Medicaid Pay Going Up for Primary Care

MedPageToday, 2012

WASHINGTON -- For two years, primary care doctors will be paid for seeing Medicaid patients at the same rates they receive from Medicare, under a proposed rule announced Wednesday.
Under the Centers for Medicare and Medicaid Services (CMS) proposal, family physicians, internists, and pediatricians will be paid at Medicare rates instead of state-set Medicaid rates for primary care services provided in fiscal years 2013 and 2014.
Although Medicaid rates vary from state to state, they are generally about 66% of Medicare rates for the same service, although in some they're just a third, according Roland Goertz, MD, chairman of the board of the American Academy of Family Physicians.
That means primary care physicians would see an average 34% pay bump for treating Medicaid patients in 2013 and 2014, an amount that will total $11 billion, according to CMS.
That extra money will come from the federal government, not states, Cindy Mann, director of CMS' Center for Medicaid, told reporters in a Wednesday afternoon press call.
The Affordable Care Act (ACA) lowered the income threshold for Medicaid, which is projected to bring an additional 16 million currently uninsured people into the insurance program for the poor.
The proposal announced Wednesday was included as a way to ensure that doctors have enough of an incentive to treat all of those newly-enrolled Medicaid patients.
The proposal also increases payment rates for pediatric vaccines, which have been reimbursed at the same rate since 1994, according to the proposed rule.
The FDA has proposed moving some Rx drugs into a , allowing them to be dispensed by pharmacists without a prescription.
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