HB573: HB573 Insurance; remove dentists from participation with care management organizations

Georgia's Medicaid managed care system relies on care management organizations, private insurers that coordinate and pay for Medicaid patients' health care under Chapter 21A of Title 33 of the Official Code of Georgia Annotated. Currently dentists participate in these organizations alongside other health providers. This bill changes the legal definition of 'health care services' in O.C.G.A. § 33-21A-2 to explicitly exclude dental services. It also repeals the Code section that governs how dentists participate with care management organizations (O.C.G.A. § 33-21A-8), leaving that section reserved (blank) for future use. Together these changes would take dentists out of the Medicaid care management organization system as it is currently structured. The bill does not specify a separate effective date, and repeals any conflicting laws.

• Rewrites the definition of 'health care services' in O.C.G.A. § 33-21A-2 to specifically exclude dental services from that category.
• Repeals O.C.G.A. § 33-21A-8, the section that governs dentist participation with Medicaid care management organizations, leaving it reserved.
• Removes the cross-reference tying the definition of 'health care services' to O.C.G.A. § 33-21-1, replacing it with a new standalone definition.
• Repeals any other Georgia laws that conflict with these changes.

Dentists who currently participate in Georgia's Medicaid care management organizations, the care management organizations themselves, and Medicaid patients who receive dental care through those managed care plans would all be affected by this change.

By excluding dental services from the definition of health care services and repealing the section on dentist participation, the bill would change how dental care is handled within Georgia's Medicaid managed care system, potentially affecting how dentists are paid and how patients access dental benefits.

• Section 1 revises paragraph (6) of O.C.G.A. § 33-21A-2 to redefine 'health care services' as covering medical care and hospitalization but explicitly excluding dental services.
• Section 2 repeals O.C.G.A. § 33-21A-8, which relates to participation by dentists in care management organizations, and reserves that Code section.
• Section 3 repeals all other Georgia laws that conflict with this Act.

1. 2025-02-26House Second Readers (House)
2. 2025-02-24House First Readers (House)
3. 2025-02-21House Hopper (House)

• Ron Stephens (R, HD-164)Primary sponsor
• Steven Sainz (R, HD-180)
• Lee Hawkins (R, HD-027)

• Medicaid
• dental care
• health insurance regulation
• care management organizations