Georgia Families® Frequently Asked Questions (FAQs)

The Georgia Department of Community Health (DCH) is the single State Agency designated to administer and supervise the administration of Georgia’s Medicaid program. (42 C.F.R. § 431.10). DCH oversees program administration and funding for all Georgia Medicaid and PeachCare for Kids® services.

Georgia Families® is a partnership between DCH and private health plans (also called “care management organizations” or “CMOs”) to provide benefits and healthcare services to Medicaid and PeachCare for Kids® members, Planning for Healthy Babies® (P4HB) enrollees, Georgia Pathways to Coverage members, and Georgia Families 360° Members. 

• PeachCare for Kids® is the State Children’s Health Insurance Program.
• The P4HB program is Georgia’s Section 1115 Family Planning Waiver program.
• The Pathways to Coverage Program is Georgia’s Section 1115 Waiver for persons who otherwise would not qualify for Medicaid, are ages 19-64 with incomes up to 100% of the Federal Poverty Level, and who participate in qualifying activities. Pathways members must participate in qualifying activities.
• The Georgia Families 360° program facilitates the coordination of care for children, youth and young adults in foster care or receiving adoption assistance and select youth involved with the Department of Juvenile Justice.

• Parents/Caretakers with Children Medicaid (formerly Low-Income Medicaid)
• Transitional Medicaid
• Pregnant Women
• Children under 19 (formerly Right From the Start Medicaid)
• Planning for Healthy Babies® (P4HB)
• Newborns
• PeachCare for Kids®
• Select categories of the ABD population*
• Women’s Health Medical Assistance (members less than 65 years of age and diagnosed with breast or cervical cancer)
• Refugees
• Pathways to Coverage

Select categories of the ABD population transition on the Operational Start Date of the new CMO contracts.

The following groups are automatically enrolled in Georgia Families 360º:

• Children and youth in foster care
• Adoption Assistance children and youth
• Youth involved with the Department of Juvenile Justice (DJJ)

All open records requests should be submitted via the DOAS Records Management Portal for responsive procurement records for eRFP #41900-DCH0000133. For technical assistance with the records management portal, please use the contact information below:

Monday - Friday 8 a.m. to 5 p.m. EST

Phone: (404) 902-5630

Email: [email protected]

Changes may affect a range of stakeholders, including:

• Medicaid members (including the Aged, Blind, and Disabled (ABD) population)
• Providers
• Care Management Organizations (CMOs)
• Sister State Agencies (e.g. DBHDD, DJJ, DHS/DFCS, DOE, DPH)
• Community-based organizations
• Internal DCH teams

State Readiness refers to the activities the Department of Community Health (DCH), sister agencies, and implementation partners are undertaking to prepare for a successful transition to the new Suppliers. State Readiness includes operational planning, training, systems readiness, provider and member education, and cross-agency coordination.

Implementation planning and State Readiness activities are underway. More information regarding the timelines and implementation activities will be posted on the Georgia Families® – Latest News page as information becomes available.

Training activities have started and will be ongoing. Training information as well as a training schedule will be posted on the Georgia Families® – Latest News page as information becomes available. These materials will help stakeholders understand the programs and provide assistance with navigating the transition.

Details will be available on the Georgia Families® – Latest News website.

Send questions and/or feedback to the Georgia Families® Project Implementation Team at: [email protected].

Providers will be encouraged to contract with the awarded CMOs to ensure continuity of care for members. Additional training and contracting guidance will be provided once NOA is issued.

No. Members should continue using their current Medicaid health plans and services as normal. No action is needed at this time. When changes are required, DCH or the CMOs will notify members directly.

When the new CMOs are in place, members will receive information on selecting a plan. Those who do not select will be auto-assigned based on family or provider history and quality performance measures.

Yes. Core Medicaid and PeachCare for Kids® benefits will continue (physician visits, hospital services, pharmacy, labs, transportation, etc.). Some new value-added benefits may be offered by CMOs.

Members receiving services under NOW and COMP 1915(c) home and community-based waivers are not impacted by this transition and will remain in their current programs.

Value-Added Benefits are extra services provided at no additional cost to enhance members’ health and well-being. The new CMOs will offer VABs and specific details will be available after final contracts are awarded.