On January 27, 2026, the Georgia Department of Administrative Services issued its formal decision on appeals related to one of the largest Medicaid managed care procurements in state history. The appeals, submitted by Amerigroup and Peach State Health Plan, were denied. The state’s prior Notice of Intent to Award would stand. CareSource, Humana, Molina, and UnitedHealthcare would take over management of healthcare benefits for approximately 2.2 million Georgians enrolled in Medicaid and PeachCare for Kids.
For autism providers across the state, the decision ends one period of uncertainty and begins another. The transition will force more than 1.1 million Medicaid beneficiaries to change health plans, disrupt established provider relationships, and introduce new credentialing requirements, prior authorization processes, and payment systems. In an industry where continuity of care matters enormously, the disruption could be profound.
“Georgia has never experienced disruption of this magnitude,” Peach State Health Plan wrote in its protest filing, warning that the change would compel seventy-five percent or more of members in most regions to switch care management organizations.
The Reshuffled Deck
The procurement reshapes Georgia’s Medicaid landscape. Of the three incumbent managed care organizations, only CareSource survived. Amerigroup, a subsidiary of Elevance Health that currently manages care for roughly 460,000 Georgians, did not receive a contract. Neither did Peach State Health Plan, part of Centene, which covers approximately 700,000 beneficiaries. Both companies have held Georgia Medicaid contracts since the state first moved to managed care in 2006.
The newcomers are Humana Employers Health Plan of Georgia, Molina Health Care of Georgia, and UnitedHealthcare of Georgia. UnitedHealthcare also won the Georgia Families 360 contract, which covers healthcare for approximately 33,000 children in foster care, adoption assistance programs, and certain juvenile justice programs.
The contract is worth an estimated $4.5 billion dollars annually. The state also intends to transition more than 200,000 elderly, blind, and disabled Georgians into managed care under the new arrangements, further expanding the scope of the change.
The Credentialing Scramble
For autism providers, the practical challenges began immediately after the December 2024 award announcement. Credentialing with a new managed care organization can take six months or longer. Providers must first complete Georgia’s state enrollment process, then navigate each MCO’s additional requirements. The timeline leaves little margin for error.
Some providers have found the new MCOs responsive. Molina, Humana, and CareSource have initiated outreach to begin credentialing processes. UnitedHealthcare has been another matter.
“We were able to start credentialing with Molina Health, Humana, and CareSource,” one provider advocate wrote in an email obtained by news outlets. “However, UHC says they have no idea of what the contract is that they won in GA. We can’t get through to anyone with UHC to start the process. This is alarming as this is one of the largest bids won in GA.”
Nearly two months later, the same advocate reported still having difficulty reaching UnitedHealthcare representatives. The credentialing delays create cascading problems: providers who are not credentialed cannot bill for services, and patients whose providers are out of network may face higher costs or lose access to care entirely.
The Lame Duck Problem
The transition has created a different set of challenges with the outgoing MCOs. Amerigroup, in particular, appears to have reduced its operational engagement since learning it would not receive a new contract.
Several Georgia autism therapy providers have reported mounting frustrations with the company.
Credentialing for new clinicians has slowed to a crawl. Previously empaneled providers have suddenly been treated as out of network. Payments arrive with significant delays, if they arrive at all. And providers describe having no recourse through formal or informal channels within the company’s management.
Jessie Johnson, owner of BlueAsh Behavior, a clinician-owned autism therapy practice in Fayetteville, experienced the dynamic firsthand. After Amerigroup abruptly stopped processing her clinic’s claims—citing credentialing issues that Johnson said were contradicted by the fact that Georgia Medicaid itself continued paying her directly—she spent months chasing explanations that kept shifting.
“We’ve been told we’re not credentialed, that it’s a provider relations issue, and that it’s a clerical error,” Johnson told The Citizen in December 2025. “But the claims still aren’t being paid.” BlueAsh eventually resorted to covering payroll out of operating funds and, ultimately, Johnson’s personal savings. “Amerigroup cutting off a quarter of our monthly revenue over an issue that should be easy enough to resolve has decimated us,” she said.
