Georgia Medicaid Rate Increase Update

​Since the 10% Medicaid rate increase was announced on December 10, the Georgia Department of Community Health has been working with their vendors to update systems and coordinate the rate increase changes. Catherine Ivey, DCH Deputy Executive Director, has provided the following update:

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• The GAMMIS system claims reprocessing for all claims paid prior to 1/1/22 is expected to be ready for implementation within 60 days and timely filing edits will be overridden for these claims.
• DCH has received many inquiries from providers billing the new rates for CCSP services who find that the existing prior authorizations do not support the increase.   DCH has verified that while the rate increases have no impact on number of units authorized, the rates are not supported in existing PAs.  DCH is working with the PA contractor through its partner, the Division of Aging, to mass adjust PAs but there is no determined date at this time.
• PAs that support ICWP and SOURCE have been adjusted by Alliant Health Solutions and should fully support the new rates.
• Providers who have attempted to rebill claims for the period 7/1/21 – 10/1/21 are asked to wait for the mass reprocess since any claims rebilled over 90 days prior to the original paid date must be voided and resubmitted versus adjusted. Some providers are having difficulty rebilling the original claims.

Additional updates will follow as needed. In addition, the Banner Message below was posted recently and references the mass update to make the rate increase retroactive to July 1, 2021. Members should monitor their banner messages for further updates on the timing of the mass update.  
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