Primary Care Medicaid Rate Increase Delayed in 47 States

Primary care physicians were supposed to see Medicaid reimbursement levels match Medicare rates for the next two years, but since the policy’s Jan. 1 start date, most physicians are still waiting to see the larger payments, according to a report by Kaiser Health News.

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Nevada, Michigan and Massachusetts are the only states that have begun the increased payment rates — averaging 73 percent higher than previous Medicaid primary care rates — that were intended to encourage more primary physicians to treat the flood of newly eligible Medicaid patients beginning next year. However, the bottlenecking seems to be occurring within CMS, which has approved only seven of the 50 states that submitted applications to pay the higher rates, according to the report.

The physicians are still eligible for retroactive pay increases originating from Jan. 1, but some state policies have required physicians to have registered with the incentive program by April or May this year to be eligible for the back pay, according to the report.

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