Three CMOs currently hold the Georgia Families contract: Amerigroup Community Care (Elevance), CareSource (nonprofit), and Peach State Health Plan (Centene). A competitive re-procurement concluded with DCH selecting four organizations to take over the program: CareSource (the only current incumbent retained), Humana, Molina Healthcare, and UnitedHealthcare; both Amerigroup and Peach State Health Plan were not selected and are set to exit the program. As of April 2026, the award remains in a formal protest phase pending a Notice of Award (NOA), and DCH has extended the current three CMOs' contracts through the end of state fiscal year 2027 (June 30, 2027) to bridge the gap until the new contracts take effect. This is a live, unresolved transition, not a settled outcome.

• Amerigroup Community Care (Elevance): current incumbent, not selected for the next contract cycle
• CareSource: current incumbent, retained in the next contract cycle
• Peach State Health Plan (Centene): current incumbent, not selected for the next contract cycle
• Humana: newly selected, not yet operational
• Molina Healthcare: newly selected, not yet operational
• UnitedHealthcare Community Plan: newly selected, not yet operational

Long-term services and supports are not integrated into Georgia Families' MCO benefit package. Nursing facility care and most HCBS waivers are carved out and delivered fee-for-service rather than through the CMOs. This is consistent with Georgia's HCBS waiver portfolio operating largely outside the managed care structure entirely.

Not integrated into managed care

Behavioral health is generally carved into Georgia Families: each CMO manages behavioral health as part of its standard benefit package, not through a separate statewide behavioral health vendor. Specialty mental health services delivered by Community Service Boards (Georgia's public mental health provider network) operate alongside and coordinate with CMO-managed behavioral health rather than replacing it, making this a coordinated hybrid rather than a clean carve-in or carve-out.

Carved in

Dental is largely an in-plan CMO benefit, particularly for children under the EPSDT benefit. Certain dental services for adults are more limited and may be carved out or delivered under separate arrangements, consistent with Georgia's broader pattern of adult optional-benefit limitations. No single statewide dental administrator vendor was identified.

Pharmacy is fully carved out of Georgia Families to a single statewide State Pharmacy Benefits Manager (SPBM), Gainwell Technologies. Every Medicaid prescription claim in Georgia flows through Gainwell regardless of which CMO a member is enrolled in, and the state (not the individual CMOs) maintains the Preferred Drug List and prior authorization tiers centrally. This is a cleaner, fully carved-out model compared to the hybrid carve-in-with-shared-formulary structure seen in several other states.

• Gainwell Technologies

Non-emergency medical transportation is carved out of Georgia Families to a statewide broker, Verida. Members and providers book NEMT directly through Verida rather than through their CMO. Notably, Georgia Pathways to Coverage (the state's 1115 work-requirement demonstration) enrollees do not receive NEMT as a covered benefit at all, except for members aged 19-20 accessing it through the EPSDT benefit, a distinctive limitation not seen in the state's standard Medicaid population.

• Verida

Providers interact with the state's Medicaid claims and administrative functions through GAMMIS (Georgia Medicaid Management Information System, mmis.georgia.gov), the state's public-facing MMIS portal for provider manuals, fee schedules, and provider notices. Pharmacy claims route separately through Gainwell Technologies' own systems as the state's SPBM.

180 agency updates tracked for Georgia. Available with Pro.