Georgia Senator Calls Amerigroup’s 30% ABA Technician Rate Cut ‘Indefensible.’ Amerigroup Calls It ‘Clinically Defensible.’

ATLANTA – Georgia state Sen. Brian Strickland stood outside the Capitol on Oct. 22 with foster parents and therapy providers and demanded that Amerigroup reverse what providers describe as a 30% cut in ABA reimbursement. “It is indefensible to cut these rates without at least providing adequate notice and opportunity for the state to review network adequacy for our children served by Medicaid,” Strickland said, according to FOX 5 Atlanta.

Amerigroup administers coverage for Georgia Families 360°, the state’s Medicaid managed care program for about 27,000 children and young people in foster care or adoption assistance, and select youth involved in the juvenile justice system. Providers reported a 30% reduction, effective Sept. 1. Amerigroup said its reductions affected some technician-delivered services. Clinics told the Georgia Recorder they received notice in August.

Strickland, a McDonough Republican who chairs the Senate Judiciary Committee and has a child with autism, called on Amerigroup, Peach State Health Plan, and CareSource to reverse rate cuts and provider terminations pending a network-adequacy analysis, GPB reported. “We are watching you,” he said.

In a statement published by FOX 5 Atlanta on Oct. 23, Amerigroup defended the changes. The company said it “rebalanced ABA provider reimbursement based on service complexity and clinical expertise” and raised rates for treatment planning and caregiver engagement. It also said rates for services provided by licensed clinicians did not decrease, and that the changes were not limited to foster-care members but apply “across Amerigroup’s Georgia Medicaid business.” Amerigroup also said medically necessary autism services remain covered. In an Oct. 5 report, the Georgia Recorder said Amerigroup had described the change in an email to the state as “a more targeted and clinically defensible approach.”

Some providers say the new rates are not sustainable. Rep. Lee Hawkins, the Gainesville Republican who chairs the House Health Committee, told the Recorder that industry representatives said 75% of the clinics they surveyed expected to reduce or stop serving foster children at the new rate. The survey’s methodology was not published. Emma Chenoweth, owner of Appleseeds Behavioral Center in Kennesaw, told GPB that Amerigroup gave the clinic a chance to contest the rate changes, but the center would still lose money every week.

Molly Jones, a provider at Appleseeds whose nonspeaking daughter, Cora, receives ABA, described what is at stake. “We’ve definitely seen a huge difference in her communication,” she told FOX 5.

The dispute has also become an issue in the attorney general race. Strickland has pledged to hold companies accountable if elected, Fox News reported. His Democratic opponent, state Rep. Tanya Miller, said in a statement reported by GPB that Strickland should answer for a crisis “created on his watch” and that she would use the office’s consumer protection and investigative tools to enforce insurers’ network standards.

Amerigroup sets its own provider rates, but the Department of Community Health oversees whether members can get covered care. Agency spokeswoman Lauren Williams told the Recorder that Amerigroup must arrange out-of-network care when no in-network provider is available, and Medicaid director Stuart Portman said the state’s ability to review changes is “much more on the back end.”

Georgia’s general election is Nov. 3. The General Assembly’s next regular session begins in January 2027. A December 2024 notice of intent named UnitedHealthcare of Georgia the apparent winner of the foster-care contract. In an April 23 update, the Department of Community Health said the procurement was in protest and that it would extend current contracts through June 30, 2027, pending a final award.

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