility

Medicaid coverage is available for certain categories of people specified by law, based on income, resources or assets. The Department contracts with the Georgia Department of Human Resources (DHR) to perform certain functions within the Medicaid program including determination of eligibility. DMA works with DHR's Division of Family and Children Services to see that eligibility determinations are accurate. During FY 92, the Department reviewed 3,403 cases. By correcting errors promptly, Georgia maintained an error rate below the federal tolerance level of three percent for the fifth consecutive year.

Categorically Needy -
Receiving Cash Assistance

Eligible individuals are those who receive cash assistance under the Aid to Families with Dependent Children (AFDC) program or the Supplemental Security Income (SSI) program. Over 66 percent of the recipients in this category receive AFDC (45.1 percent children and 21.6 percent adults).

In FY 92, this category represented 63.7 percent of all recipients and 53.8 percent of all

benefits expenditures.

Expenditures

Categorically Needy Receiving Cash Assistance

Expe-n.d.i- tu-r-e-s-

Aged ....................................................................................... $128,621,478

Blind ...................................................................................

10,469,989

Disabled ............................................................................... 567,988,043

Children in Families with Dependent Children .............. 183,530,633

Adults in Families with Dependent Children .................. 233,150,715

Recipients

per Recipient

.- .--

52,618

$2,444.44

2,740

3,821.16

124,674

4,555.79

243,596

753.42

116,818

1,995.85

Total

for

Eligibility

Category

........................................ -- ..-

$1,123,760,858
-

540,446

$- 2,079-.3-2.

Categorically NeedyNot Receiving Cash Assistance

Eligible individuals include:

pregnant women who would be eligible for AFDC if their children were born and living with them;

families no longer receiving cash public assistance due to increased earnings or loss of certain work-related deductions;

aged, blind and disabled individuals including those who have lost their SSI benefits because their SocialSecurity payments have increased. Also included are nursing home residents whose income exceeds the SSI income limit. These individuals retain $30 monthly income for personal needs and contribute the remainder toward the cost of nursing home care; and

children with disabilities living at home who qualify for nursing home care and children in foster or adoptive homes.

In FY 92, this group represented 16.3 percent of all recipients and 30.4 percent of all

benefits expenditures.

Categorical- ly Needy ..Not Receiving Cash Assistance ....
Aged

Expenditures $394,646,370

Blind ........................................................................................ 10,157,903

Disabled ................................................................................

130,910,957

Children in Families with Dependent Children ..............

58,151,370

Adults in Families with Dependent Children .................. 36,520,107

Other Children .................................

................................ 5,863,866

Recipients
36,023 1,414 10,155
60,808 25,318 4,641

Expenditures

per Recipient

.

...

$10,955.40

7,183.81

12,891.28

956.31

1,442.46

1,263.49

Total

for

Eligibility

- Cat- ego- ry .....-..............- .......................-........-

$636,250,573 ................

138,359 .....

$4,598.55
.

Medically Needy

This program covers pregnant women, children, and aged, blind or disabled persons in their homes or nursing homes who meet the categorically needy qualifications except for income or resources. Persons with incomes over 133 %percentof the AFDC payment level for their family size may "spend down" by applying incurred medical expenses.

The number of recipients who qualify as medically needy has decreased by about half

since FY 88 because of the Right From the Start Medicaid program, which now covers

many pregnant women and children formerly in this category. In FY 92, medically needy

recipients represented about 0.9 percent of all recipients and 0.8 percent of all benefits

expenditures.

Expenditures

Medically Needy

--

--

Expenditures ..

-

--..-R-ecipien.-t-s -..

Aged ........................................................................................

$1,844,221

1,023

Blind ............................ .......................................................

239,789

158

Disabled .................................................................................. 4,560,652

1,273

Children in Families with Dependent Children ..............

2,370,499

1,398

Adults in Families with Dependent Children ..................

3,604,083

1,168

per Recipient
$1,802.76 1,517.65 3,582.60 1,695.64 3,085.69

Other Children .......................................................................

-.--- - -

Total

for

Eligibility

Category

............................................. - ..

3,939,290
- -
$16,558,534

2,127 7,147

1,852.04
. -
$2,316.85

Right From the Start Medicaid

Right From the Start Medicaid (RSM) began in FY 89 as a result of the federal Omnibus Budget Reconciliation Act of 1987. Individuals eligible for RSM include:

children under age 6 and pregnant women whose net family income does not exceed 133 percent of the federal poverty level (or$18,564 for a family of four). Resource limitations are not imposed on these groups; and

children born after September 30, 1983, whose family income does not exceed 100 percent of the federal poverty level (or $13,956 for a family of four). No resource limitations are applied to this group.

RSM experienced the largest actual increase in recipients in FY 92, rep- resenting- 18.0 percent of all recipients and 14.6 percent of all benefits expenditures.

Expenditures

Right
-

From

th- e Start M-- edicaid

Expenditures

RSM Child .............................................................................. $117,237,998

RSM

Adult

......................

....................................................

--

-

- 188,963,296

T-~ o- tal for Eli.g.- ibility Ca.t- egory .......-.....................................

$306,201,294 .

Recipients

per Recipient

97,279 55,151

$1,205.17 3,426.29

152,4- 30 -- $2,00- 8.80

Qualified Medicare Beneficiaries
Profile of Recipients
BY AID CATEGORY

Qualified Medicare Beneficiaries are individuals who are eligible for Medicare Part A whose income does not exceed 100 percent of the federal poverty level ($6,816 for one person) and whose resources do not exceed twice the SSI resource limit.

Medicaid coverage of this eligibility category was mandated in FY 89 by the

Medicare Catastrophic Coverage Act of 1988. In FY 92, this group represented 1.1

percent of all recipients and 0.4 percent of all payments.

Expenditures

Qualified Medicare Beneficiaries

Expenditures

--

.

- -

Aged ............................. . ....................................................... $5,668,511

Disabled ................................................................................... 1,723,635

Recipients - . 7,670 1,977

per Recipient
$739.05 871.84

To- tal for Eli- gibility Ca- t-egory .......~ ...................p ............... ~ .- $7,3- - 92,146 - 9..,647

$766.26

Recipients
Other 0.5%

Payments

BY SEX

Recipients

Payments

BY AGE GROUP

Recipients
Age 65+

BY RESIDENCE

26.9%
Recipients

Payments
Age 6-20 13.3%
Age 21-44 27.9%
Payments

BY RACE

Recipients
Other 1.5%

Payments
Other 1.1%

Services
Physician Services Pharmacy Services

Making health care available and accessible to medically indigent Georgians is the focus of the state's Medicaid program. A broad array ofservicesis available to address theneeds of those covered by the program.
Reimbursement for physician, pharmacy, hospital and nursing facility services accounted for 87 percent of benefits expenditures in FY 92. In the Appendix of this report are charts containing details about payments and services in FY 92 and previous years.
In the fall of 1991, all state agencies were directed to reduce their FY 92 budgets due to revenue shortfalls. DMA was asked to reduce state funds by approximately $37 million. Rather than eliminate coverage for any recipient, the Governor and the legislature chose to delay certain rate increases for providers and reduce some services for adults including non-emergency dental care, vision care, podiatry services and hearing aids. Coverage of certain high-cost prescription drugs, cough and cold medications for adults, and medications available without a prescription was eliminated, and the maximum number of prescriptions covered per month for adults without prior approval was reduced from six to five. Prior approval requirements were placed on specified drugs, including expensive antihistamines, anti-anxiety drugs and analgesics.

Medicaid pays for services provided by licensed physicians. More than 80 percent of all recipients visited physicians last year.

Providers with

FY 92

Expenditures

FY 92

- Ca- tegory of- Service - --P- aid Cla- ims - Recipien- ts p- er Recipi- ent Expenditu- res

P- h y s l c ~ a- nServices -

11,386

699,183

$421 93

$295,008,581

-- ---- -----

On April 1,the maximum allowable payment for physician services became the lower of the submitted charge or Medicare's Resource-Based Relative Value Scale rate for the procedure. The Department used Medicare's RBRVS rates for the Atlanta region as the statewide maximum allowable fee. Physician services accounted for 14percent of benefits expenditures in FY 92.

Drugs requiring a prescription, insulin, diabetic supplies and certain non-prescription drugs are covered. Certain drugs require prior approval. In July 1991, the Department contracted with the Georgia Pharmacy Foundation to review and process prior approval requests for pharmacy.

Adult recipients must have prior approval to obtain more than five prescriptions per month and for certain drugs. Children under 21 years of age must have prior approval for more than six prescriptions per month.

Providers with

FY 92

Expenditures

Category of Service
- --

-- Paid- C. laims - Re- c- ipients- per - Recipient

P- rescrib- ed Drug

s
-

-

- -- 1,893 -6- 78,366 - - $276 40

FY 92 Expenditure-s
$187,499,76- 0

The Department covers the products of all drug manufacturers offering rebates to the state,with certain exceptions allowed by federal law. In FY 92, drug rebates saved the state approximately $22.4 million.

Hospital Services
Nursing Facility Services

Medicaid pays for inpatient hospital services when services cannot be provided on an outpatient basis. Most inpatient hospital stays must be certified prior to admission. Outpatient services may include emergency room care, outpatient surgery and clinic services. Certain outpatient procedures must be certified prior to admission.

Cateeorv of Service
Hospital Services*
Hospital, Inpatient ..................... . ..... - ToHta-ol-s.p....i..-t.a-..l.,...O...u..t..p..a..t..i.e..n...t......................................................
* Includes out-of-state providers.

Providers with

FY 92

Expenditures

FY 92

Paid Claims Recivients ver Recivient Exvenditures

367

172,041

$3,281.25

$564,508,980

629

472,909

334.14

158,017,284

$722.526.264

Inpatient hospital services are reimbursed at a hospital-specific flat rate for each admission. During FY 92, prospective per case rates were calculated using base year costs from each hospital's fiscalyear 1988cost report. Trend factors are used to inflate base year costs. Per case rates include operating and capital-related costs. The Department provides additional reimbursement for unusually costly admissions (cost outliers) for any Medicaid recipient and for exceptionally lengthy admissions (day outliers) for children under age six in disproportionate share hospitals and under age one in other hospitals. During FY 92, the Department paid hospitals $2,256,743 for day outliers and $11,216,554 for cost outliers.

