HEALTHCARE
Medicaid autism providers warn of longer waits after cuts | Exclusive
Ansley FrancoSavannah Morning News
July 12, 2026, 5:05 a.m. ET
- CareSource, a Georgia Medicaid provider, has reduced reimbursement rates for some behavioral health services.
- Health professionals and advocates fear this will lengthen already long wait times for autism evaluations.
- Providers say the reduced rates may not cover the cost of services, potentially forcing some clinics to close.
Families seeking autism evaluations for their children in Georgia already face long waits and limited provider options, health professionals say. Some clinicians now think those waits could grow even longer after Carehealth services.
Care providers this spring that reimbursement rates for services would be reduced from 100% of the Georgia Medicaid fee schedule to 80%
The company said in a statement to the Savannah Morning News that the adjustments “reflect national trends and are necessary to help ensure taxpayer dollars are used responsibly as costs intensify.”
But for providers who specialize in autism evaluations, the concern is less about a single reimbursement change than what it could mean for access to behavioral health care in Georgia
Children’s Autism Assessment Center Clinical Director Rachel Matthews said autism evaluations are often the first step families must complete before they can access therapies, school accommodations or Katie Beckett Medicaid waivers
“Essentially, the wait times are astronomical right now. I don’t know what’s going to happen to these families,” Matthews said
Families are already waiting an estimated 10 to 24 months just to begin the evaluation process, she said, and many providers who perform autism assessments either do not accept Medicaid or only evaluate children below the age of 7
Children’s Autism Assessment Center serves patients from across Georgia, including families who travel several hours for evaluations because local options are limited, Matthews said. About 35% of the clinic’s patients utilize CareSource
A typical autism evaluation at Matthews’ clinic involves roughly eight hours of work, including intake interviews, testing, scoring, report writing and coordination with schools and other service providers
She said the reduced reimbursement rate would not cover the full cost of providing those evaluations
“We’re not trying to make this huge profit. That’s why we take Medicaid. We’re just here to help families,” she said
She also said the clinic requested additional time to continue evaluating Careuptly ending services could create continuity-of-care concerns for families who are midway through assessments. The request for a 30-day extension was approved, and the last day Children’s Autism Assessment Center could see patients who use Care
Lawmakers question the timing
The reimbursement reductions have also drawn attention from state lawmakers
During a June 23 hearing of the Georgia House Health Committee, legislators questioned the Georgia representative for Careeneral Assembly approved increased behavioral health funding
Jesse Weatherington, president of the Georgia Association of Health Plans, told lawmakers that behavioral health utilization in Georgia increased roughly 62% between 2018 and 2025 and that autism-related services increased by about 300% during the same period
He said Medicaid managed care organizations operate under a fixed per-patient reimbursement model and have faced mounting financial pressure as demand for services has grown
State Rep. Jesse Petrea, whose district includes Coastal Georgia, challenged this idea. “If your excuse is ‘Well we didn’t anticipate this growth,’ well, that’s your job.” Other lawmakers raised concerns about the effect of provider departures on children with disabilities and developmental needs
Advocates warn of longer waits
Roland Behm, co-founder of the Georgia Mental Health Policy Partnership, said he has heard from providers and families who fear the reimbursement cuts will reduce the number of clinicians willing to see Medicaid patients
Behm said the greatest risk is not simply that children will be added to waiting lists, but that they may remain on those lists for extended periods before receiving evaluations and treatment
“It’s not just getting on a list,” Behm said. “It’s how long you’re going to stay on that list before you get access to these services.”
He argued that delays in diagnosis can have consequences beyond health care because early intervention services often support communication, learning and classroom readiness
Georgia already faces significant literacy challenges. According to state education data, only about one-third of students read proficiently by third grade. Behm said longer waits for autism evaluations could add pressure to a system that is already struggling to improve early learning outcomes
“You’re going to put greater pressure on that reading at a third grade level,” he said. “All of it builds on the existing fault lines.”
What happens next?
Matthews said she has contacted families affected by the change and is trying to move up as many appointments as possible while seeking guidance from Careof evaluations
She said the clinic is unlikely to close because it serves patients with other insurance plans and private-pay families, but she worries that smaller practices elsewhere in Georgia may not have the same financial flexibility
“A lot of them are going to have to shutter their doors,” she said. “When providers start shuttering their doors, it doesn’t just affect Caree is.”
Careews asked regarding why only some behavioral health care providers received notice of a reimbursement rate change, why Carenter, and how many providers are no longer accepting Care
“CareSource’s priority is making sure our members, including children with autism, have access to the high-quality care and support they need. We understand the importance of these services and are working directly with providers to maintain access and continuity of care for our members,” an emailed statement said. “As healthcare costs continue to intensify, keeping Georgia’s Medicaid program strong is a shared responsibility. CareSource remains committed to working with providers and healthcare leaders to protect access to high-quality care for the families who need it.”
Ansley Franco is a reporter with the Savannah Morning News, covering public safety and general assignments. You can reach her at AFranco@gannett.com
