Amerigroup Slashes ABA Technician Payments By 30% Cut Threatening Care for Georgia Children

ATLANTA, GEORGIA – Amerigroup’s 30% cut to payments for technician-delivered applied behavior analysis (ABA) therapy is threatening care for Georgia foster children. Clinics told the Georgia Recorder that the reduction took effect Sept. 1, 2026, after notice in August, and some have stopped accepting new patients at the lower rate.

Hall County foster mother Krystina McQueen told the Recorder that her autistic son, who is nearly 3, had made progress in his first weeks of therapy. His clinic warned that it might not be able to keep treating him. Katie White, a court-appointed advocate for children, said her 14-year-old adopted son had already lost care. “He lost his services after only being in it about six weeks,” she told the outlet.

Georgia’s Department of Community Health (DCH) contracts with Amerigroup, CareSource, and Peach State Health Plan for Medicaid managed care. Foster children enrolled in Georgia Families 360° cannot choose another managed-care plan. Amerigroup, an Elevance Health company, runs the program, which DCH describes as serving about 27,000 children and young people in foster care or receiving adoption assistance, plus select youth in the juvenile justice system. Adoption-assistance members can opt for fee-for-service Medicaid during specified enrollment windows.

“What’s going to happen to all our children in foster care?” Dr. Michelle Zeanah told the Recorder. She runs a southeast Georgia clinic and said she is the only option for many local families. “I mean they all have Amerigroup.” At the new rate, she said, her clinic would be “too far in the red.”

Industry representatives told Rep. Lee Hawkins, a Gainesville Republican who chairs the House Health Committee, that 75% of clinics they surveyed expected to reduce or stop serving foster children at the new rate within three months. More than 90% expected to reduce or stop taking new patients, Hawkins told the Recorder. The outlet did not report the sample size or survey methods.

What Amerigroup Says

Amerigroup outlined the changes to DCH in a July 16 email obtained by the Recorder. It said it would reduce reimbursement for technician-level services, increase payments for in-person caregiver training, and maintain rates for clinical oversight and licensed or certified practitioners. It called the structure “a more targeted and clinically defensible approach.” A company spokeswoman told the Recorder that medically necessary services remained covered and patients should keep their appointments.

All three of Georgia’s Medicaid managed-care insurers have changed their ABA policies within the past year, the Recorder reported. CareSource also cut therapy payments by 20% in May. In July, it rescinded that cut for some providers in areas with shortages, according to a DCH statement reported by Atlanta News First.

What the State Says

DCH, which administers Georgia Medicaid, says Amerigroup must arrange needed care. Spokeswoman Lauren Williams told the Recorder that “in those instances where an in-network provider is not available, Amerigroup is required to secure services with an out-of-network provider” for each patient.

White told the Recorder that Amerigroup had offered no alternatives since her son lost services. She said the insurer had not responded to her provider’s certified notice rejecting the new rate.

“Our ability to review things is much more on the back end,” Stuart Portman, who heads DCH’s Medicaid division, told the Recorder. “However, we are engaging as early on as we can to make sure that the care to the beneficiaries is being provided.”

“You don’t implement a rate cut and then see what happens.” – Roland Behm, mental health advocate, to the Georgia Recorder

At a June 23, 2026, House Health Committee hearing on CareSource’s cut, DCH chief health policy officer Lynnette Rhodes said Medicaid plans could cut rates and end provider contracts independently, calling that standard practice nationwide. She also said plans must arrange needed care, including out-of-network services or higher payments on a case-by-case basis, Capitol Beat reported.

Mental health advocate Roland Behm argues that Georgia should assess the effect on access before rate cuts take effect. Federal rules require plans to document their capacity after significant changes, as defined by the state, that affect their networks, including payment changes. States must review that documentation. The rules do not expressly require advance approval of every rate cut.

The Next Contract

In December 2024, the state named UnitedHealthcare as the intended next Georgia Families 360° contractor. Amerigroup and Peach State challenged the selections; the Department of Administrative Services denied their administrative appeals on Jan. 27, 2026. In its latest posted procurement update, dated April 23, DCH said it would extend the existing contracts through June 30, 2027, pending a final award.

AT A GLANCE

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