Increased Medicaid Payment for Primary Care Questions and Answers


Today CMS is pleased to announce the release of important information for states on the implementation of the Affordable Care Act’s provisions to raise payments for services furnished by certain primary care physicians in calendar years 2013 and 2014.

Since the publication of the final rule on November 6, 2012, CMS has received questions from states and other stakeholders about this provision. CMS has developed two Question and Answer documents to address many of the questions we have received to date, one document related to fee-for-service implementation issues and a second on managed care delivery system implementation issues. We hope this information will be helpful.

The Questions and Answers may be accessed at:http://www.medicaid.gov/State-Resource-Center/Frequently-Asked-Questions/CMCS-Ask-Questions.html
 
Under the provisions of the regulation, states are required to amend their Medicaid state plans to increase payment rates; therefore, CMS has issued a state plan preprint for this purpose. The preprint “Reimbursement Template -Physician Services, Increased Primary Care Service Payment 42 CFR 447.405, 447.410, 447.415,” may be accessed at: http://www.medicaid.gov/AffordableCareAct/Provisions/Provider-Payments.html

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