Fight over Georgia’s Medicaid contracts nears the end, as foster parents plead for reversal

The battle over who should oversee Georgia’s Medicaid program could be coming to an end, and the decision could have a major impact on Georgia families in need.

Georgia could be on the verge of switching Medicaid providers, and foster parents say it could make it more difficult to care for children in need. (Krisanapong Detraphiphat/Getty Images)

The battle over who should oversee Georgia’s Medicaid program could be coming to an end, and the decision could have a major impact on Georgia families in need.

The fighting started last year after the state awarded contracts to four companies: CareSource, which previously held a contract with the state, and newcomers Molina Health Care, UnitedHealthcare and Humana. Two companies that had been contracting with the state previously, Peach State Health Plan and Amerigroup, lost their bids.

Georgia’s Medicaid program covers about 2.2 million people in the state at a price of $16 billion, according to KFF data.

The Georgia Department of Administrative Services heard arguments Thursday from Peach State and Amerigroup, who say the selection process was unfair, and the winners who remain pleased with the way things went. It comes after the department denied protests against the decisions last month.

James Washburn from law firm Nelson Mullins, arguing on behalf of Amerigroup Georgia, said the department erred, pointing to documents from Georgia Division of Family and Children Services Director and Department of Human Services Commissioner Candice Broce that he said show an effort to lobby government officials against Amerigroup as “part of an effort to shift blame from her agency to Amerigroup for performance issues.”

“The fact that Commissioner Broce expressly asked the DCH Commissioner to deny AmeriGroup a contract is the best kind of bias evidence you can find,” Washburn said at Thursday’s hearing.

Amerigroup and Peach State also argued that there were irregularities in the scoring process and that United does not meet requirements for statewide coverage, particularly when it comes to psychiatric care and treatments used by people with autism.

Attorneys representing the winning bidders argued that the protests were meritless.

“Amerigroup and Peach State bombed the test,” said attorney Alex Hontos with law firm Dorsey and Whitney, arguing for United. “They finished fifth and eighth, and when they bombed the test, instead of taking that on board and coming back and doing better the next time, studying harder, what did they do? They attacked the teacher. They attacked the test. They say that there was bias. They say that there was something wrong with the process. That’s what you’re looking at here.”

The debate means more than just dollars for the millions of people who receive care through Georgia’s Medicaid program, and that includes more than 11,000 kids in foster care who receive care primarily through Medicaid.

Ahead of Thursday’s hearing, a group of foster parents and advocates held a rally outside the state Capitol to call on the department to reject the plan to swap providers.

John DeGarmo, founder of an advocacy group called the Foster Care Institute and a foster parent to more than 60 kids in Georgia, said the plan would move foster kids from Amerigroup to United, which could mean children potentially losing access to care if they do not live near providers who accept United.

DeGarmo and others said they are especially worried about foster children with autism after ProPublica released a report that found the company has a policy to cut costs by denying effective and necessary treatments for children with autism.

DeGarmo said it’s unfair to force foster children already dealing with trauma to risk losing access to medical professionals, and he worries requiring foster parents to jump through more hoops to take care of children in need will make it less likely that people begin or continue fostering.

“An inability for children to receive health care locally will exacerbate foster parent burnout faster than anything I could think of,” he said. “And that’s what foster parents are talking about right now, burnout and compassion fatigue.”

The department did not give a timeline for a decision.