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Medicaid Pay Bump Gone in PA; Will it Affect Access?

The temporary increase in Medicaid provider fees for primary care services ended yesterday, leaving observers to wonder whether it will affect access to care for the nation’s growing Medicaid population.
The increase, mandated by the Affordable Care Act, raised Medicaid primary care rates to the same level as Medicare payments in the hope that more primary care providers would begin serving Medicaid patients in anticipation of significant growth in the Medicaid population.  Now that the two-year increase has ended, it is unclear whether providers who began serving Medicaid patients because of the increase will remain Medicaid providers and those who accepted more Medicaid patients will continue doing so.
Doctor listening to patientBecause of the relatively short duration of the increase, little research has been completed to determine whether the raise made a difference in access, but some states believe it did:  a number will use their own money to continue the raises, which during the two-year experiment were paid entirely by the federal government.
Pennsylvania is not among the states that will continue paying the enhanced Medicaid fees for primary care services.
Kaiser Health News has taken a look at this issue and the potential implications of the end of the Medicaid pay raise; see its report here.

2015-01-02T06:00:57+00:00January 2nd, 2015|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off on Medicaid Pay Bump Gone in PA; Will it Affect Access?

PA Medicaid Primary Care Fees to Plummet

Payments to Pennsylvania primary care physicians who serve Medicaid patients will fall 52.4 percent after the first of the year, when the Affordable Care Act’s two-year increase in those payments ends.
The temporary fee increase was included in the Affordable Care Act to encourage more primary care physicians to serve Medicaid patients in anticipation of the significant growth of Medicaid as a result of the reform law’s Medicaid expansion.  Under that law, Medicaid primary care fees were raised to the level of Medicare primary care rates for two years.  Nation-wide, the average Medicaid primary care fee will fall 42.8 percent.
So far, 15 states plan to use their own money to prevent the dramatic reduction of Medicaid primary care payments.  Pennsylvania is not among them.
The cut will be especially damaging to the state’s safety-net hospitals because they serve so many more Medicaid patients than the typical hospital and expect to serve even more such patients when the state’s Medicaid program expands beginning on January 1.
Learn more about the upcoming Medicaid payment cut in the new Urban Institute report Reversing the Medicaid Fee Bump:  How Much Could Medicaid Physician Fees for Primary Care Fall in 2015?, which you can find here, on the Urban Institute’s web site.

2014-12-17T06:00:15+00:00December 17th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off on PA Medicaid Primary Care Fees to Plummet

To Increase or Not to Increase? That is the Question

To induce more primary care providers to serve Medicaid patients at a time when Medicaid enrollment was about to increase significantly nation-wide, the Affordable Care Act raised Medicaid primary care reimbursement to the same level as Medicare rates for 2013 and 2014, with the federal government to pick up the tab for 100 percent of the increase in state spending for these services.
With that two-year increase coming to an end, states now must decide whether to continue the increase and pay for it themselves or let their Medicaid primary care rates return to their old levels.
According to a survey taken by the Kaiser Family Foundation, 15 states will continue the increases either in part or in full; 24 do not plan to continue the increases; and 12 still have not decided.
Some states that are continuing the increases in some form also are changing the types of primary care providers that will receive the enhanced Medicaid payments.
Pennsylvania is among the 24 states not planning to continue the rate increase.
For a closer look at the issue, including a map that illustrates each state’s intentions, see the Kaiser Family Foundation report “The ACA Primary Care Increase: State Plans for SFY 2015” here, on the foundation’s web site.

2014-11-03T06:00:34+00:00November 3rd, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off on To Increase or Not to Increase? That is the Question

PA Announces Plans for Increased Medicaid Fees

The Department of Public Welfare has unveiled its plan for increasing the fees it pays for Medicaid primary care services in 2013 and 2014.  The limited-term pay increase, which will raise Medicaid primary care payments to Medicare levels, is mandated by the Affordable Care Act.
A Pennsylvania Bulletin notice that addresses how and when the fee increases will be paid, and to whom they will be paid, can be found here.
The revised fee schedule with the new, higher fees can be found here.

2013-05-29T06:00:17+00:00May 29th, 2013|Health care reform, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Announces Plans for Increased Medicaid Fees
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