Reimbursement for outpatient hospital services is based primarily on reasonable cost using hospitals' audited Medicaid cost reports. Cost-based outpatient services are reimbursed at 94.2 percent of allowable operating costs plus 90 percent of allowable capital costs. The final determination of reimbursable costs is made at the time of outpatient settlements using audited cost reports.

Medicaid pays for care in institutional settings for recipients who are unable to remain at home or in the community. Nursing facilities are reimbursed using per diem rates calculated from standardized cost reports. Allowable costs are determined using Department policy, federal principles of reimbursement and audits of cost reports.
Medicaid covers nursing services, room and board, and personal care items for eligible recipients in a nursing facility. Certification is required prior to admission to determine the level of care needed by the recipient. Medicaid also covers diagnosis, treatment or rehabilitation for persons with mental retardation or related conditions. Services are provided in a residential setting which offers ongoing evaluation and supervision.
Rural hospitals with fewer than 100 beds can use their inpatient facilities to furnish nursing facility services, depending on patients' needs. Medicaid reimbursement for swing-bed services is an all-inclusive rate per day based on the average daily rate paid to nursing facilities for routine services during the previous calendar year.
The Office of Regulatory Services of the Department of Human Resources surveys nursing facilities and makes recommendations to DMA for intermediate sanctions, based on survey findings. In FY 92, DMA received 427 survey reports in which deficiencies were cited, resulting in 297 recommendations for plans of correction and 130recommendations for alternative sanctions. Temporary managers were placed in six facilities.
DMA contracts with the Georgia Medical Care Foundation (GMCF) to perform certain other functions required by OBRA. In FY 92, GMCF:
reviewed and approved 124 nurse aide training programs in the state; completed 61,063 preadmission reviews for nursing facility placements; conducted 2,093 on-site recipient reviews in intermediate care facilities for the mentally retarded.

Other Services

Category of Service

-

- -

- -

Nursing Faclht~es

Nurslng Home Intermediate Care - MR

Nursing Facility Services

- ToStawl i.n..g...B..e..d...S..e..r...v.ic.e..s.....- ............................................................

Providers with

FY 92

Expenditures

FY 92

Paid
- -

Claims- Recipi- ents pe- r Rec- ipient- Ex- penditures

12

1,752

$65,326 72 $114,452,420

329

38,690

12,885 55

498,542,081

7

19- 3.

- 837.03

161,547

$613,156,048

In July 1991,per diem rates were adjusted to account for costs that nursing facilities must incur to comply with reform requirements of the federal Omnibus Budget Reconciliation Act (OBRA) of 1987 and 1990. Use of the 1990 cost reports as the basis for computing reimbursement rates along with a 9.3 percent growth allowance resulted in an overall average rate increase of 7.7 percent.

In November 1991, return on equity costs were eliminated as an allowable cost for nonDodge facilities. Also, the cost cap for unusable cost reports was reduced to 90 percent of the non-property standards, and the allowability of professional dues for national, state and local associations was limited to 50 percent of reasonable costs.

A variety of other services accounted for about 13 percent of benefits expenditures in FY 92. Among the services in this category are maternal and child health services, other practitioner services, mental health services, waiver services, transportation and equipment.

Maternal and Child Health

Georgia Medicaid covers an array of services for pregnant women, including pregnancyrelated services, which cover postpartum home visits, and perinatal case management, which links pregnant women with services they may need such as medical care, transportation and nutrition counseling.

In FY 92, the Department continued efforts to broaden services for pregnant women and infants, adding coverage of two new programs:

Substance abuse day treatment, available in four areas of the state since May 1992,helps pregnant women addicted to illicit drugs and alcohol.

Early intervention case management helps locate necessary services for children up to age three who are at risk of developmental problems.

From birth to age 21, all children covered by Medicaid can receive preventive health care under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. EPSDT provides immunizations and comprehensive examinations.

Medicaid covers family planning services and supplies. Federal funding pays 90 percent of the cost. In FY 92, the Department added coverage of the Norplant system, an implant which provides contraceptive protection for u p to five years.

Providers with

FY 92

Expenditures

FY 92

Category of Service

.- - ~

- -

- -

Maternal & Child Health

- . - -

Paid Claims -

Recipients per Recipient Expenditures

-

- p -

-

Early & Periodic Screening, Diagnosis
& Treatment ........................... .............. 233

209,340

$79.21

$16,582,802

Early Intervention Case Management .......... 25

712

512.27

364,738

Family Planning ................................................ 23 Perinatal Case Management .......................... 25

80,291 19,954

464.98 115.13

37,333,363 2,297,363

Pregnancy - Related Services .......................

- -

~-

-~-

Total ......................................................................

-

--

37

.

- - --

6,096 --

- -

90.92

554,247

~- $5- 7,132,5- 13

Other Practitioner Services

Services from a variety of practitioners are covered by Medicaid. Dental services were the most widely used in this category. More than one-fourth of all recipients visited a dentist last year, with children ages 6-14 representing about 36 percent of those receiving dental services. Payments for preventive services accounted for the majority of expenditures in the dental program. Reimbursement for dental services is based on the lower of the usual and customary charge or the statewide maximum allowable amount.

In FY 92, Georgia Medicaid began reimbursing health departments and private providers through the diagnostic, screening and preventive services program. Among the services are antepartum and postpartum care, adult immunizations, and screening and treatment of hypertension, tuberculosis, and sexually transmitted diseases.

During FY 92, the maximum allowable payment for podiatrists, nurse midwives, psychologists, nurse practitioners, diagnostic, screening and preventive services providers and vision care providers became the lower of the submitted charge or Medicare's Resource-Based Relative Value Scale rate for the procedure.

Reimbursement for services in this category accounted for 2.2 percent of payments last year.

Providers with

FY 92

Category of Service

-

~

Paid Claims -

Recipients

-

-

Other Practitioner Services

Dental ....................... . ................................... 1,506

221,711

Diagnostic, Screening & Preventive Services

47

14,139

Nurse Midwife ............................. . .......... 55

3,252

Nurse Practitioner ........................................

81

8,593

Optometry ........................ . .........................

475

Physician's Assistant ....................................

*

65,201 2,716

Podiatry .......................................................... 163

34,909

Psychology ...................................................

297

11,041

Other (Medicare Coinsurance & Deductibles)

-.

. -~

.

Total ........................................................................

-.

- - - --

5,383 -~ .-

* Physicians are reimbursed for services of enrolled physician's assistants.

Expenditures per Recipi~en. t
$124.99 41.71 792.57 51.06 48.52 51.11 71.70 564.23 497.18
--
-~ -

FY 92 Expenditures
~
$27,710,963 589,788
2,577,422 438,727
3,163,589 138,807
2,502,860 6,229,703 2,676,319
~
$46,028,178 ~- -

Mental Health Services

Medicaid covers a comprehensive range of services provided by outpatient mental health

clinics. Individuals with chronic mental illness, mental retardation or substance abuse

problems also may receive case management services. These services, offered in the

community, help individuals live more independently and are less expensive than

institutional services.

Providers with

FY 92

Expenditures

FY 92

Category of Service Mental Health Services

--

-

Paid C.la- -ims

Recipients per Recip- ie- nt E -- xpenditure.s-

Mental Health Clinic ........................................

Mental -

.H- ealth Case Man.-a- gement

..................

~

---

Total .....................................................................

- --

~

-

74 16
--

48,223

$841.40

$40,574,724

Waiver Services
Georgia Medicaid has four home and community-based programs for which the federal government has waived certain provisions of Medicaid law. These waivers allow the state to provide a set of non-institutional services to specified groups of people who would otherwise require institutionalization.

Community Care services help frail, elderly individuals remain in the community through provision of adult day rehabilitation, respite care, emergency response systems, alternative living, homemaker aide and home-delivered services. The mental retardation waiver program provides a similar range of services for persons with mental retardation.

Model waiver services include private duty nursing and medical day care for children under age 21 who are respirator or oxygen dependent.

The Independent Care program was begun in May 1992to help a limited number of adult Medicaid recipients with disabilities live in their own homes or in the community instead of hospital settings. By the end of the fiscal year, two recipients had been approved for participation in the program. Among the available services are case management, home modification, skilled nursing, transportation, companion services,medical equipment and supplies, occupational therapy, counseling and personal emergency response services.

Providers with

Category of Service

Paid Claims

Waiver Services Community Care ............................................ 240 Mental Retardation Waiver Program ........... 94 Model Waiver Services .................................... 19
Total ....................................................................

FY 92 Recipients
9,948 348 81

Expenditures

FY 92

per Recipient Expenditures

$2,938.94 25,428.93 29,985.01

$29,236,577 8,849,269 2,428,786
$40.514.632

Transportation

In addition to emergency ambulance services, Medicaid covers non-emergency transportation services for recipients who need medical care and have no other means of transportation. During FY 92, emergency helicopter transportation for children under age 21 became a covered service.

Category of Service

Providers with

FY 92

Expenditures

FY 92

Paid Claims Recipients per Recipient Expenditures

Transportation

Ambulance ...................................................

207

Non-Emergency Transportation ..................... 525

Total ........................................................................

53,146 103,445

$106.69 250.08

$5,669,927 25,869,588 $31,539,515

Equipment and Devices

Medicaid offers reimbursement for the rental or purchase of equipment including hospital beds, wheelchairs, oxygen equipment and walkers. Medicaid also covers devices such as artificial limbs and braces.

Eyeglasses for recipients are purchased through a contract with an optical laboratory. Volume buying gives the Department a lower unit price.

Category of Service

Providers with

FY 92

Expenditures

FY 92

Paid Claims Recipients per Recipient Expenditures

Equipment & Devices

Durable Medical Equipment .......................... 456

Eyeglasses ........................................................

