Health Information Technology (Health IT) leads Georgia’s strategic efforts for the use of health information technology throughout Georgia. The goals of Health IT are to reduce health care disparities, improve health outcomes, increase the efficiency of health care delivery, and reduce overall health care costs.
Healthcare Facility Regulation (HFR) protects the residents of Georgia by ensuring the highest quality of health and safety in Georgia’s licensed health care facilities. Using statutory and regulatory standards, HFR inspects, licenses and regulates more than 15,000 health care facilities in Georgia.
Medicaid is the federal and state-funded medical assistance program that provides low-income individuals with access to free and low-cost medical care. Medicaid provides support for pregnant women, children, retirees age 65 and older, and people who are legally blind or disabled. Those who need nursing home care or those who have breast or cervical cancer may also qualify. The division also oversees a number of waiver programs that provide home- and community-based medical, behavioral and social services to enrollees. As part of the Children’s Health Insurance Program (CHIP), Medicaid administers PeachCare for Kids,® a comprehensive, managed care program for uninsured children in low-income families living in Georgia.
State Health Benefit Plan (SHBP), with enrollment of more than 660,000 individuals, is responsible for the administration of the health insurance coverage provided to state employees, teachers, school personnel and certain contract groups, as well as retirees and eligible dependents. SHBP offers its members two basic plan options: Wellness and Standard. In 2012, SHBP’s Wellness Plan membership became the largest in the U.S.
Office of the General Counsel provides legal advice and support to the Commissioner, the Board of Community Health and all divisions and offices within DCH, including support in administrative and judicial cases. The Office of the General Counsel also prepares contracts, drafts and monitors proposed legislation, analyzes health care policy issues, and researches state and federal laws applicable to the department’s operation. The office oversees the work of four sections: Medicaid Legal Services; Contracts Administration; Privacy, Security and Compliance; and Public Records.
Office of the Inspector General (OIG) safeguards the integrity of the department from both internal and external risks. The office remains diligent in its oversight to detect, prevent and investigate waste, fraud and abuse in Medicaid, PeachCare for Kids, the State Health Benefit Plan, as well as all other agency programs and operations.
The Office of Health Planning administers the Certificate of Need Program, conducts reviews of Design and Construction projects, and administers the Managed Care Patient’s Rights program. Health Planning also collects and maintains various health care facility surveys including the Hospital Financial Survey and Annual Hospital Questionnaire and coordinates state health planning activities.
Communications & Legislative Affairs serves as the department’s internal and external outreach arm responding to the department’s diverse information, communications and marketing needs. The office is also the agency’s primary point of contact for all activities involving the Georgia General Assembly and governmental relations analyzing bills and helping to shape legislative strategies for the department’s programs and health care in general. Additionally, the office assists Georgians with questions related to Medicaid and other agency programs and services. The office supports the department’s dedication to A Healthy Georgia.
Financial Management is responsible for the financial interests of the department. This includes the budgeting and accounting for the funds appropriated to DCH and the funds management for the State Health Benefit Plan. Financial Management is comprised of the Office of Planning and Fiscal Analyses, Financial and Accounting Services, Reimbursement Services and the Budget Office.
Information Technology (IT) oversees four units: the Medicaid Management Information System (MMIS) for claims processing/payments; the Membership Enrollment Management System (MEMS) for the State Health Benefit Plan; Information Technology Infrastructure (ITI) for the agency’s end-user computing; and Information Technology Security (ITS) to oversee all DCH systems and ensure compliance with all security standards. IT is also responsible for new initiatives including the Integrated Eligibility System for Medicaid and other assistance programs administered by other state health agencies.
Operations executes mission-critical initiatives, improves processes and assists agency leadership and regulatory authorities as necessary. Operations is comprised of administrative and program offices: Offices of Vendor Management, Grant Management, Human Resources, Procurement, Purchasing, Quality Assurance, Support Services, the State Office of Rural Health, the Non-Emergency Transportation Program (NET), and the Breast Cancer Tag Program. Operations plays a key role in the execution of the agency’s strategic plans, best practices and timely and responsive customer service.