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Hearsay within hearsay was not admissible under the business/public records exception.

Topic: Public Health, Decided by Judge Schroer 
Docket Number: 1642575 , Decision Date: 2016-08-29 
Attachment: Click here to download the decision. 

Although inspection reports and a sheriff’s report could be admissible under the business and/or public records exceptions to the hearsay rule, the statements from third parties within those reports did not fall under those exceptions and, as they did not fit under other exceptions to [..] Read More..

Care management organization failed to demonstrate authority to recover reimbursements.

Topic: Public Health, Decided by Judge Schroer 
Docket Number: 1638270 , Decision Date: 2016-08-04 
Attachment: Click here to download the decision. 

Peach State Health Plan (Peach State), a care management organization (CMO) sought to recover payments made to JLD, a speech therapy provider, based primarily on its determination that JLD failed to document the duration of speech therapy sessions.  However, in the absence of a contract [..] Read More..

Resource level required for spouse to live in community must be determined using reasonable method.

Topic: Public Health, Decided by Judge Miller 
Docket Number: ***** , Decision Date: 2016-08-18 
Attachment: Click here to download the decision. 

A nursing home resident and his spouse, who resided in the community, were denied Nursing Home Medicaid because their combined resources exceeded program limits.  Federal law allowed for redetermination of the resource limit where it was necessary to allow the community spouse to generate sufficient [..] Read More..

Company did not “reproduce” WIC vendor stamp by using generic stamp to clarify store number.

Topic: Public Health, Decided by Judge Kennedy 
Docket Number: 1637592 , Decision Date: 2016-05-02 
Attachment: Click here to download the decision. 
Attachment: Click here to download the decision on appeal. 

The parent company of several WIC-participating grocery stores used a generic four-digit rotary stamp to clarify the store numbers on vouchers that had been returned for illegible or missing vendor stamp imprints.  The Department of Public Health sought to terminate WIC participation for several of [..] Read More..

Vendor disqualified for six months for keeping expired food items in stock..

Topic: Public Health, Decided by Judge Kennedy 
Docket Number: 1619233 , Decision Date: 2016-01-04 
Attachment: Click here to download the decision. 

The Department of Public Health determined after investigation that, on three separate occasions, a WIC vendor had kept one or more WIC-approved food items that were outside of the manufacturer’s expiration date in stock, despite having received several warnings.  Accordingly, the vendor was subject to [..] Read More..

Vendor terminated for failure to meet minimum square footage requirement.

Topic: Public Health, Decided by Judge Miller 
Docket Number: 1561610 , Decision Date: 2015-10-02 
Attachment: Click here to download the decision. 

The Georgia WIC Program requires vendors to maintain 3,000 square feet of continuous retail food sales space open to the public, including administrative and storage space. The store at issue only contained 2,138 square feet of continuous retail food sales space, including administrative and storage [..] Read More..

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