1

--Orthotics/Prosthetics ....................................

169

Total .......................................................................

42,940 49,682 10,063

$364.66 20.78 347.51

$15,658,298 1,032,527 3,496,943
$20,187,768

All Others

Georgia Medicaid pays forthe services of ambulatory surgical centers, community health centers and rural health clinics as well as laboratory, x-ray, dialysis, home health and hospice services.

Home health services accounted for the largest expenditure in this category. The program provides skilled nursing and home health aide services,physical therapy and speech therapy to recipients who are homebound. Home health services require prior authorization.

Category of Service

Providers with

FY 92

Expenditures

FY 92

Paid Claims~R- ecipients- per Recipient Expenditures

All Others

Ambulatory Surgical ........................................ 20

Dialysis .............................................................. 150

Home Health ..................................................

80

Hospice ............................................................. 21

Laboratory/Radiology ................................... 86

Rural Health Clinic/

Community Health Centers ....................- .... 31

Total ......................................................................
-.

2,214 446
12,028 224
110,393
7,113

287.10 8,506.86 1 ,738.65 3,904.36
61.37
107.24

$ 635,640 3,794,061
20,912,459 874,576
6,774,560
762,799 $33,754,095

Indigent Care Trust Fund

Fiscal Year 1992 marked the second year of Georgia's Indigent Care Trust Fund, with 68 disproportionate share hospitals participating in the fund. Voluntary contributions from these hospitals, which serve a higher than average number of Medicaid and other lowincome patients, totaled $95,607,241. The Department used these funds to attract $154,332,292 in additional federal Medicaid matching dollars for a total trust fund amount of $249,939,533.
Almost $242 million of the trust fund monies were used to help participating hospitals recover a portion of the cost of providing services to patients unable to pay for their medical care. Hospitals must use at least 15percent of their trust fund receipts to provide and expand primary care services as described in plans approved by the Department andeach hospital's respective district health director. More than $36 million was used for primary care services.
Indigent Care Trust Fund: Funding Levels
Dollars (millions)
1 $300

Contributions Federal Match

Payments to Hospitals

Total Funds Generated

The trust fund has played a vital role in improving access to health care for indigent Georgians. Hospitals have used trust fund dollars for such purposes as recruiting physicians to underserved areas, placing nurses in local schools and offering health prevention, maintenance and education services.
The fund also has helped to relieve some of the burden shouldered by smaller, rural hospitals suffering pressures from economic conditions. About three-fourths of the hospitals participating in the trust fund are located in rural areas of the state. Without the additional support, many hospitals might have been forced to close their doors or seek help through higher county taxes.
Trust fund monies also paid for outreach training and recruitment of Medicaid providers through contracts with the Georgia Hospital Association and the Medical Association of Georgia and for Continuum's Powerline, a toll-free number which offers referrals for prenatal care.

The Future of the Trust Fund

In September 1991, the federal Health Care Financing Administration published rules prohibiting states from using donated fund programs like Georgia's trust fund. In November 1991, Congress lifted the moratorium and allowed the programs to continue through June 1993. During its 1992 session, the Georgia General Assembly approved placing on the November ballot a constitutional amendment to enable the trust fund to continue by restructuring it to conform to federal regulations.

Participating Hospitals The following hospitals were designated as disproportionate share facilities and partici-
pated in the Indigent Care Trust Fund for FY 92:

Appling General Hospital Archbold Memorial Hospital Athens Regional Medical Center Bacon County Hospital Barrow Medical Center Berrien County Hospital BJC Medical Center Brooks County Hospital Bulloch Memorial Hospital Central State Hospital (Milledgeville) Chattooga County Hospital Clinch Memorial Hospital Coffee Regional Hospital Colquitt Regional Medical Center Crawford Long Hospital Crisp Regional Hospital Dodge County Hospital Dorminy Medical Center Early Memorial Hospital Effingham County Hospital Egleston Children's Hospital Emanuel County Hospital Evans Memorial Hospital Floyd Medical Center Gilman Hospital Grady Memorial Hospital Hamilton Medical Center HCA Fairview Park Hospital Hutcheson Medical Center Irwin County Hospital Jeff Davis Hospital Jefferson Hospital Louis Smith Memorial Hospital Marion Memorial Hospital

Medical Center of Central Georgia The Medical Center (Columbus) Medical College of Georgia Hospital Memorial Hospital (Adel) Memorial Hospital (Bainbridge) Memorial Medical Center Meriwether Memorial Hospital Miller County Hospital Mitchell County Hospital Patterson Hospital Peach County Hospital Perry Hospital Phoebe Putney Memorial Hospital Pickens General Hospital Roosevelt Warm Springs Institute St. Joseph's Hospital (Dahlonega) Scottish Rite Children's Medical Center Shepherd Spinal Center Smith Hospital (Hahira) South Georgia Medical Center Southeast Georgia Regional Medical Center Southwest Hospital and Medical Center Stewart Webster Hospital Sumter Regional Hospital Tanner Medical Center (Villa Rica) Tattnall Memorial Hospital Taylor Regional Hospital Tift General Hospital Ty Cobb Health Care System University Hospital Upson Regional Medical Center Wayne Memorial Hospital West Georgia Medical Center Worth County Hospital

Cost Containment
Collections -FY 92
Measurable Cost
Avoidance -FY 92

The Department works to ensure accurate and appropriate payment for services using a claims processing system with an intricate series of computer edits and audits.
Program integrity and compliance with state and federal regulations are monitored through reviews, audits and investigations. When overpayments are identified, the Department makes collections. Other measures, such as precertification and prior approval, have been instituted to prevent payment for services which are not appropriate or medically necessary.
In FY 92, collections and measurable cost avoidance saved a total of $617,924,102.
Third Party Liability ..........................................................................................$....1. 2,372,172
Because Medicaid is designated as the payor of last resort, the Department works with providers and eligibility workers to identify coverage for medical care through insurance or other liability sources where appropriate. In FY 92, about 15 percent of Medicaid recipients had other insurance coverage. The Department also investigated cases involving accidental injuries for which a third party was liable.
Hospital Cost Settlement ..................................................................................$.... 5,291,020
In certain situations, e.g., outpatient services, the Department makes payment adjustments after comparing interim payments and actual reimbursable costs from audited cost reports.
Other Collections ...............................................................................................$...1..1,169,011
The Department collects funds identified through investigations, utilization reviews, audits of providers and special situation recovery efforts. Also included in this category are voluntary refunds by providers.
Third Party Claim Cost Avoidance -Medicare ...........................................$. 425,543,212
BecauseMedicaid is the payor of last resort, claims for recipients who are covered by both Medicaid and Medicare must first be submitted to Medicare for payment. The Department avoids costs by ensuring that Medicare pays first.
Third Party Claim Cost Avoidance - Other ..................................................$.. 38,102,452
Claims must go to other insurance or liability sources before being submitted to Medicaid for payment. The Department avoids costs by identifying those sources and requiring payment by them before Medicaid payment is made.
Precertification of Admission ...........................................................................$...77,542,202
DMA contracts with the Georgia Medical Care Foundation (GMCF),a federally-qualified peer review organization, to certify hospital admissions, elective or emergency, for medical necessity. Elective hospitalizationsmust be certified by GMCFbefore admission. Emergency hospitalizations must be certified within two working days of admission. GMCF received 134,833 requests for precertification in FY 92.

Prior ApprovalIPrepayment or Pretreatment Review ...................................$. 13,237,475
The Department employs several prior approval measures to make certain that recommended services are appropriate and medically necessary. Prior approval procedures for office visits, home health services, surgery, durable medical equipment, dental procedures, optometric services and orthotics and prosthetics saved $2,865,207 last year.
Reviewing claims for multiple surgeries and claims from providers outside the state saved an additional $10,372,268.
Hospital Audits ....................................................................................................$.....4,614,636
Under the Department's common audit agreement with Blue Cross & Blue Shield of Georgia, Inc., 188 hospital cost reports were audited in FY 92. These audits resulted in prospective per case rate adjustments for inpatient services.
Nursing Facility Audits ......................................................................................$....7,331,922
Working with DMA, the Georgia Department of Audits performed on-site audits on 68 facilities, 20 percent of all nursing facilities participating in Medicaid. Audits resulting in reductions in allowable costs save money by lowering prospective reimbursement rates.
Pharmacy Prior Approval .................................................................................$....2. 2,720,000
The Department requires pharmacies and physicians to seek prior approval before dispensing certain drugs or more than five prescriptions per recipient per month for adults and more than six for children. Drugs placed on prior approval are those which have severe side effects, a high potential for abuse, uses restricted to a specific diagnosis, a very high cost or inappropriate utilization. Approval was granted to approximately 92 percent of the 76,165 requests for prior approval received in FY 92. Most of the savings from prior approval comes through avoidance of the use of certain drugs rather than from disapproval of requests.
Total Measurable Cost Avoidance and Collections ......................................$. 617,924,102

Appendix Tables and Charts

Fiscal Year

A HISTORY OF MEDICAID *
BENEFITS EXPENDITURES

Cash **
Benefit
Payments

Percentage Change

Payments ***
by Date
of Service

Percentage Change

1992

+ $2,090,163,405

21 %

+ $2,150,797,385 (est)

19%

The figures on this table include Medicare copayments and deductibles, but exclude Medicare premium payments.
** Paid during each fiscal year. In this Annual Report all 'expenditures,' 'benefits' or 'payments' are cash benefits payments,
with the exception of 'payments by date of service.'
*** Expendituresfor sewices provided during each fiscal year. Since PI77, based on a State Attorney General's ruling, pay-
ments have been made from the budget for the same year in which the Medicaid service was rendered. Final expenditure amounts are not known until some time after a fiscal year has ended, since providers have six months from the month of
sewice to file a claim. Date of service figures are expenditures as of June 30, 1992, for FY 87 - FY 91; FY 92 is an
estimate. Note that the figures for fiscal years before 1987were revised ill 1987to exclude Medicare premium payments.
+ Does not include Indigent Care T ~ sFtund amount of $249,939,533.

