Types of Medicaid Plans

Georgia Medicaid offers benefits on a Fee-for-Service (FFS) basis or through managed care plans. Under the FFS model, Georgia pays providers directly for each covered service received by a Medicaid beneficiary. Under managed care, Georgia pays a fee to a managed care plan for each person enrolled in the plan. In turn, the plan pays providers for all of the Medicaid services a beneficiary may require that are included in the plan’s contract with the state. In general, Georgia set provider payments under fee-for-service. Section 1902(a)(30)(A) of the Social Security Act requires that such payments be consistent with efficiency, economy, and quality of care, and are sufficient to provide access equivalent to the general population.