The Medicaid Pay Parity program was a provision outlined within the Affordable Care Act that increased Medicaid provider reimbursement to match that of Medicare providers. This provision expired on December 31, 2014 and was not extended nationally. However, some states are choosing to continue Medicaid pay parity.
7 States chose to extend Medicaid pay parity: Alabama, Colorado, Iowa, Maryland, Mississippi, and New Mexico. In addition, Alaska is paying doctors even more than the Medicare rate.
8 states chose to increase Medicaid reimbursement, but not to the full Medicare rate: Connecticut, Delaware, Hawaii, Maine, Michigan, Nebraska, Nevada, and South Carolina
In addition to these state legislative action, federal legislative action was taken in the form of the Medicaid Parity Act of 2015 (H.R.1502). This bill was introduced by Representative John Lewis on March 19, 2015 and was referred to the Subcommittee on Health on March 20, 2015. This bill seeks to amend title XIX (Medicaid) of the Social Security Act to extend through 2019.
Another bill, the Ensuring Access to Primary Care for Women and Children Act, (H.R.2253), was introduced by Representative Kathy Castor in the House of Representatives on May 12, 2015. It was referred to the Subcommittee on Health on May 15, 2015. This bill seeks to amend title XIX of the Social Security Act to extend the application of the Medicare payment rate floor to primary care services furnished under Medicaid and to apply the rate floor to additional providers of primary care services.
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Colorado’s Patient-Centered Medical Home Pilot Met Numerous Obstacles, Yet Saw Results Such As Reduced Hospital Admissions | September 2012 | Health Affairs | |
Patient-Centered Medical Homes Improve Access and Quality of Care | August 2011 | Amerigroup | |
Strategies States Can Use to Support the Infrastructure of a Medical Home | May 2008 | National Academy for State Health Policy |
Title | Source | Date |
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Community Care of North Carolina Finds Success With Transitional Care | AAFP News | April 22, 2015 |
Administration bears down on states to expand Medicaid | Modern Healthcare | April 25, 2015 |
Montana governor signs Medicaid expansion bill | Modern Healthcare | April 29, 2015 |
$12 Million health care bill heads toward final approval in the House | Vermont Digger | April 30, 2015 |
NY Medicaid overhaul envisions combined outpatient care | Associated Press | May 2, 2015 |
Program aims to link newly insured to primary care doctors | West Virginia Gazette | May 4, 2015 |
Limited access to primary care could be crowding Md.’s ERs | WTOP | May 11, 2015 |
New Health Policy Brief: Medicaid Primary Care Parity | Health Affairs Blog | May 13, 2015 |
New Health Policy Brief: Medicaid Primary Care Parity | Health Affairs Blog | May 13, 2015 |
$3 Billion in Medicaid Funding Held Up in Legislature | Ozarks First | May 14, 2015 |