FY 92 ADMINISTRATIVE EXPENDITURES

Function
Contracts: DHR Interagency Contract Fiscal Agent Computer Services Georgia Medical Care Foundation Contract

$35,160,867 *
18,691,135 1,753,174

Percent of Total
47.24% 25.11 %
2.36%

Divisions: Program Compliance Operations Institutional Policv & Reimbursement Systems Management Professional Services Communitv Services Commissioner's Office Maternal & Child Health
TOTAL **

$4,298,862 4,223,086 3.882.869 2,139,120 1.796.178 1 .115.043 1,046,615 322,526
$74,429.475

5.78% 5.67% 5.22% 2.87% 2.41 % 1.50% 1.41 % 0.43%
100.00%

Federalfunds only. State matchingfunds appear in the Department of Human Resources budget. Services provided provided through this contract include eligibility determination, administration and case management for the community care program, recipient appeal hearings, and certificationof facilities for participationin Medicaid.
** Total figure does not include the cost associatedwith the NurseAide Training program mandated by Congress. In FY92,
the cost of the program was $3,748,289. These funds were paid directly to nursing homes but matched 50150 federallstate instead of the normal federal participation rate for Medicaid benefits.

FY 92 MEDICARE PREMIUMS

Type of Premium 100% State Premium. Part B

Expenditures $4.693.589

Percent of Total
6.00%

State-Federal Premiums. Parts A & B State Share Federal Share
Total Medicare Premiums

$27,507,810 46,063,629
$78,265,028

35.15% 58.85%
100.00%

The State pays the Part B premiums for MedicareIMedicaid individuals who are eligible for Part B benefits and also pays the Part A premiums for certain QMB individuals who are entitled to Part A benefits.

COLLECTIONS AND MEASURABLE COST AVOIDANCE
FY 89 - FY 92

COLLECTIONS
Third Party Liability *
Hospital Cost Settlement
Other Collections **
Total Collections

$6,198,275 $8,632,666 $10,493,609

1,369,772 2,074,992

3,327,668

8,131,088

8,276,242 12,146,830

$15,699,135 $1 8,983,900 $25,968,107

$1 2,372,172 5,291,020 11,169,011
$28,832,203

MEASURABLE COST AVOIDANCE

Third Party Claim Cost Avoidance-Medicare $315,593,760 $336,614,291 $440,996,962

$425,543,212 ***

Third Party Claim Cost Avoidance-Other

52,898,883 54,694,676 37,776,967 *** 38,102,452

Precertification Admission
Prior Approval and Prepayment or Pretreatment Review

-
8,509,853

-

+ 98,309,001

9,764,327 14,487,364

77,542,202 ++
13,237,475

Hos~itaAl udits

3,187,109

2,524,340

2,696.050

4,614.636

Nursing Home Audits + + +

Pharmacy Prior Approval

-

-

+ 16,500,000

22,720,000

Total Measurable Cost Avoidance GRAND TOTAL

$384,853,605 $409,467,553 $618,116,115 $400,552,740 $428,451,453 $644,084,222

$589,091,899 $617,924,102

* **
***
+ ++ + + +

Includes 'voluntary recoveries' with third party liability.
Includes collections originating from Investigations and Compliance, Surveillance and Utilization Review, audits of providers, special situation recovery efforts and voluntary refunds.
Reflects a change in federal reporting requirements.
Estimate revised after first year of operation of program.
Estimated cost savings decreased due to programmatic changes.
Estimatedfrom audited base year cost reports. Reductions in allowed costs result in cost avoidance through prospective future reimbursement rates.

BENEFITS PAID BY AID CATEGORY BY TYPE OF SERVICE FY 92

Type of Medical Service
Community Health Services
Dental
Early & Periodic Screening,
Diagnosis and Treatment Family Planning
Hospital, Inpatient
Hospital, Outpatient **

Age 65 or Over
$25,307,526
658,637

Blind

Disabled

$841,038 $33,944,476

60,852

2,803,760

Other Adults

Other Children

$480,531

$853,520

6,538,735 17,648,979

Total Pay rnents
$61,427,091
27,710,963

0 0 24,522,497 9,272,895

4,515 31,512

242,886 1,219,880

249,986 34,964,308

16,085,415 1,117,663

2,788,781 165,867,961 212,603,310 158,726,431

1,237,857 53,290,494 52,544,143 45,100,067

16,582,802 37,333,363 564,508,980 161,445,456

Mental Health Case Management

13,475

9,657

2,087,493

39,622

91,080

2,241,327

Mental Health Clinic

1,259,599

117,164 30,677,709

3,427,033

5,093,219

40,574,724

Nursing Facility Intermediate Care-MR
Nursing Facility Services ***
+ Other Care ++ Other Practitioners
Physician **

1,547,455

437,993 112,409,817

376,423,723 10,377,460 111,861,519

0 35,268

57,155 5,658

1,206,454 22,086,845

45,971

2,124,481

4,208,127

7,468,410

1,781,601 76,963,279 112,092,926 82,449,819

114,452,420 498,703,628
15,053,443 295,374,470

Prescribed Drugs

Rural Health Clinic
Total Payments +++

22,c'oo

2,812

165,158

191,834

380,995

762,799

$530,780,580 $20,867,681 $705,183,287 $462,238,201 $371,093,656 $2,090,163,405

Source: Annual Statistical Report on MedicalCare (HCFA 2082) for FY92. Mediire copayments and deductibles are included, but not Mediire premiums.
which were $78,265,028 in FY92. Ad categoly subtotals are not available for "Other"service types on the HCFA 2082 report (see notes below). Paymentsof $316,115,166 madefor "Right from the Statt'and "Medically Needy" recipientsare included in the "Othet"subtotals: $192,567,379 for pregnantwomenand
$123,547,787 for children.
lncludes home health and community care, mentalretardationand modelwaiver services.
*' lncludes dialysis expenditures. Facilltyand labomtoryexpenditures are under outpatient hospital and professionalfees are under physician.
"* lncludes skilled nursingfacilitiis,swing bedservices and other intermediatecare facilities. These are services other than those providedin an
institutionfor mental disease.
+ lncludes ambulance, ambulatorysurgical, dignostic,screening8 preventive services, durable medicalequipment, early interventioncase management,
hospice, non-emergency transportation. optornetrics-eyeglasses, orthotics/prosthetics, perinatal case management, pregnancy-related services and therapists programs.
+ + Includes chiropmctors, nurse midwives, nurse practitioners, optometrists, physician's assistants, podiatrists and psychologists. + + + Does not include Indigent Care Trust Fund amount of $249,938,533.

RECIPIENTS BY AID CATEGORY BY TYPE OF SERVICE FY 92

Type of Medical Service Community Health Services Dental Early & Periodic Screening
Diagnosis and Treatment
Family Planning Hospital, Inpatient
Hospital, Outpatient **
Laboratory/Radiology Mental Health Case Management Mental Health Clinic Nursing Facility Intermediate Care-MR
Nursing Facility Services ***
+ Other Care ++ Other Practitioners
Physician **
Prescribed Drugs Rural Health Clinic
Total Recipients

Age 65 or Over
9.873 8,760
0 0 30,851 47,522 3,066 15 1,055 25 30,530 45,393 30,097 85,274

Blind 31 2 595

Disabled 10.454 25,033

81 113 1,103 2,098 425
10 153
6 1,154 1,858
841 3,405

4,396 4,935 41,173 86,221 21,588 2,245 19,689 1,720 7,000 58,068 25,471 120,326

Other Adults
559
52,661

Other Children

Unduplicated Totals

61 6

21.81 4

134,662

221,711

5,079 65,273 60,666 127,500 64,663
73 11,112
0 5 57,589 25,343 167,688

199,784 9,970
38,248 209,595
20,651 111
16,214 1 1
68,744 39,859 322,494

209,340 80,291 172,041
472,936 110,393
2,454 48,223
1,752 38,690 231,652 121,611 699,187

427 97,334

23 4,312

1,072 138,079

1,665 198,455

3,926 409,849

7,113 848,029

Source: Annual Statistical Reporton MedicalCare (HCFA 2082) for SFY92. Aid categorysubtotals are not availablefor "Other" servicetypes on the HCFA 2082 (seenotes below). There were 157,123 "Right from the S t a t and"Medically Needy"recipients includedin the "Other" subtotals: 56.319 pregnant women and 100,804 children.
lncludes home healthand community care, mentalretardationand modelwaiver services.
*' lncludes dialysis recipients. Facilityand labomtory recipientsare under outpatient hospital and professionalfees are under physician.
*** lncludes skilled nursing facilities, swing bed services, andother intermediatecare facilitiis. These are sewices other than those providedin an
institutionfor mental disease.
+ lncludes ambulance, ambulatory surgical, diagnostic.screening & preventive services, durable medical equipment, early intervention case management,
hospice, non-emergency transportation,optometrics-eyeglasses, orthotics/pr~~theticpse,rinatal case management, pregnancy-related services, and therapists programs.
+t lncludes chiropractors, nurse midwives, nurse practitioners,optometrists, physician'sassistants, podiatristsand psychologists.

