HB1502: HB1502 Community Health, Department of; contracts with care management organizations for the provision of healthcare services for Medicaid or PeachCare for Kids recipients; establish requirements

Georgia's Medicaid and PeachCare for Kids programs rely on care management organizations, private companies that Georgia contracts with to arrange healthcare for enrollees called members. This bill adds a new section to Georgia law spelling out how the Department of Community Health must handle these contracts once current ones expire. The department would have to publish a public request for applications, give the public a chance to comment before issuing it, and contract with any care management organization that meets minimum quality standards. Members could choose any qualifying plan available in their region. The department would evaluate organizations yearly starting July 1, 2027, and recertify them every five years and then every three years. Organizations denied a contract or terminated could appeal to the commissioner and then to Fulton County Superior Court. The law would take effect as soon as the Governor signs it or it otherwise becomes law.

• Requires the Department of Community Health to publish a public request for applications from care management organizations once existing contracts expire.
• Requires the department to seek public comment on a request for applications at least 60 days before issuing it and post a summary of comments and its responses.
• Sets minimum quality and performance standards the department must use to evaluate care management organizations, including cost efficiency, provider network size, and past experience.
• Requires annual evaluations of care management organizations starting July 1, 2027, with results published publicly, plus recertification every five years and then every three years.
• Gives care management organizations denied a contract or terminated the right to a hearing, an appeal to the commissioner, and judicial review in Fulton County Superior Court.
• Lets the department require corrective action plans, suspend new member enrollment, or terminate a contract if an organization does not comply with its contract terms.

The bill affects the Department of Community Health, the care management organizations that contract with it to run Medicaid and PeachCare for Kids managed care plans, and the Medicaid and PeachCare for Kids recipients (called members) who are enrolled in those plans.

Georgians enrolled in Medicaid or PeachCare for Kids would gain a guaranteed ability to pick from any qualifying care management plan in their region, and the state would have to publicly evaluate and disclose how well these companies perform, changing how these contracts are awarded and policed.

• Adds new Code Section 49-4-159.5 to Title 49 defining 'care management organization,' 'existing contracts,' and 'member' for purposes of this law.
• Subsection (b) requires the department to publish a request for applications once existing contracts expire and contract with every organization that meets minimum standards.
• Subsection (c) automatically cancels any pending procurement without a final contract as of the bill's effective date.
• Subsection (d) requires the department to set minimum quality and performance standards weighing cost efficiency, provider network size, and past experience.
• Subsection (f) requires annual evaluations starting July 1, 2027, public reporting of results, and recertification five years after initial contracting and every three years after that.
• Subsections (g) and (h) create a hearing and appeal process for denied or terminated organizations and let the department require corrective plans, suspend enrollment, or terminate noncompliant contracts.
• Section 2 makes the Act effective upon the Governor's signature or it otherwise becoming law, applying to all future department contracts with care management organizations.

1. 2026-03-06House Second Readers (House)
2. 2026-03-04House First Readers (House)
3. 2026-03-03House Hopper (House)

• Trey Kelley (R, HD-016)Primary sponsor
• Bruce Williamson (R, HD-112)
• Demetrius Douglas (D, HD-078)

• Medicaid
• PeachCare for Kids
• healthcare contracts
• managed care
• Department of Community Health