The Georgia Department of Insurance was authorized to refuse the issuance of a license to an individual who pled guilty to insurance fraud, identity fraud, and making false statements in the same year he submitted his application.
Petitioner\’s health condition improved to the extent that he no longer required skilled nursing or skilled rehabilitation services on a daily basis. Because he failed to meet the nursing facility level of care, he no longer qualified for participation in the Georgia Pediatric Program (GAPP) .
Occassional skilled needs do not qualify for GAPP. Read More
Reducing a child’s skilled nursing hours did not meet the state’s obligation to provide early and periodic screening, diagnostic, and treatment (EPSDT) through the Georgia Pediatric Program (GAPP), because the child’s condition was extremely fragile and there was a high risk of rapid deterioration and caregiver fatigue.