PERCENTAGE OF EXPENDITURES, PERCENTAGE OF RECIPIENTS AND AVERAGE YEARLY PAYMENT PER RECIPIENT BY AID CATEGORY FY 92

Basis of Eligibility Aged
Blind *
Disabled
AFDC Adult ** AFDC Child **
RSM Adult RSM Child Medically Needy Adult Medically Needy Child
TOTAL ***

Percentage

Percentage

Expenditures of Total Recipients

of Total

Average Paid Per Recipient

$530,780,580 20,867,681
705,183,287 269,670,822 247,545,869 188,963,296 117,237,998
3,604,083 6,309,789

25.4% 1 .O%
33.7% 12.9% 11.8% 9.1% 5.6% 0.2% 0.3%

97,334 4,312
138,079 142,136 309,045 55,151 97,279
1,168 3,525

11.5% 0.5% 16.3% 16.8% 36.4% 6.5% 11.5% 0.1% 0.4%

$5,453.19 4,839.44 5,107.10 1,897.27 801 .00 3,426.29 1,205.17 3,085.69 1,790.01

$2,090,163,405

100.0%

848,029

100.0% $2,464.73

Source: Annual Statistical Report on Medical Care (HCFA 2082)for SFY 92.
Most aged and a portion of the blind and disabled are covered by Medicare, so expenditures do not reflect the total cost of health care. Medicare coinsurance and deductibles are included.
** Includes recipientswho receive cash assistance and those who do not. *** Does not include Indigent Care Trust Fundamount of $249,939,533,

NUMBER OF VISITS FOR SELECTED TYPES OF SERVICE AND NUMBER OF PRESCRIPTIONS BY AID CATEGORY
FY 92

Type of Medical Service Aged Blind Disabled
AFDC Adult ** AFDC Child **
RSM Adult RSM Child Medically Needy Adult Medically Needy Child
Unduplicated Totals

Community & Outpatient
Clinic * Home Care Hospital

133,481 9,767
2,745,366 188,551 278,668 12,051

821,974 22,477
666,534 9,730 6,157 1,829

786 1,936 128,347 163,313 250,369 46,476

12,040 9
1,340

3,314 4
139

78,715 89
1,272

3,381,273

1,532,158

671,303

Source: Annual Statistical Report on Medical Care (HCFA 2082)for SFY 92. Number of visits to mental health clinics
** Includes recipients who receive cash assistance and those who do not.

Prescribed Rural Health

Physician

Drugs

Clinic

8,971 10,260 577,581 472,694 809,279 101,296 395,013
818 8,211

2,715,518 100,852
3,516,597 1,290,111 1,411,523
241,144 558,979
230 7,454

1,618 268
14,273 24,270 26,068
8,659 7,812
3 96

2,384,123

9,842,408

83,067

PERCENTAGE OF TOTAL RECIPIENTS UTILIZING EACH SERVICE
FY 89 - FY 92

Cateaorv of Service
Ambulance Ambulatory Surgical Community Care Dental Diagnostic, Screening & Preventive Services Dialysis Durable Medical Equipment Early & Periodic Screening,
Diagnosis and Treatment Early Intervention Case Management Family Planning Home Health Hospice Hosoital. lnoatient Hospital, Outpatient Laboratory/Radiology Mental Health Case Management Mental Health Clinic Mental RetardationWaiver Program Model Waiver Services Non- Emergency Transportation Nurse Midwife Nurse Practitioner Nursing Facility IntermediateCare- MR Nursing Facility Services Optometrics- Eyeglasses Optometry

FY89
5.5% 0.1 % 1.5% 29.3% -
-
5.1 %
19.0% 9.5% 2.6%
<0.1% 23.3% 50.9%
9.2% 0.2% 4.6%
-
14.0%
0.3%
0.3% 5.6% 6.9% 8.6%

FY90 6.0% 0.1 % 1.3% 26.7%
-
<0.1% 5.1 %
19.7%
-
9.5% 2.0% <0.1% 28.1 % 51.1% 10.3% 0.2% 4.3% 0.1 % 19.5% 0.3%
0.3% 5.2% 5.6% 7.4%

FY91 6.1 % 0.2% 1.2% 27.4%
-
0.1 % 5.0%
22.3% 9.4% 1.8%
<0.1% 28.9% 52.4% 11.6%
0.3% 5.2% <0.1% <0.1% 14.2% 0.4% 0.4% 0.2% 5.3% 6.5% 8.8%

Other Coinsurance and Deductibles *
Perinatal Case Management Physician Phvsician's Assistant Podiatry Pregnancy- Related Services Prescribed Drugs Psychology Rural Health Clinic/Community Health Centers Swing Bed Services

0.4%
-
77.2% -
4.4%
-
78.6%
0.9%
0.7%
-

0.2% -
76.6% -
4.5%
-
77.6% 0.7% 0.8% -

0.4% 0.6%
76.7% 4.6%
-
76.8% 1.1% 0.9%
<0.1%

Source: Medicaid Expenditures by Recipient County of Residence report and previous Annual Reports. Other Coinsuranceand Deductibles includes Physical, Rehabilitation,and Speech therapies, and Chiropractor.

FY92 6.3% 0.3% 1.2% 26.1 % 1.7% 0.1 % 5.1 %
24.7% 0.1 % 9.5% 1.4%
<0.1% 20.3% 55.8% 13.0%
0.3% 5.7% <0.1% <0.1% 12.2% 0.4% 1 .O% 0.2% 4.6% 5.9% 7.7%
0.6% 2.4% 82.4% 0.3% 4.1 % 0.7% 80.0% 1.3% 0.8% <0.1%

AVERAGE PAYMENT FOR SERVICES PER RECIPIENT
FY 89 - FY 92

Type of Service
Ambulance Ambulatorv Suraical Communitv Care Dental Diagnosis, Screening & Preventive Services Dialysis Durable Medical Equipment Early and Periodic Screening,
Diagnosis and Treatment Early Intervention Case Management Family Planning Home Health Hospice Hospital, Inpatient Hospital, Outpatient Laboratory/Radiology Mental Health Case Manaaement Mental Health Clinic Mental Retardation Waiver Program Model Waiver Services Non- Emergency Transportation Nurse Midwife Nurse Practitioner Nursing Facility Intermediate Care- MR Nursing Facility Services Optometrics- Evealasses Optometry Orthotics/Prosthetics Other Coinsurance and Deductibles Perinatal Case Management Phvsician Physician's Assistant Podiatry Pregnancy-Related Services Prescribed Druas Psychology Rural Health Clinic/Community Health Centers Swing Bed Services Average Payment per
Recipient for all Services Annual Percent Change

FY 89
$95.95 200.62 2.437.91 185.54
-
300.31
50.99 -
149.38 1.91 8.26 3,345.58 2,406.43
271.33 37.79
744.57 1.043.57
-
-
215.18 655.98
-
51,750.00 9,513.32 15.50 42.01 41 6.02 223.98
-
351.24
-
82.65
-
289.38 169.02 97.94
-

FY 90
$1 07.44 196.20
2.376.10 105.15
-
5,775.72 322.98
53.89 -
172.03 1.942.24 4,273.07 2,058.86
307.59 42.46
858.41 1.051.77 7,768.51
-
246.03 729.07
57,111.69 10,352.57
17.15 49.07 357.35 222.51
-
382.56
-
81.98
-
280.98 327.37 102.30
-

FY 91
$122.36 250.62
2.906.67 124.40 -
6,824.30 345.1 1
79.76 -
389.84 1.672.05 4.022.36 2,204.44
348.67 51.61
861.23 922.09 28,076.96 21,197.41 190.89 708.88
42.83 61,353.08 10,812.24
18.77 50.73 336.91 399.83 89.81 398.99
-
82.81 -
273.90 456.1 1 107.47 1,159.95

FY 92 $1 06.69
287.10 2.938.94
124.99 41.71 8,506.86 364.66
79.21 51 2.27 464.98 1.738.65 3,904.36 3,281.25 334.14
61.37 91 3.34 841.40 25,428.93 29,985.01 250.08 792.57
51.06 65,326.72 12,885.55
20.78 48.52 347.51 497.18 115.13 421.93 51.1 1 71 -70 90.92 276.40 564.23 107.24 837.03

$2,179.25 $2,220.09

9.26%

1.87%

$2,358.94 6.25%

$2,464.73 4.48%

Source:Table "Benefitsand Recipients by Category of Service"and previous Annual Reports. Payments and recipients include Medicare copayments and deductibles. Amounts do not include Indigent Care Trust Fund.

PERCENTAGE OF TOTAL EXPENDITURES FOR EACH CATEGORY OF SERVICE
FY 89 - FY 92

Category of Service
Ambulance Ambulatorv Suraical Community Care Dental Diagnostic, Screening & Preventive Services Dialysis Durable Medical Equipment Early & Periodic Screening,
Diagnosis and Treatment Early Intervention Case Management Family Planning Home Health Hospice Hospital, Inpatient Hospital, Outpatient LaboratoryIRadiology Mental Health Case Manaaement Mental Health Clinic Mental Retardation Waiver Program Model Waiver Services Non- Emergency Transportation Nurse Midwife Nurse Practitioner Nursing Facility Intermediate Care- MR Nursing Facility Services Optometric- Evealasses Optometry Orthotics/Prosthetics Other Coinsurance and Deductibles Perinatal Case Management Phvsician Phvsician's Assistant Podiatry Pregnancy- Related Services Prescribed Druas Psychology Rural Health ClinicICommunity Health Centers Swing Bed Services Total

0.2% <0.1%
1.6% 2.5%
-
0.7%
0.4%
-
0.7% 2.2% ~0.1% 25.7% 6.3% 0.2% 0.1 % 2.2%
1.4% 0.1 % 7.6% 24.4% 0.1 % 0.2% 0.3% <0.1%
-
12.4% -
0.2% -
10.4% 0.1 % ~0.1%
-
100.0%

0.3% ~0.1%
1.4% 1.3%
0.1 % 0.7%
0.5%
-
0.7% 1.7% ~0.1% 26.1 % 7.1 % 0.2% 0.1 % 2.0% 0.2%
2.2% 0.1 %
7.3% 24.2% <0.1% 0.2% 0.2% ~0.1%
13.2%
-
0.2% -
9.8% 0.1 % ~0.1%
-
100.0%

0.3% <0.1%
1.5% 1.4%
-
0.2% 0.7%
0.8%
-
1.5% 1.2% <0.1% 27.0% 7.7% 0.3% 0.1 % 2.0% 0.3% 0.1 % 1.1% 0.1 % ~0.1% 6.2% 24.4% 0.1% 0.2% 0.2% ~0.1% ~0.1% 13.0%
0.2%
8.9% 0.2% <0.1% <0.1%
100.0%

0.3% <0.1%
1.4% 1.3% <0.1% 0.2% 0.7%
0.8% <0.1%
1.8% 1 .O% <0.1% 27.0% 7.6% 0.3% 0.1 % 1.9% 0.4% 0.1 % 1.2% 0.1 % ~0.1% 5.5% 23.9% <0.1% 0.2% 0.2% 0.1 % 0.1 % 14.1% <0.1% 0.1% ~0.1% 9.0% 0.3% <0.1% ~0.1% 100.0%

Source: Benefit expenditures (by date of payment) are reported in the FY92 Annual Statistical Report on Medical Care (HCFA 2082) and estimated from the SFY 92 Medicaid Expendituresby Recipient County of Residence. 'Total Expenditures"include copayments and deductibies for persons eligible for Medicare and Medicaid, but not Medicare premiums. Indigent Care Trust Fund is not included.

