
CMO Reviews and Reports
Managed Care Periodic Audit Reports
Per federal regulations, the Department of Community Health must periodically, but no less frequently than once every three years, conduct or contract for an independent audit of the accuracy, truthfulness, and completeness of the encounter and financial data submitted by, or on behalf of each Care Management Organization (CMO) and post the results of these audits on our website. 42 CFR§ 438.602(e) and (g).
Please see below the results of the 2020 periodic audits for each CMO:
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Amerigroup 2020 MLR Final Signed Report - Posted 12/08/22
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CareSource 2020 MLR Final Signed Report - Posted 12/08/22
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Peach State 2020 MLR Final Signed Report - Posted 12/20/22
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WellCare 2020 MLR Final Signed Report - Posted 12/08/22
Please see below the results of the 2019 periodic audits for each CMO:
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Amerigroup 2019 MLR - Final Report - Posted 11/09/22
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CareSource MLR - Final Report - Posted 11/09/22
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Peach State 2019 MLR - Final Report - Posted 11/09/22
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WellCare MLR - Final Report - Posted 11/09/22
Encounter Data Reports
“Encounter data” are claims that have been paid by CMO’s or delegated vendors (e.g., dental, vision, and pharmacy) to health care providers that have rendered health care services to members enrolled with the CMO.
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GA CMO Encounter Report - Amerigroup August 2020 thru July 2022 - Posted 12/13/22
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GA CMO Encounter Report - Amerigroup October 2020 thru September 2022 - Posted 12/13/22
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GA CMO Encounter Report - CareSource August 2020 thru July 2022 - Posted 12/13/22
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GA CMO Encounter Report - CareSource October 2020 thru September 2022 - Posted 12/13/22
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GA CMO Encounter Report - Peach State August 2020 thru July 2022 - Posted 12/13/22
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GA CMO Encounter Report - Peach State October 2020 thru September 2022 - Posted 12/13/22
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GA CMO Encounter Report - Wellcare August 2020 thru July 2022 - Posted 12/13/22
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GA CMO Encounter Report - Wellcare October 2020 thru September 2022 - Posted 12/13/22
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CMO Flash Reports

The Care Management Organization (CMO) Flash Report provides a quick reference overview of the Georgia Families program, including member enrollment, CMO financial filings with the Department of Insurance, CMO self-reported utilization data, prior authorization performance, timely access performance and trends to watch.
Click the links to the left to review CMO reports from 2019 to the present.