MedicaidAdministrativeHigh impact
[Georgia] Expired License/Certification and Provider Enrollment
CareSource·GA·Network
Effective date
Jul 16, 2026
We identified it
Jul 17, 2026
Summary
CareSource Georgia Medicaid has clarified provider enrollment requirements regarding expired licenses and certifications. Providers must maintain current licenses, report expirations immediately, and understand the suspension/termination timeline: enrollment files are suspended the day after expiration, terminated 30 days after suspension if not remedied, with no retroactive re-enrollment allowed. Medical residents may use Residency Training Permits (RTP) only for outpatient prescription medications.
Action Required
IMMEDIATE: All providers enrolled with CareSource Georgia Medicaid must verify current license and certification status in GAMMIS. Billing team must: (1) Create a tracking system for all provider license/certification expiration dates; (2) Establish internal reminder process to alert providers 90+ days before expiration; (3) Ensure providers understand the reporting requirement to notify CareSource immediately upon any expiration, suspension, probation, limitation, or revocation; (4) Document that enrollment files will be suspended the day after expiration if updated credentials are not submitted; (5) Inform providers that terminated enrollments require a new application with no retroactive enrollment option. For medical residents using RTPs: Verify RTP status is current and restrict billing to outpatient prescription medications only. Contact CareSource Provider Services (1-855-202-1058, Monday-Friday 7am-7pm ET) or GAProviderRelations@CareSource.com with questions. Failure to maintain current credentials will result in enrollment suspension and potential termination, blocking all claims processing.