State Affairs Georgia reports CareSource clawbacks and higher costs are prompting psychologists to leave its Medicaid network, potentially limiting child diagnostic access.
Medicaid repayment demands
According to State Affairs Georgia, psychologists who diagnose children with autism and other conditions have received demands from CareSource to repay Medicaid funds. The source says dozens of psychologists received letters in March seeking repayment of thousands of dollars paid since 2025. State Affairs Georgia reports that one psychologist was ordered to repay nearly $30,000. The source describes the clawbacks as raising fears of financial ruin for local clinics.
Higher costs for providers
State Affairs Georgia reports that pediatric therapists across Georgia faced steep cost hikes in May from CareSource and Peach State Health Plan, two of the state’s Medicaid providers. The source says those changes threatened access to critical treatments for hundreds of vulnerable children during formative years. Records obtained by State Affairs Georgia showed that local psychologists diagnosing children with autism and other special needs were also notified of CareSource cost increases.
Network participation concerns
According to State Affairs Georgia, the combined effect of higher costs and repayment demands has prompted many psychologists to drop CareSource from their coverage network. The source reports that this could require children and families to pay out of pocket for expensive diagnostic tests. It also says children could potentially go untreated entirely if families cannot obtain those services through the network.
Effects described by psychologists
State Affairs Georgia includes comments from a licensed psychologist who said that providers cannot afford to operate under the current pressures. The source reports that the psychologist serves about 2,000 clients, roughly half of whom are children. It also says another affected clinic serves students traumatized by the mass shooting at Apalachee High School. State Affairs Georgia characterizes the situation for psychologists as especially dire because of both cost increases and clawback notices.
What this means for Georgia patients
For Georgia patients looking to find treatment locally, this report describes Medicaid-network changes that may affect access to child diagnostic services; the directory lists 255 published clinics in Georgia.
This is general information, not medical advice.
More Georgia reporting on access & coverage.
This report is educational and is not medical advice. Coverage, availability and eligibility can change; verify details with the named source or your care team.