Georgia Medicaid, PeachCare beneficiaries enroll HMOs despite concerns over partial rollout

Georgia's Medicaid and PeachCare programs has enrolled hundreds of thousands of beneficiaries in HMOs "despite complaints that the program has become an administrative and medical nightmare in areas where it has been tried so far," the Florida Times-Union reports (Larrabee, Florida Times-Union, 8/31).

Gov. Sonny Perdue's (R) reform plan was implemented on June 1 in the Atlanta, Columbus and Macon areas, where about 600,000 beneficiaries were moved from fee-for-service plans to HMOs.

The HMOs are being administered by Amerigroup, Centene and WellCare (Kaiser Daily Health Policy Report, 4/28).

State officials on Wednesday said the complete rollout of the program will occur on Friday as planned, although the total number of Medicaid and PeachCare beneficiaries enrolled in HMOs will be fewer than the 1.2 million originally predicted.

Officials said the total number will be only 847,000, in part because the state began checking beneficiaries' citizenship status and incomes in January.

The Atlanta Journal-Constitution reports that "[m]any doctors have cited payment and patient-care problems experienced when the managed care program started in metro Atlanta and central Georgia, and they fear they will surface as the program expands this week" (Miller, Atlanta Journal-Constitution, 8/31).

A group of Georgia physicians last month filed a lawsuit against the HMOs alleging that they have not paid providers for millions of dollars in outstanding claims (Kaiser Daily Health Policy Report, 8/17).

Critics of the program also say the HMOs have been slow to grant permission for medical treatments (Florida Times-Union, 8/31).

Comments

David Cook, executive director of the Medical Association of Georgia -- which has written a letter to Perdue asking that implementation of the program be delayed -- said doctors are "concerned about continuing to be able to treat Medicaid patients," adding, "A lot of (patients) don't know who their doctor is."

The state Department of Community Health, which operates Medicaid and PeachCare, said initial problems with the HMO system have for the most part been corrected, and officials from the three HMOs said they are ready for the statewide implementation and have sent ID cards to beneficiaries in the last week (Atlanta Journal-Constitution, 8/31).