The problems have forced some providers to create separate tracking systems for every claim, dedicating staff time to correcting loading errors in Amerigroup’s systems. For companies that serve predominantly Medicaid patients, the payment delays create significant financial stress, challenging their ability to meet payroll and draining cash reserves.
The UnitedHealthcare Question
The selection of UnitedHealthcare for the Georgia Families 360 contract has drawn particular scrutiny from autism advocates. In December 2024, ProPublica published an investigation based on leaked internal documents showing that Optum, which manages behavioral health benefits for UnitedHealthcare, has been pursuing a strategy to limit access to applied behavior analysis therapy for children with autism.
According to the documents, the company has worked to reduce the number of ABA providers in its Medicaid networks, in some states cutting more than forty percent of in-network provider groups. It has also deployed what internal documents describe as “rigorous utilization management” to scrutinize the medical necessity of therapy for individual patients, leading to denials of covered treatment.
Foster care advocates have expressed alarm at the prospect of UnitedHealthcare taking over from Amerigroup. John DeGarmo, founder of the Foster Care Institute and a foster parent to more than sixty children in Georgia, testified at an administrative hearing that the change could mean foster children losing access to care if they do not live near providers who accept UnitedHealthcare.
“An inability for children to receive health care locally will exacerbate foster parent burnout faster than anything I could think of,” DeGarmo said.
UnitedHealthcare’s parent company, UnitedHealth Group, has disputed ProPublica’s characterizations, stating that its programs comply with applicable laws and that it has expanded its ABA provider network by more than 110 percent over the past three years. But the company has faced investigations in multiple states over its ABA coverage practices, and the concerns persist.
The Timeline Uncertainty
The contract start date has been pushed back repeatedly as the appeals process has unfolded. Originally scheduled for July 1, 2025, the transition was first delayed to mid-2026, then potentially to January 2027.
The extended timeline offers some advantages. Providers have more time to credential with the new MCOs. Patients have more time to understand their options and select plans. The systems necessary for billing, claims processing, and care coordination have more time to be tested and refined.
But the delays also extend the period of uncertainty. Providers cannot plan staffing, expansion, or capital investments without knowing which payers will cover their patients. Families cannot be certain that their current providers will remain in network. The incumbent MCOs operate under contracts that have been extended twice, with unclear incentives to maintain service quality.
“A longer lead time is better,” said Steven Miracle, CEO of Georgia Mountains Health Services, a nonprofit with a large Medicaid clientele. “Because we’ve got to get providers credentialed with the new insurance companies. We’ve got to get the organizational relationships set up so that we can do billing collections. I mean there’s a lot that has to happen. You can’t just say, ‘Okay we’ve got a new company.’ Health care is much more complex than that.”
What Providers Can Do Now
For autism providers navigating the transition, the path forward involves several practical steps. Begin credentialing with all four winning MCOs immediately, even before the formal contract start date is announced. Document any delays or difficulties with the credentialing process, particularly with UnitedHealthcare. Maintain detailed records of claims submitted to outgoing MCOs and track payment timelines.
Providers should also review their current patient panels to understand exposure to each MCO. Patients currently covered by Amerigroup or Peach State will need to select new plans once open enrollment begins. Providers can help patients understand their options and, where possible, guide them toward MCOs with which the provider has established relationships.
The Autism Providers of Georgia and similar advocacy organizations have indicated they will continue monitoring the transition and sharing updates. Staying connected to these networks may provide early warning of problems and collective leverage in addressing them.
The transition represents the largest disruption to Georgia’s Medicaid system in two decades. For autism providers, who depend heavily on Medicaid reimbursement and whose patients require continuity of care, the stakes are particularly high. The appeals have been denied. The transition will proceed. What remains to be seen is whether the systems, the MCOs, and the state are prepared for what comes next.
