Updates & Announcements

Quick References

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

Please Note: The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

Georgia Pathways

The Pathways to Coverage Program began on July 1, 2023. For more information about the program, please visit https://dch.georgia.gov/georgiapathways.


2025 Virtual Trainings

Did you know that CareSource offers virtual educational forums? We invite to join us at an upcoming informative session.


General Updates

2026Date
Navigate April 2026 Pharmacy Policy Updates (1/6)04/01/2026
Navigate April 2026 Pharmacy Policy Updates (2/6)04/01/2026
Navigate April 2026 Pharmacy Policy Updates (3/6)04/01/2026
Navigate April 2026 Pharmacy Policy Updates (4/6)04/01/2026
Navigate April 2026 Pharmacy Policy Updates (5/6)04/01/2026
Navigate April 2026 Pharmacy Policy Updates (6/6)04/01/2026
Navigate Policy Updates (2/2) - March 202603/01/2026
Navigate Policy Updates (1/2) - March 202603/01/2026
Navigate Place of Service Code for EPSDT Visits02/20/2026
Navigate Depression Screenings with Medical Provider Incentive Update02/19/2026
Navigate Required Action to Prevent Claims Denials- Group/Billing Provider Enrollment in GAMMIS02/17/2026
Navigate 30-Day Readmission Policy02/17/2026
Navigate Prior Authorization Requirement Update02/10/2026
Navigate Prepay Auditing Update02/06/2026
Navigate Pharmacy Policy Updates February 202602/01/2026
Navigate Policy Updates February 2026 (1/2)02/01/2026
Navigate Policy Updates February 2026 (2/2)02/01/2026
Navigate Multiple Procedure Payment Reduction for Therapies01/30/2026
Navigate Policy Updates - January 202601/01/2026
Navigate Policy Updates - January 202601/01/2026
Navigate Pharmacy Policy (Q3 - 2025) Updates January 202601/01/2026
Navigate Pharmacy Policy (Q2 - 2025) Updates January 202601/01/2026
2025Date
Navigate Urgent Medical Device Correction - FreeStyle Libre 3 and FreeStyle Libre 3 Plus Sensors12/30/2025
Navigate Prior Authorization Requirement Update REVISION 12/01/2025
Navigate Routine Vision Vendor Change to EyeMed Starting 2/1/202612/01/2025
Navigate Versant Policies12/01/2025
Navigate Policy Updates December 202512/01/2025
Navigate Policy Updates December 202512/01/2025
Navigate Policy Updates December 202512/01/2025
Navigate Prior Authorization Requirement Update12/01/2025
Navigate Lymphedema Compression Treatment Items Claims Editing Enhancements11/24/2025
Navigate Georgia Pathways Copays11/03/2025
Navigate SKYGEN Policies Revised 11/01/2025
Navigate Policy Updates November 202511/01/2025
Navigate Avalon Policy Updates - November 202511/01/2025
Navigate CareSource Policy and Prior Authorization changes11/01/2025
Navigate 2025 Order, Prescribe and Refer (OPR) UpdateREVISION10/24/2025
Navigate Newborn RSV Prevention10/23/2025
Navigate Launch of HealthPlanResources.com10/22/2025
Navigate Claims Editing - Add-On Codes, E/M and Special Services10/20/2025
Navigate Revenue Code Billing Requirements10/17/2025
Navigate Claim Edits for Durable Medical Equipment10/17/2025
Navigate Policy Updates September 202509/01/2025
Navigate September 2025 Policy Updates09/01/2025
Navigate September 2025 Policy Updates09/01/2025
Navigate Revised Process for Clinical Practice Guideline (CPG) Audits08/29/2025
Navigate Pharmacy Policy Updates August 202508/27/2025
Navigate Prior Authorization Requirement Update08/20/2025
Navigate Clarification on Behavioral Health Outpatient Therapy Codes08/20/2025
Navigate Policy Updates August 202508/01/2025
Navigate Policy Updates August 202508/01/2025
Navigate CareSource Expands Partnership with SKYGEN to Leverage Enhanced Provider Services and Support for Georgia Medicaid Population07/11/2025
Navigate Avalon Policy Updates - Q4 202407/01/2025
Navigate Avalon Policy Update - Colorectal Cancer Screening07/01/2025
Navigate Policy Updates July 202507/01/2025
Navigate Coding Documentation Guides Available06/26/2025
Navigate EPSDT Billing Update06/23/2025
Navigate Maintaining Accurate Provider Information06/12/2025
Navigate Prior Authorization Requirement Update06/10/2025
Navigate Policy Updates (3/3) June 202506/01/2025
Navigate Policy Updates (2/3) June 202506/01/2025
Navigate Policy Updates (1/3) June 202506/01/2025
Navigate CareSource Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint REVISION05/28/2025
Navigate Pharmacy Policy Updates May 202505/16/2025
Navigate Prothesis and Orthosis Claims Editing Logic04/21/2025
Navigate Pharmacy Policy Updates April 202504/01/2025
Navigate 2025 Order, Prescribe and Refer (OPR) UpdateREVISION03/21/2025
Navigate It's Patient Experience Survey Season03/14/2025
Navigate Policy Update March 202503/10/2025
Navigate PCP Name on Card: What You Need to Know03/07/2025
Navigate Maintaining Provider Information in GAMMIS02/13/2025
Navigate Avalon Policy Updates - Q3 2024REVISION02/05/2025
Navigate Prior Authorization Requirement Update02/04/2025
Navigate Policy Updates February 202502/01/2025
Navigate Avalon Policy Updates - Q3 202402/01/2025
Navigate Policy Updates February 202502/01/2025
Navigate 2025 Order, Prescribe and Refer (OPR) UpdateThis notification has been revised. Please see notification dated 3/21/202501/31/2025
Navigate Update Provider Dental Resources - Policy Clarifications and RevisionsUPDATE01/10/2025
Navigate Newborn RSV Prevention01/13/2025
Navigate Policy Updates January 202501/01/2025
Navigate Evolent Policy Updates January 202501/01/2025
Navigate Policy Updates January 202501/01/2025
Navigate TurningPoint Policy Updates January 202501/01/2025
Navigate Updating Demographics01/01/2025
Navigate Updated Provider Resources - Policy Clarifications and RevisionsThis notification has been revised. Please see notification dated 01/10/202501/01/2025
Navigate Interactive Health Library01/01/2025
Navigate 2025 Obstetrics Quality Program01/01/2025