PROVIDERS WITH PAID CLAIMS BY CATEGORY OF SERVICE FY 89 - FY 92

Category of Service
Ambulance Ambulatory Surgical Community Care Dental, Adult Dental, Child Diagnostic, Screening & Preventive Services Dialvsis Durable Medical Equipment Early & Periodic Screening,
Diagnosis and Treatment Early Intervention Case Management Family Planning Home Health Hospice Hosoital. lnoatient Hosoital. Outoatient Laboratory/Radiology Mental Health Case Management Mental Health Clinic Mental Retardation Waiver Proaram Model Waiver Services Non- Emeraencv Transoortation Nurse Midwife Nurse Practitioner Nursing Home Intermediate Care- MR Nursing Facility Services Optometry

FY89
194 10
289 1,214 1,155
-
-
381
263
-
22 96
8 391 41 4
62
-
121
-
-
455 29
-
11 297 41 9

Number of Providers

FY90

FY91

193

202

11

16

214

225

1,004

947

1,010

974

-

-

90

139

41 2

42 1

132

166

-

-

22

22

112

95

12

17

360

360

41 5

500

75

80

-

-

45

48

25

53

-

9

549

535

43

50

-

37

11

12

305

327

395

426

FY92 207 20 240
1,000 1,056
47 150 456
233 25 23 80 21
367 629
86 16 74 94 19 525 55 81 12 329 475

Perinatal Case Manaaement

-

-

10

25

Phvsician

8.746

8.529

9.1 10

11.386

Podiatrv Pregnancy-Related Services

145

135

138

163

-

-

-

37

Prescribed Drugs

1,919

1,895

1,870

1,893

Psychology

154

155

224

297

Rural Health Clinic/Community Health Centers

2 1

19

22

31

Swing Bed Services

-

-

4

7

Claims for Medicare coinsuranceand deductibleand for adjustments are excluded.

NOTE: The number of providers with paid claims can be considerably less than the number of providers "enrolled." For example, the number of providers enrolled for inpatient hospital during FY 92 was 460; for nursing facility services, 332; for pharmacy, 2,172; for physicians, 21,846; and for child dental, 1,880. The total number of providers enrolled at the end of FY92 was 34,052. Out-of-state providers are includedfor all years. If a provider has more than one location, the provider is only counted once. Source: Provider Palticipation Summary.

COMPARISON OF ELIGIBLES, RECIPIENTS AND EXPENDITURES
FY 89 - FY 92

July August September October November December January February March
Mav June

464,355 464,180 464,568 470,858 469,998 469,117 475,928 477,490 484.837
487,910 496,482

499,841 500,992 504,703 51 0,241 514,554 525,071 527,292 523,397 541.232
547,957 559,732

564,556 563,093 577,901 585,772 590,357 592,740 602,834 601,454 630.392
646,896 650,975

682,179 676,395 689,624 71 1,428 714,893 728,095 731,058 740,051 754,094
760,268 770,871

Average Monthly Eligibles Annual Percent Chanae

475,764 5.06%

525,310 10.41 %

603,994 14.98%

726,014 20.20%

Average Monthly Recipients Annual Percent Chanae

275,067 4.89%

292,421 6.31 %

336,152 14.95%

402,501 19.74%

Average Monthly Expenditures (millions)
Annual Percent Change

$1 00.1 80 15.69%

$115.492 15.28%

$144.230 24.88%

$174.1 80 20.77%

Average Monthly Expenditure per Monthly Eligible
Annual Percent Chanae

$210.57 10.12%

$219.86 4.41 %

$238.79 8.61 %

$239.91 0.47%

Average Monthly Expenditure per Monthly Recipient
Annual Percent Change

$364.20 9.82%

$394.95 8.44%

$429.06 8.64%

$432.75 0.86%

Note: Source for eligibles is Medical Eligibles Statewide-End of Month Report. Not all of those eligible are recipients of services. Sourcefor FY89-92 recipients was based on change in Provider ParticipationAnalysis after Medicare coinsurance and deductiblewere excluded from report. Expendituresdo not include Indigent Care Trust Fund.

ANALYSIS OF RECIPIENTS AND EXPENDITURES BY RECIPIENT'S COUNTY FY 92

County 1 APPLING 2 ATKINSON 3 BACON 4 BAKER 5 BALDWIN 6 BANKS 7 BARROW

Benefits Paid
$7,392,478 3,108,026 3.977.071 1,470,926
48,467,290 1,981,996
11.398.051

Estimated 1992
Population
16,290 6,428 9.898 3,741 40,900 10,666 30,751

% Population

Unduplicated Receiving

Recipients

Medicaid

3,196

19.62%

1,647

25.62%

2.01 0

20.31%

891

23.82%

5,686

13.90%

1,092

10.24%

4.417

14.36%

% of Total State
Recipients
0.38% 0.19% 0.24% 0.11% 0.67% 0.13% 0.52%

Expenditures Per
Recipient
$2,313.04 1,887.08 1.978.64 1,650.87 8,523.97 1,815.01 2.580.50

9 BEN HILL 10 BERRIEN 11 BlBB 12 BLECKLEY 13 BRANTLEY 14 BROOKS 15 BRYAN 16 BULLOCH 17 BURKE 18 B U T S 19 CALHOUN 20 CAMDEN 21 CANDLER 22 CARROLL 23 CATOOSA 24 CHARLTON 25 CHATHAM 26 CHATAHOOCHEE 27 CHATOOGA 28 CHEROKEE 29 CLARKE 30 CLAY 31 CLAMON 32 CLINCH 33 COBB 34 COFFEE 35 COLQUIT 36 COLUMBIA 37 COOK 38 COWETA 39 CRAWFORD 40 CRISP 41 DADE 42 DAWSON

10,551,469 6,194,282 61,938,376 3.808.1 57 3,305,904 9,263,665 4,098,911 14.545.913 12,395,696 7,443,277 2,683,436 4.080.421 9.044.406 21,403,317 10,560,133 2,793,844 77.842.801 2,364,150 7,850,272 15.605.523 29,540,501 2,445,642 41,866,579 3.525.783 55,450,421 15,713,203 17,706,354 12.458.963 4,835,275 14,942,874 3,336,591 14,084,740 3,379,294 2,054,407

16,809 14,644 155,165 10.791 11,461 15,931 15,973 44.620 21,292 15,857 5,187 31-213
8.012 73,897 43,935
8,790 224.454
17,521 23,013 93.330 90,631
3,481 188,362
6.374 463,264
30,618 37,915 68.320 13,923 55,720
9,303 20,705 13,603
9,756

4,033 2,755 27,241 1.667 2,130 3,836 2,408 6.396 5,563 2,404 1,293 2.683 2.282 9,238 4,417 1,639 34.394
798 3.391 5.797 10,690 1,167 17,948 1,638 21,290 6,749 8,456 4.184 2,667 7,031 1,421 5.906 1,575 1,062

23.99% 18.81 % 17.56% 15.45% 18.58% 24.08% 15.08% 14.33% 26.1 3% 15.16% 24.93%
8.60% 28.48% 12.50% 10.05% 18.65% 15.32%
4.55% 14.74% 6.21 % 11.80% 33.52% 9.53% 25.70%
4.60% 22.04% 22.30%
6.12% 19.16% 12.62% 15.27% 28.52% 1 1.58% 10.89%

0.48% 0.32% 3.21 % 0.20% 0.25% 0.45% 0.28% 0.75% 0.66% 0.28% 0.15% 0.32% 0.27% 1.09% 0.52% 0.19% 4.06% 0.09% 0.40% 0.68% 1.26% 0.14% 2.1 2% 0.19% 2.51% 0.80% 1 .00% 0.49% 0.31 % 0.83% 0.17% 0.70% 0.1 9% 0.1 3%

2,616.28 2,248.38 2.273.72 2.284.44 1,552.07 2,414.93 1,702.21 2.274.22 2,228.24 3,096.21 2,075.36 1.520.84 3.963.37 2,316.88 2,390.79 1.704.60 2.263.27 2,962.59 2.315.03 2.692.00 2,763.38 2,095.67 2,332.66 2.1 52.49 2,604.53 2,328.23 2,093.94 2.977.76 1,813.00 2,125.28 2,348.06 2.384.82 2,145.58 1,934.47

ANALYSIS OF RECIPIENTS AND EXPENDITURES BY RECIPIENT'S COUNTY FY 92

County 43 DECATUR 44 DEKALB 45 DODGE 46 DOOLY 47 DOUGHERTY 48 DOUGLAS 49 EARLY 50 ECHOLS 51 EFFINGHAM 52 ELBERT 53 EMANUEL 54 EVANS 55 FANNIN 56 FAYElTE 57 FLOYD 58 FORSMH 59 FRANKLIN 60 FULTON

Benefits Paid
$21,888,080 134.1 65.235
9,162,262 6,189,675 40,348,559 14.305.682 9,113,244
421,684 6,276,692 9.372.777 14.121.187 3,235,609 5,429,939 4.767.968 33,406,103 10,550,685 10,735,422 208.1 95,731

Estimated 1992
Population *
26,395 564.756
18,217 10,244 99,649 73.585 12,265 2,415 26,578 19.606 21.258 9,027 16,547 64.578 84,067 45,611 17,227 671.444

