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HHS Releases Final Regulatory Guidance for Increased Medicaid Primary Care Payment Rates through the ACA

Today, the federal Department of Health and Human Services released a final rule regarding the increase in Medicaid primary care payment rates through the Affordable Care Act (ACA). The ACA increased rates to Medicare primary care rates for calendar years 2013 and 2014.

The increased payments will apply to primary care services provided by physicians with a specialty designation of family medicine, general internal medicine, or pediatric medicine or related subspecialties. The final rule defines how states can identify eligible providers and services, and the regulations also provide guidance for meeting statutory requirements when making payments through managed care arrangements.

The federal government will provide 100% of the financial support, also known as federal financial participation or FFP,  for this increase. In effect, the states will receive federal funds to cover the difference between their current Medicaid payment amounts and the applicable Medicare rates.

 

To view the final rule:  http://www.ofr.gov/(X(1)S(inzp4wxrutgayxne1ogtgeqq))/OFRUpload/OFRData/2012-26507_PI.pdf

The final rule will be published in the Federal Register on November 6, 2012, at which time it can be viewed at: http://www.gpoaccess.gov/fr

 

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