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Chapter 195-2 RESIDENCY CAPITATION

Rule 195-2-.01 General Definitions

(1) "Residency Capitation" means the funding provided to each designated teaching hospital or hospital authority operating a teaching hospital based on:
(a) The number of residents in training, times a fixed dollar amount; and
(b) The fixed dollar amount being set by the appropriation provided for this purpose divided by the total number of residents in training at all designated teaching hospitals and all teaching hospitals operated by a hospital authority.
(2) "Teaching Hospital" is an institution owned and operated by a hospital authority which provides medical education and training of residents in addition to its other medical care delivery system responsibilities.
(3) "Designated Teaching Hospital" means a teaching hospital operated by other than a hospital authority, which hospital agrees to contract with the state to offer or continue to offer a residency program approved by the American Medical Association, which program has at least 50 residents, and which hospital operates a 24 hour, seven-day-per week emergency room open to the public, and which hospital files a semiannual statistical report consistent with those filed by other state funded tertiary, neonatal obstetrical centers with the Family Health Section of the Department of Human Resources.
(4) "Medical Education and Training" consists of an AMA approved residency program, one year or longer in duration, which prepares graduates of medical schools to practice in a general or specialty field of medicine or surgery.
(5) "Accreditation Council for Graduate Medical Education" is the body established to accredit residency programs.
(6) "Certification" is the process utilized to determine the number of residents receiving medical education and training through a designated teaching hospital or a teaching hospital operated by a hospital authority which serves as the basis for issuance of capitation payments.
(7) "Resident" means an individual at any level of training in an ACGME-accredited Graduate Medical Education Program, including subspecialty programs.
(8) "Fellow" refers to an individual undertaking post-graduate residency training in a field of research that is not accredited by the ACGME.

Rule 195-2-.02 Residency Capitation Grants-Funding Procedures

(1) For the annual provision of capitation funds to established Residency Programs, the Board requires the following conditions to be met:
(a) Specification of the total number of residents to be trained during a year;
(b) Maintenance of approval of the program by the Accreditation Council for Graduate Medical Education;
(c) Compliance with all Board guidelines, rules and regulations; and
(d) Submission of all reports and such other documents as may be reasonably required by the Board and/or outlined in the Georgia Board of Health Care Workforce Report Guidelines;
1. Certification of Residents. The teaching hospital or designated teaching hospital shall certify the exact number of residents in training during a prescribed period and provide to the Board (utilizing such forms and reporting procedures as may be deemed necessary) information on residents as follows:
(i) A written monthly statement from the authorized official certifying the exact number of residents in training during the period shall be submitted no later than the tenth (10) day of the following month;
(ii) Documentation including resident's name, social security number, medical or surgical specialty, post-graduate year, and indication of resident full-time equivalent participation during report period shall be submitted on a monthly basis, no later than the tenth (10) day of the following month; and
2. Practice Location of Graduates. The teaching hospital or sponsoring institution of the Residency Program shall annually submit a report to the Board indicating the practice location of each graduate to assist the Board in evaluating the effectiveness of the Program in meeting the need for physicians in Georgia.
(i) Graduate practice location reports shall be due no later than September 1st of each year and include the practice location (city/state), additional training being pursued (e.g. fellowship), military service obligation, other state or federal service obligation (e.g., Board Georgia Board of Health Care Workforce, National Health Service Corp.), or other activity of those residents completing their medical education and training at the teaching hospital or designated teaching hospital.
(ii) Teaching hospitals/sponsoring institutions shall be expected to monitor, update, and report to the Board, any changes in the practice status of graduates for a period of five years post-graduation.
(2) Payment Process. Based upon the Certification of residents supplied by the teaching hospital or designated teaching hospital, the Board shall authorize disbursement of residency capitation funds in quarterly installments.
(a) The Board shall pay up to $10,000 per annum, or prorata reduction thereof, to the hospital authority of a teaching hospital or to a designated teaching hospital for each resident receiving medical education and training. If the funds appropriated for this purpose are insufficient to fund the full amount payable to the hospital authority or the designated teaching hospital, the Board shall calculate the amount otherwise payable in accordance with the funds actually appropriated.
(3) State Audit. The teaching hospital/designated teaching hospital shall be subject to an audit of the financial records relating to Residency Capitation upon request of the Board or other duly authorized officer or employee of the State of Georgia upon reasonable request. For this purpose the teaching hospital/designated teaching hospital shall:
(a) Maintain for three (3) years after receipt of Residency Capitation funds, all directly pertinent books, documents, papers and records involving related transactions;
(b) Retain sufficient records for the conduct of an audit for any year for which payments are in dispute until that dispute is resolved; and
(c) Be subject to reductions in payment of Residency Capitation funds based upon the findings of a state audit disallowing any previous such payment.
(4) Retention of Graduates. Practice status/location of graduates will be monitored by the Board for five (5) years from date of graduation. In the event retention of graduates practicing in Georgia should fall below an acceptable number, over any five (5) consecutive year period, the Board shall have the authority to adjust the rate of capitation paid to said Program. The acceptable rate of retention will be determined by the Board from time to time and set forth in the Agreement between the Board and the teaching hospital/designated teaching hospital.