% Population

Unduplicated Receiving

Recipients

Medicaid

6,208

23.52%

48.91 0

8.66%

3,575

19.62%

2,591

25.29%

21,835

21.91 %

5.454

7.41 %

3,721

30.34%

317

13.13%

3,383

12.73%

4.035

20.58%

5.085

23.9%

2,011

22.28%

2,450

14.81%

1.584

2.45%

11,407

13.57%

3,171

6.95%

3,131

18.17%

101.226

15.08%

% of Total State
Recipients
0.73% 5.77% 0.42% 0.31 % 2.57% 0.64% 0.44% 0.04% 0.40% 0.48% 0.60% 0.24% 0.29% 0.19% 1.35% 0.37% 0.37% 11.94%

Expenditures Per
Recipient
$3,525.79 2.743.1 0 2,562.87 2,388.91 1,847.88 2.622.97 2,449.1 4 1,330.23 1,855.36 2.322.87 2.777.03 1,608.96 2,216.30 3.010.08 2,928.56 3,327.24 3,428.75 2.056.74

62 GLASCOCK 63 GLYNN 64 GORDON 65 GRADY 66 GREENE 67 GWINNElT 68 HABERSHAM 69 HALL 70 HANCOCK 71 HARALSON 72 HARRIS 73 HART 74 HEARD 75 HENRY 76 HOUSTON 77 IRWIN 78 JACKSON 79 JASPEF~ 80 JEFF DAVIS 81 JEFFERSON 82 JENKINS 83 JOHNSON 84 JONES

921,275 21,244,787
9,542,751 8.1 66.601 5,170,802 37,423,838 8.361.006 25,576,895 4,669,479 9.285.741 3.665.444 4,888,669 3,698,525 11,466,226 23,025,951 3.689.247 10,722,866 1,977,732 3.430.1 40 13,202,910 7,204,722 4,538,624 6.237.371

2,439 64,662 36,288 20.982 12,202 365,142 28.579 98,735
9,217 22.727 18.405 20,395
8,927 60,777 92,300
8.949 31,045
8,746 12.450 18,012 8,533
8.61 8 21.458

248 9,002 3,775 4.240 2,440 13,148 2.672 9,601 2,175 3.457 1.940 2,646 1,703 4,697 10.307 1.858 4,304 1,470 1.994 4,710 2,640 1.940 2.218

10.17% 13.92% 10.40% 20.21% 20.00% 3.60%
9.35% 9.72% 23.60% 15.21% 10.54% 12.97% 19.08% 7.73% 11.17% 20.76% 13.86% 16.81% 16.02% 26.15% 30.94% 22.51% 10.34%

0.03% 1.06% 0.45% 0.50% 0.29% 1.55% 0.3% 1.13% 0.26% 0.41 % 0.23% 0.31% 0.20% 0.55% 1.2% 0.22% 0.51% 0.17% 0.24% 0.56% 0.31 % 0.23% 0.26%

3,714.82 2,360.01 2,527.88 1.926.09 2,119.18 2,846.35 3.129.12 2,663.98 2,146.89 2.686.07 1.889.40 1,847.57 2,171.77 2,441.1 8 2.234.01 1.985.60 2,491.37 1,345.40 1.720.23 2,803.17 2,729.06 2.339.50 2.81 2.1 6

ANALYSIS OF RECIPIENTS AND EXPENDITURES BY RECIPIENT'S COUNTY FY 92

County 85 LAMAR 86 LANIER 87 LAURENS 88 LEE 89 LIBERTY 90 LINCOLN 91 LONG 92 LOWNDES 93 LUMPKIN 94 MACON 95 MADISON 96 MARION 97 MCDUFFIE

Benefits Paid
$3.577.1 85 3,541,908 17,726,651 2,737,806 9.476.877 1,609,966 1,172,784
32,572,719 3.889.387 9,331,732 7,762,837 1,953,454 11-017.584

Estimated 1992
Population
13.490 5,723 41,374 16.814 54.573 7,700 6,417 78,615 15.078 13,566 21,776 5,783 20.818

% Population

Unduplicated Receiving

Recipients

Medicaid

1.930

14.31%

1,416

24.74%

8,220

19.87%

1,854

11.03%

5.235

9.59%

950

12.34%

771

12.01%

13,767

17.51%

1.469

9.74%

3,485

25.69%

3,135

14.40%

1,188

20.54%

4.091

19.65%

% of Total State
Recipients
0.23% 0.17% 0.97% 0.22% 0.62% 0.11% 0.09% 1.62% 0.1 7% 0.41 % 0.37% 0.14% 0.48%

Expenditures Per
Recipient
$1.853.46 2,501.35 2,156.53 1.476.70 1.81 0.29 1,694.70 1,521.12 2,366.00 2.647.64 2,677.68 2,476.1 8 1,644.32 2.693.1 3

99 MERIWET'HER 100 MILLER 101 MITCHELL 102 MONROE 103 MONTGOMERY 104 MORGAN 105 MURRAY 106 MUSCOGEE 107 NEWTON 108 OCONEE 109 OGLETHORE

8,377,322 3,475,018 8.740.832 7,747,831 2,402,605 5,556,280 5,996,291 53.565.749 12,466,454 2,472,958 2.1 41.040

23,188 6,497
20.978 17,706 7,411 13,330 27,054 185.492 43,257 18,229 10.101

4,154 1,519 5.341 2,651 1,441 2,092 2,830 27.308 6,590 1,221 1.225

17.91% 23.38% 25.46% 14.97% 19.44% 15.69% 10.46% 14.72% 15.23%
6.70% 12.13%

0.49% 0.18% 0.63% 0.31 % 0.17% 0.25% 0.33% 3.22% 0.78% 0.14% 0.14%

2,016.69 2,287.70 1.636.55 2,922.61 1,667.32 2,655.97 2,118.83 1.961.54 1,891.72 2,025.35 1.747.79

111 PEACH 112 PICKENS 113 PIERCE 114 PIKE 115 POLK 116 PULASKI 117 PUTNAM

7,392,172 5,943,540 3.923.597 3.71 2.059 13,310,116 5,753,895 4,899,134

21,923 14,932 13.790 10.578 34,987
8,389 14,627

4,295 2,152 2.424 1.377 5,851 1,912 2,079

19.59% 14.41% 17.58% 13.02% 16.72% 22.79% 14.21%

0.51 % 0.25% 0.29% 0.16% 0.69% 0.23% 0.25%

1,721.11 2,761.87 1.61 8.65 2.695.76 2,274.84 3,009.36 2,356.49

119 RABUN 120 RANDOLPH 121 RICHMOND 122 ROCKDALE 123 SCHLEY 124 SCREVEN 125 SEMINOLE

4,577,619 3,003,883 110,041,116 10.381.742
950,049 5,040,013 2.934.1 88

12,052 8,301 196.295 55.966 3,712 14,322 9.322

1,661 2,252 32.436 4.062
720 2,821 2.1 05

13.78% 27.13% 16.52%
7.26% 19.40% 19.70% 22.58%

0.20% 0.27% 3.82% 0.48% 0.08% 0.33% 0.25%

2,755.94 1,333.87 3.392.56 2.555.82 1,319.51 1,786.61 1.393.91

ANALYSIS OF RECIPIENTS AND EXPENDITURES BY RECIPIENT'S COUNTY
N 92

County 127 STEPHENS 128 STEWART 129 SUMTER 130 TALBOT 131 TALIAFERRO 132 TATTNALL 133 TAYLOR 134 TELFAIR 135 TERRELL 136 THOMAS

Benefits Paid
$7,032,512 2,246,890 15.590.772 1,571,501 71 8,262 8.731.584 4,676,502 7,920,904 5,020,285
21,530,876

Estimated 1992
Population
24,063 5,850
31.276 6,750 1,981 18.337 7,907 11,381 11,022
40,337

% Population

Unduplicated Receiving

Recipients

Medicaid

3,473

14.43%

1,403

23.98%

7.235

23.1 3%

1,260

18.67%

41 3

20.85%

3.979

21.70%

2,205

27.89%

2,746

24.13%

2,993

27.1 5%

8,083

20.04%

% of Total State
Recipients
0.41 % 0.17% 0.85% 0.15% 0.05% 0.47% 0.26% 0.32% 0.35% 0.95%

Expenditures Per
Recipient
$2,024.91 1,601.49 2.1 54.91 1,247.22 1,739.13 2.1 94.42 2,120.86 2,884.52 1,677.34 2,663.72

138 TOOMBS 139 TOWNS 140 TREUTLEN 141 TROUP 142 TURNER 143 TWIGGS 144 UNION 145 UPSON 146 WALKER 147 WALTON 148 WARE 149 WARREN 150 WASHINGTON 151 WAYNE 152 WEBSTER 153 WHEELER 154 WHITE 155 WHITFIELD 156 WlLCOX 157 WILKES 158 WlLKlNSON 159 WORM
STATEWIDE **

16,764,620 1,436,199 3,176,464
18,013,028 4,237,268 4,416,864 4,300,740 8,913,416 18,328,158 13,255,544 19,023,183 3.026.81 9 12,302,996 13,745,528
540,774 2.818.162 6,853,753 19,358,489 4,753,963 3,270.542 3,905,251 6,809,632
$2,090,163,405

24,906 6,988 6,202
57,461 9,004 10,146 12,409
27.21 1 60,362 39,924 36,701
6.288 19,774 23,131 2,341 5.073 13,457 74,973 7,251 10.964 10,582 20,429
6,702,754

5,777 725
1,557 8,961 2,535 1,950 1,646 4.022 6,603 5,289 7,700 1.276 4,126 4,763
364 1.199 1,535 7,914 1,730 1.968 1,811 4,201
848,029

23.20% 10.37% 25.1 0% 15.59% 28.15% 19.22% 13.26% 14.78% 10.94% 13.25% 20.98% 20.29% 20.87% 20.59% 15.55% 23.63% 11.41% 10.56% 23.86% 17.95% 17.11% 20.56%
12.65%

0.68% 0.09% 0.18% 1.06% 0.30% 0.23% 0.19% 0.47% 0.78% 0.62% 0.91 % 0.15% 0.49% 0.56% 0.04% 0.1 4% 0.18% 0.93% 0.20% 0.23% 0.21 % 0.50%
102.72%

2,901.96 1,980.96 2,040.1 2 2,010.16 1,671.51 2,265.06 2,612.84 2.216.17 2,775.73 2,506.25 2,470.54 2.372.1 2 2,981.82 2,885.90 1.485.64 2.350.43 4,464.99 2,446.1 1 2,747.96 1.661.86 2,156.41 1,620.96
$2,464.73

Estimated populationfor 1992 based on 1990 census figures from the Governor's Office of Planning and Budget.
** Statewide totals reflect unduplicatedrecipients and expendiiures as listed elsewhere in this report. The sum of '% Total State
Recipients' exceeds 100% since a recipient may reside in more than one county during a year. Expenditures do not include IndigentCare Trust Fund amount of $249,939,533 or Medicare premiums.

