Federal Bill Seeks to Continue Enhanced Medicaid Payments Beyond 2014, Assure Access to Care

Under the Affordable Care Act (ACA), certain Medicaid primary care specialties are eligible for enhanced reimbursement to be paid at Medicare rates for 2013 and 2014. A new federal bill—the Ensuring Access to Primary Care for Women and Children Act— would extend this payment boost beyond 2014 when it is currently set to expire.

On Oct. 13, 2014, the Pennsylvania Medical Society (PAMED), Pennsylvania Chapter of the American College of Physicians, and the Pennsylvania Chapter of the American Academy of Pediatrics sent a letter to Sen. Pat Toomey and Sen. Robert Casey asking for their support and cosponorship of this bill (S. 2694)

“Primary care physicians are the most severely impacted by low Medicaid reimbursement rates,” said the presidents of the three organizations in the letter, including PAMED President Bruce MacLeod, MD.

“If the payment increase is not continued in 2015 there will most certainly be a negative impact on access to primary care services as many primary care physicians will not be able to accept new Medicaid patients into their practices and the efforts to recruit physicians to the Medicaid program will suffer,” they said.

The organizations also said that the transfer of approximately 40,000-60,000 children from the Children’s Health Insurance Program (CHIP) to Medicaid on Jan. 1, 2015 — just as the equal payment is scheduled to expire — is likely to result in significant access issues.

“The enhanced Medicaid reimbursement rate will address the important issue of financial stability for primary care providers and also take steps to assure access for the growing Medicaid patient population,” concluded the letter.