News from the Capitol

The Legislative Insider is published during the Legislative Session by the Georgia Dental Association. It contains updates on the activities of GDA's Government Affairs team as well as information about bills relevant to dentists and patient care.

Georgia Department of Community Health Announces Major CMO Contract Shakeup

Jan 24, 2025
The Department of Community Health's recent Notice of Intent to Award may presage significant changes to the administration of Georgia's Medicaid programs.

The Department of Community Health’s (DCH) recent announcement is making headlines around the state of Georgia. After a bidding process that lasted more than a year, DCH issued a Notice of Intent to Award new contracts to 3 new Care Management Organizations (CMO) and 1 incumbent, Care Source. The other 6 bidders, including incumbents, Amerigroup and Peach State Health Plan, have filed protests against the decision. The outcome of these protests could have major ramifications for dentists and their patients.  

What happened? 

In September of 2023, DCH issued a Request for Proposals seeking to establish contracts with qualified CMOs for Georgia’s Medicaid programs. A total of 10 companies provided responses, and over the next year they were evaluated by a team at DCH. The resulting Notice of Intent to Award was then released after review of all submissions was complete. As part of Georgia’s procurement process, bidders are allowed to file protests in an effort to dispute the results of a decision, and protests were filed by the losing bidders shortly after the notice was posted.  

What happens next? 

Following the protest filing period, a review will be conducted by the Department of Administrative Services, and a decision will be made. This decision can be appealed, and the protest process can take a substantial amount of time. Last time Georgia accepted bids for CMO contracts, the protest process took 326 days (9/9/2015-8/1/2016). It is difficult to know exactly how long the process will take, but with history as a guide, one could expect a significant wait. Once a decision is made, a Notice of Award will be issued, or remedial action will be taken. The companies protesting DCH’s decision are primarily seeking a cancellation of the current process and a reissuance of the Request for Proposals which would take the whole bidding process back to the beginning.  

How will this affect Georgia’s dentists and their patients? 

Removing 2 out of 3 incumbents and replacing them is not a small task. Georgia Medicaid had almost 2 million people enrolled in August 2024, and up to 75% of the Georgia Families members could be required to transition to a new plan. If the Department of Community Health moves forward as intended, the Request for Proposals offers some insight into how the transition will take place for patients. In a scenario where any number of new CMOs are selected, the document states that there will be a 30-day open enrollment period for existing members 120-days ahead of the operational start date. As a part of this process, the Department of Community Health commits to, “an extensive Member, Provider, and stakeholder outreach campaign.” 

How can I get involved and stay up to date on health policy affecting Georgia dentists? 

Georgia Dental Association members have many opportunities to get involved with GDA’s ongoing legislative advocacy. To get more involved in advocating for dentistry in the state of Georgia, consider attending LAW Day, signing up as a contact dentist, or donating to GDAPAC.