Medical Assistance Advisory Committee
Community Care
Community Mental Health
Consumer
Dental

The Medical Assistance Advisory Committee gives technical and policy advice to the
Department and acts as a liaison between the Department and the provider community. Subcommittees of this group, representing professional groups and consumers, are appointed by the Commissioner and meet several times each year. Subcommitteesplay a vital
role in studying the effects of proposed policy changes and relaying the concerns of their associates to the Department. Subcommittees and their members (as of June 30,1992) are
listed below.
Martin Miller, Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V. aldosta Carl Evans, Vice Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .W. inder Joyce D. Barlow, R.N.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. lbany H.DeanBeasley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Merlene Cheshire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B. aldwin Brenda W. DeLoach, R.N.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. aldosta Gail Finley, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .G. riffin LeannaHogan,R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. thens Jane McCombs, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A.tlanta Fred McGinnis, Ph.D.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta PattieS.Pearson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .R. ome Carol Robinson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A.tlanta Patricia Ann Rogers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F.airburn Denita Varga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .N. orcross
Annette Maxey, Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Decatur Cynthia Luke, R.N., Vice Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Columbus Joann Colwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A.tlanta Charles A. Dillon, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J.onesboro JerryGarber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta Von Slade McCranie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Valdosta William A. Norton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S.tatesboro Bobby C. Robbins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L. awrenceville Doris Taggart-Thomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta MarianWilder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S.myrna Martha Williams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Americus
Annette Bowling, Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Albany Martha Eaves, Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Conyers Cheryl Finn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Karen Geiger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Sharmaine Greenland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. ecatur Vicky 0.Kimbrell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Becky A. Kurtz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta EthelMaeMathews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta NancyMoulton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Calvin E. Peterson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. tlanta PatsySherrod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .W. aycross Sonya P. Smith . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta CindyWade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. alton
Dewitt T. Walton, Jr., D.D.S., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. acon James Barenie, D.D.S., Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Augusta Frank Arnold, D.D.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C. ovington Robert Bays, D.D.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Randall R. Benner, D.D.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. oultrie Roy Brooks, D.D.S.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E.ast Point Darryl A. Chapman, Sr., D.M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Cordele F. Marion Durst, 111, D.M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Janet H. Harrison, D.D.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M. illedgeville

Durable Medical Equipment EPSDT Formulary
Home Health Hospice

E. Douglas Henson, D.D.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta R. H. Sasser, D.D.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S. wainsboro James S. Soteres, D.M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta
Eric Holgate, Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Larry Ezzard, Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M. arietta Ed Carson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. thens JimDouglas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .N. orcross Mamie Gray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V.aldosta James Parkinson, R.R.T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D.alton David Petsch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Alex Saint-Amand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .W. arm Springs DanWeatherly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S.avannah TerryWhite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S. avannah
Margaret Bean, R.N., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R. ome Kevin D. Mason, M.D., Vice Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. tlanta Melody Carter, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Atlanta Virginia Garrett Galvin, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. arietta Melba Hill, R.N., P.H.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta Noble Maseru, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta WintonG.King,M.D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Decatur John S. O'Shea, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Booker Poe, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta Barbara Sweeney, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Ann Vossen, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. arietta
Jeff Lurey, R.Ph., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .N. orcross Nevorn S. Askari, M.D. ,Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta Florence Maria Battle Shafiq, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L. ithonia W. Fred Blackmon, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Ron Byrd, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .R. inggold Aubrie Lamar Duncan, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Roopville MarcA.Goshko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .P. ennsylvania William S. McLean, D.O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. emorest James S. McWilliams, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. edartown Gary C. Richter, M.D.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. tlanta Reuben S. Roberts, Jr., M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .H. awkinsville Shelia Ann Robinson, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Perry Chester Sosebee, R.Ph.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. thens Danny A. Toth, R.Ph.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .L. aGrange Robert R. Warnock, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. onyers Richard A. Wherry, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. ahlonega
Hal Smith, Jr., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E. astman Janet Berhang-Doggett, R.N., Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Augusta MaryLordArgo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. thens Sharon Campbell, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Darleen Cox, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T.homasville JohnHarris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D.ecatur BarbaraMaxedon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Nelle B. Ramage, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Denise Retterbush, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V. aldosta
JoThurman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .a.sper Daisywise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta
Anne Stewart, Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Savannah Sharon Smith, Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Marietta Vivian Granger, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Ruth Lee, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T. ifton
41

Hospital
Nursing Home
Optometric Orthotics and Prosthetics Pharmacy

Joan Lipovsky, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Teresa Jones Warren . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .G. ainesville Cathy Wiggins, R.N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .LaGrange
J. Mike Sims, Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C.olumbus Ken Beverly, Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T. homasville Jerry W. Adams. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Americus Virgil E. Cooper, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. acon DennisL.Crum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Athens Morton Ganeles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A.tlanta Dominic Ingrando . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ublin
Ramsey Jennings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statesboro Thomas Kelly, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. ugusta
J. David Lawrence, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C.ommerce EdOllie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. .lbany JamesG.Peak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .P.erry
William T. Richardson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tifton Richard G. Stovall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marietta Herbert H. Weldon, Jr.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Atlanta
Bobby Johnson, Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Atlanta Rachel Athon, Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Conyers LarryBaird . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T.occoa C. Lyn Burnette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Cordele JewellS.Clifton. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S.avannah Francis M. Feltham. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Rosalyn M. Harbuck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .G. riffin William Jackson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta JeanMorgan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M. illedgeville Caroline Nahley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. olumbus E. C. Nelson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M. illedgeville John Sims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Americus MeredithSmith . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B. axley James R. Westbury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J.ackson
Edwin K. Porter, O.D., Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. ublin William L. Dobbs, O.D., Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Covington Lamar A. Brown, O.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. idalia Paul Y. Cuthbertson, O.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. arietta Mark S. Dickinson, O.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Marietta George Grant, O.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hinesville S. Cliff Rainey, O.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LaGrange Ray D. Williams, O.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. mericus
Grover Jeffcoat, C.O., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S. avannah Carol Walsh, M.A.T., CC-A, Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Atlanta JamesM.Barnes,C.O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Haniff Chaudhary, C.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ecatur Laura Dennison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lawrenceville Riley Hawkins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Warm Springs TedL.Hyde,C.O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Macon J. William Limehouse, C.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Augusta Grant Rice, C.P.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta
Harold Jones, R.Ph., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Neil L. Pruitt, R.Ph., Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Toccoa M. C. (Butch) Bowling, Jr., R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gainesville Jean Courson, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T. ifton Stephen Gay, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S. tatesboro Harold Jones, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Augusta
42

Physician
Podiatry Psychology Transportation

George D. McFarland, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. unwoody Diane Nykamp, Pharm.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta CindySchwartz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S.henandoah Evan Ward, Jr., R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Susan Whitworth, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .L. aGrange Patricia Ziegler, R.Ph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. tlanta
Robert F. Long, M.D., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Savannah Wallace D. Mays, M.D., Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. mericus J. Daniel Beeson, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Thomasville William H. Borders, Jr., M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Larry Boss, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V.illa Rica Camille Davis-Williams, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Norman L. Elliott, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Shelley Griffin, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W. aynesboro Charlie Humphries, Jr., M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. lbany Frank Isele, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. lbany William Kanto, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ugusta Clyde 0.Lord, M.D.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. tlanta Ellis L. Malone, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. ustell Richard A. Wherry, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ahlonega
Norm Kornblatt, D.P.M., Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. ouglasville Glen A. Dowling, D.P.M.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. lbany Mark W. Shaffer, D.P.M. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Stone Mountain
A. Bartow Ray, Jr., Ph.D., Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Americus Gary Dudley, Ph.D., Vice Chairperson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Marietta Ralph Allsop, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Adelle Burnsed-Geffen, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Savannah Mary Nell Chestnut, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta Marcelo De La Serna, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ecatur Donald C. Kent, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta MorganD.Kyle,Ph.D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T. ucker Sylvia Shellenberger, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M. acon
Mickey Reeves, Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Brunswick Ben Hinson, Jr., Vice Chairperson. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Macon Ila P. Austin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .H. azelhurst Ernest R. Doss, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .L. incolnton JanLaw . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E.astman Don Lindsey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ublin DonMathis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A. tlanta JuneAllenMerritt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B.lakely MarshallNewsome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M. orrow Charles N. Sims, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ouglas Richard Tibbetts, A.E.M.T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .L. aGrange Connie Ward Whittington . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ublin Stevewidener . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .T.homasville

We wish to reaffirm the Department's full commitment to the principles of Equal Employment Opportunity. The Department's policy is to assure that opportunities for employment, advancement, and for dignity in work are equally available to all. Employees and applicants are evaluatedon thebasis of performance,skill and experiencewithout regard to race, color, sex,age, religion,nationaloriginor physicaldisability.
Pnnled on Recycled Paper

State of Georgia Department of Medical Assistance 2 Martin Luther King, Jr. Drive S.E. Atlanta, Georgia 30334