Organized medicine seeks info on Medicaid primary care pay boost

NEWS IN BRIEF — Posted June 10, 2013

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National medical organizations including the American Medical Association in May sent a letter to the Centers for Medicare & Medicaid Services asking the agency to share more information on a scheduled pay increase to Medicaid primary care services under the Affordable Care Act.

The ACA had directed states to increase rates for primary care services provided by primary care physicians up to 100% of Medicare rates for calendar years 2013 and 2014. States had until March 31 to modify their Medicaid programs to reflect the changes and submit them to the federal government, which subsequently had 90 days to approve the plans. The letter expressed concerns that states had only a brief window of time to implement this ACA provision, resulting in confusion among state employees and physicians alike.

“One overarching concern shared by our organizations is the lack of a coordinated plan to educate and communicate to eligible providers about the payment increase and steps physicians must take to participate,” the organizations wrote in a May 7 letter to Cindy Mann, director of the CMS Center for Medicaid and CHIP Services.

To qualify for the pay increase, primary care doctors must attest their eligibility for it. In the letter, the groups said that doctors were having problems accessing their respective states’ self-attestation forms. The groups requested that CMS share various details about this process for each state, including the dates by which physicians need to attest their eligibility for the pay increase.

The enhanced Medicaid rates are retroactive to Jan. 1, which means physicians won’t lose out on any payments owed to them because of administrative delays.

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