CareSource Reverses 20% Therapy Rate Cut For Some Georgia Providers

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CareSource has reversed a controversial 20% reimbursement rate cut for some pediatric therapy providers in Georgia following months of criticism from families, therapists and state lawmakers. However, the change does not apply to every provider, leaving some clinics facing reduced payments and uncertainty.

The rate reduction, which took effect earlier this year, affected providers offering services such as speech, occupational, physical and behavioral therapy to children enrolled in Georgia Medicaid. Many providers warned the cuts threatened access to care, particularly in rural areas where therapy options are already limited. Some clinics reduced services or stopped accepting CareSource patients altogether.

According to Atlanta News First, CareSource has notified some providers that it will restore reimbursement rates, but others remain excluded from the reversal. Those providers say the uneven decision continues to create financial challenges and could still impact access to therapy for Georgia children.

Advocates Urge Georgia Lawmakers to Seek Broader Medicaid Waivers and Expand Coverage

Health care advocacy groups and some Georgia lawmakers are pushing state leaders to pursue broader Medicaid waiver authority and expansion efforts to increase access to health coverage for low-income residents. The calls come amid ongoing debate over the state’s current Medicaid “Pathways to Coverage” waiver program and efforts to close the coverage gap that leaves hundreds of thousands uninsured in Georgia — one of the states that has not adopted full Medicaid expansion under the Affordable Care Act. Supporters argue that expanded waivers and coverage would help more Georgians gain essential care, while critics caution about potential costs and administrative challenges under existing waivers that include work requirements and narrow eligibility criteria.