Georgia lawmakers demand Medicaid plans reverse autism therapy rate cuts

When a payer changes what it pays, the people who feel it first aren't in the Capitol. They're in clinics, waiting rooms and living rooms. That was the message at a press conference where state Sen. Brian Strickland and Rep. Scott Hilton stood with advocates, families and providers and called on two Medicaid care management organizations to reverse reimbursement cuts for autism therapy.

A father's case for early intervention

Strickland, who is also the nominee for attorney general, said he was there as a dad. His son received an autism diagnosis at an early age, and the family found speech therapy, occupational therapy and applied behavior analysis, known as ABA. He said ABA helped his son learn skills that come easily to other children, and that it meant his son could attend a typical kindergarten class.

His broader point was economic as well as personal. Early intervention, he said, helps shape what a child with autism looks like as an adult, and investing early saves families and the state money over time.

What the lawmakers say happened

• The rate reductions were announced after the General Assembly adjourned in May, with little or no notice to providers.
• CareSource pulled back its original announced cut after a House hearing on the issue. Providers are still sounding the alarm about other steps, including a stop to credentialing clinicians.
• Amerigroup went ahead with a 30 percent cut. Providers were told in August, and it took effect September 1, less than a month later.
• Amerigroup is the plan responsible for children in foster care and children adopted out of foster care. Strickland said legislative studies found that about one in four children in foster care has autism, and that helping those children manage their behaviors improves their chances of being adopted.
• The lawmakers say the cuts are narrowing the network of providers, which means longer waits and, depending on a family's zip code, possibly no access to care at all.

What they are demanding

Strickland called on the plans to rescind any rate cuts and provider terminations immediately, until a network adequacy analysis confirms they are meeting their contracts with the state and with federal law. He said lawmakers will expect rate reductions to be justified in advance and will hold the companies accountable. He also said the cuts have nothing to do with fraud allegations, which he said some people have raised. His remarks, as I have them, end with lawmakers saying they stand ready to use their power.

Why this matters heading into 2027

The dispute is about notice and oversight. How much warning do providers and the state get before a plan changes rates, and can the state verify that a network still serves families before the change takes effect? Those questions don't have to wait for January 11. In Georgia, issues like this often take shape in study committees, agency meetings and hearings in the fall, and they arrive at the Capitol already framed.