Georgia

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Medicaid & CHIP Redesign Initiative

In 2012, a state-commissioned report of a comprehensive assessment of Georgia's Medicaid Program and Children's Health Insurance Program (CHIP/PeachCare for Kids) recommended moving state Medicaid recipients into managed care. As a result, the state is planning to implement a Medicaid Medical Coordination Program for aged, blind or disabled (ABD) Medicaid recipients. (Source: State Medicaid Redesign Initiative website) Navigant 2012 Report

In October 2013, the state announced its intention to submit a Medicaid SPA to CMS as part of its plan to implement a Medicaid Medical Coordination Program for ABD Medicaid recipients. (Source: State DCH website; Public Notice, 10/10/2013)
Medicaid State Plan Amendment, (10/10/2013)

In June 2014, the state cancelled its RFP to establish a contract with a vendor to provide Medicaid managed care to ABD beneficiaries because contract proposals were over budget. The RFP would have allowed enrollees access to a nurse phone line and case management services in order to better coordinate their care. For now, services provided to ABD Medicaid beneficiaries will continue to be paid for using the traditional fee-for-service model; and a revised RFP will be issued on July 11, 2014. (Georgia Health News, 6/9/2014; HMA Weekly Roundup, 6/11/2014; HMA Weekly Roundup, 6/18/2014)

Balancing Incentive Program

In June 2012, CMS awarded the state an estimated $64.4 million of enhanced Medicaid funds (a 2% enhanced rate). (Source: CMS BIP website)
CMS Award Announcement (6/13/2012)

Medicaid §1115 Demonstration Waiver

On May 7, 2015, Kaiser Health News reported that Georgia officials are considering utilizing a §1115 waiver to increase the state’s Medicaid spending flexibility, in order to then look at different ways to provide and manage health care coverage for more uninsured residents.  (Source: KaiserHealthNews, 5/7/2015; GeorgiaHealthNews, 5/14/2015)