Doctors Ask for Longer Medicaid Primary Care Payment Hike

Five physician societies recently asked leaders of two power congressional committees to extend the Affordable Care Act’s Medicare primary care payment increase program for at least two more years, through 2016.


Five physician societies recently asked leaders of two power congressional committees to extend the Affordable Care Act’s Medicare primary care payment increase program for at least two more years, through 2016.

The societies argue that many states have only recently implemented the law’s provision under which the federal government pays to increase Medicaid rates for designated primary care services to the comparable Medicare rates, and the program is expected to expire at the end of 2014.

“Allowing this program to expire would further burden the already challenged Medicaid system,” according to the letter to the Senate Finance and House Energy & Commerce Committees. “Patients will face obstacles to connecting with a patient-centered medical home and will be forced to rely on episodic, acute care services provided in other settings, foregoing the most cost-effective coordinated and preventive care services that primary care physicians provide. Policies aimed at improving access to physicians in the Medicaid program are strongly supported by our organizations because we understand that investments such as these lead to better quality of care for patients and decreased costs for state governments.”

The societies also note that the slow start-up by states to begin paying at the higher rate and lack of assurances that the program will extend beyond 2014 has not given enough time to evaluate the effectiveness of the program. They also ask that physicians practicing obstetrics and gynecology as qualified specialties be permitted to participate if they meet the threshold for 60 percent of Medicaid billings as primary care services.

Physician societies signing the letter, available here, are the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists and American Osteopathic Association.

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