Proposed Rule Would Boost Medicaid Pay for Primary Care Physicians

On Wednesday, HHS released a proposed rule that would implement a provision in the federal health reform law that calls for a two-year increase to Medicaid reimbursements for primary care physicians, the Washington Post reports (Aizenman, Washington Post, 5/9).

Rule Details

Under the rule, the federal government would cover the entire cost of the increase. States would receive more than $11 billion in 2013 and 2014 to bring Medicaid reimbursement rates for PCPs in line with those paid under Medicare (Viebeck, "Healthwatch," The Hill, 5/9).

The provision in the health reform law is one of many intended to address the growing shortage of PCPs, which more acutely affects Medicaid beneficiaries. Overall, the PCP shortage will reach 45,400 by 2020, according to estimates from the Association of American Medical Colleges.

The health reform law is expected to put further strain on the primary care workforce, as more than 30 million U.S. residents are expected to gain health coverage through the law beginning in 2014 (Washington Post, 5/9).

Acting CMS Administrator Marilyn Tavenner said the funds "will be an important tool for states to ensure their primary care networks are prepared for increased enrollment as the health care law is implemented" (Fox, National Journal, 5/9).

Reactions

Officials from the Association of American Medical Colleges and the American Academy of Pediatrics praised the announcement, "Healthwatch" reports.

AAP president Robert Block said, "This rule, once made final, will help enable pediatricians to provide the highest quality care" ("Healthwatch," The Hill, 5/9).

Sen. Orrin Hatch (R-Utah) criticized the short-term nature of the proposed rule. He said, "It's nonsensical to think a temporary two-year bump in pay will actually attract and retain doctors to the Medicaid program unless the White House thinks Congress will keep extending these higher payment rates in perpetuity" (Norman, CQ HealthBeat, 5/9).