Roland Behm

Follow the child: Was medically necessary care actually delivered? Follow the money: What did Georgia pay, and what additional public costs resulted from unmet needs? Accountability requires answers to both. #GeorgiaMedicaid #MedicaidAccountability #gapol

Was treatment recommended? Authorized? Was a provider available? Did the child actually receive care? Those are the questions Georgia DCH must answer when evaluating Medicaid access. Claims and provider lists alone aren't enough. #GeorgiaMedicaid #MedicaidAccountability #gapol

Georgia's Department of Community Health pays Medicaid managed care plans billions each year. DCH must ensure those plans maintain adequate provider networks and deliver timely access to care—not just submit reassuring reports. #GeorgiaMedicaid #MedicaidAccountability #gapol

When Medicaid treatment isn't delivered by the MCOs , schools, foster care, hospitals, and crisis services may bear the consequences. Taxpayers can pay twice: first for Medicaid coverage, then for the response to unmet need. #GeorgiaMedicaid #MedicaidAccountability #gapol

For a child who needs autism or behavioral health treatment, months without care can mean lost progress, worsening symptoms, or a crisis. Delaying medically necessary treatment is not a harmless administrative inconvenience. #GeorgiaMedicaid #MedicaidAccountability #gapol

A provider directory full of names means nothing if no one is accepting patients. When a Medicaid plan's network cannot provide necessary covered care, federal law requires timely out-of-network arrangements paid for by the MCO. #GeorgiaMedicaid #MedicaidAccountability #gapol

EPSDT isn't just about screening children. It's a federal TREATMENT mandate. Medicaid must cover medically necessary services to correct or ameliorate a child's condition—including qualifying autism and behavioral health treatment. #GeorgiaMedicaid #MedicaidAccountability#gapol

Amerigroup. CareSource. Peach State Health Plan. Three companies. One fundamental obligation: arrange timely access to medically necessary covered care. An insurance card is not care, neither is an authorization. #GeorgiaMedicaid #MedicaidAccountability #gapol

Georgia pays Amerigroup, CareSource, and Peach State Health Plan billions each year to arrange Medicaid care. But coverage means little when children can't get treatment. Taxpayers paid for care. Children should receive it. #GeorgiaMedicaid #MedicaidAccountability #gapol

There is no rewind button for early childhood development. Early support — including #BabiesCantWait and #AppliedBehaviorAnalysis — can change the course of a child’s life. Help that arrives late may never fully catch up. @GADCH must protect access. #ProtectChildrensCare #gapol

Lawmakers call the loss of ACA coverage by more than 500,000 Georgians a “personal choice.” That is wrong. Many families are being forced to choose among health insurance, rent, food, transportation, child care, and medication. That is not consumer preference. #gapol

Lawmakers call the ACA broken, but doing so does not pay for insulin, keep rural hospitals open, cover cancer treatment, or help a child get therapy. If lawmakers oppose the ACA, they should explain what coverage system they have or will put in its place (none to date). #gapol

Lawmakers point to Georgia Pathways to Coverage in response to the loss of 500,000 ACA enrollees. Pathways is not a substitute for the Marketplace. Its strict enrollee requirements are meant to limit capacity to 30,000, so there is no room at that inn. #gapol

Lawmakers claim that Georgia Access is a success in responding to concerns about 500,000 Georgians losing ACA coverage. Irrelevant. Lawmakers should not declare victory simply because a website exists. #gapol

If the state does not know whether hundreds of thousands of Georgians became uninsured, then the state has an information problem, not a talking point. Lawmakers should find out before minimizing the harm. #gapol

"They found other coverage," is a response by lawmakers to the loss of more than 500,000 Georgia Marketplace enrollees. If so, produce the data showing where these Georgians went. Without that data, “they found other coverage” is not analysis. It is wishful thinking. #gapol

#gapol #parity #MentalHealthMatters

What will be the impact on next year's elections when 500,000 Georgians lose their ACA Marketplace insurance on January 1st? #gapol georgiarecorder.com/2025/07/…

In 2022, Georgia promised mental health parity. John King promised enforcement. Three years later, both promises are still waiting to be kept. #gapol share.google/mpEyHJr42NmZxnr…