Georgia Medicaid insurer denied psychotherapy for thousands

ATLANTA — A newspaper finds that the insurance company that manages medical care for many Georgia children has denied or partially denied more than 6,500 requests for psychotherapy between 2019 and mid-2022. In a January report to state lawmakers, the department said fewer than 100 psychotherapy requests were denied in calendar year 2019 and the 2021 and 2022 budget years by the state’s Medicaid managed care contractors, including Amerigroup. But the newspaper found through documents obtained in open records requests that Amerigroup denied hundreds of authorization requests for psychiatric residential treatment, something the Department of Community Health didn’t include in its report to lawmakers. “We will get people the right services at the right time, all the time.” But Human Services Commissioner Candice Broce, who also leads her department’s Division of Family & Children Services — the state’s foster care agency — has been sharply critical. The insurer often rejected such expensive stays with the same language citing a lack of medical necessity, frequently saying, “Records no longer show you have these issues.” Among children denied entrance to residential treatment: an 11-year-old girl who smeared feces in the bathroom of a foster care home and attempted to jump out of a window hours after being released from a psychiatric unit.