HB 573: Insurance; remove dentists from participation with care management organizations

Georgia's Medicaid care management organizations (CMOs) are private managed care plans the state contracts with to coordinate Medicaid patients' health care, including dental services under current law. This bill would change that setup. It rewrites the definition of 'health care services' in the law governing these organizations (O.C.G.A. § 33-21A-2) to specifically exclude dental services. It also repeals Code Section 33-21A-8, the section that currently governs how dentists participate with care management organizations, leaving that section blank ('reserved') rather than replaced with new rules. The bill does not specify an alternate system for covering dental care under Medicaid managed care; it simply removes dentists and dental services from the CMO framework. No effective date is stated beyond the standard process of becoming law.

• Rewrites the definition of 'health care services' in the law governing Medicaid care management organizations (O.C.G.A. § 33-21A-2) to exclude dental services.
• Repeals Code Section 33-21A-8, which currently sets the rules for how dentists participate with care management organizations, and leaves that section reserved (blank).
• Removes dentists as required or covered participants within the Medicaid managed care plan structure without creating a replacement mechanism in this bill's text.

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

If enacted, dental services and dentists would no longer fall under the Medicaid care management organization system in Georgia. This could change how dental care for Medicaid enrollees is arranged, billed, or coordinated, since the law removes the existing framework without spelling out a replacement.

• Section 1 revises the definition of 'health care services' in O.C.G.A. § 33-21A-2 to state that the term 'shall not include dental services.'
• Section 2 repeals Code Section 33-21A-8, which relates to participation by dentists in care management organizations, and reserves that section (leaves it blank rather than replacing it).
• Section 3 repeals any other laws that conflict with this Act.

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

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

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