Docs push for Medicaid pay parity extension; 15 states set to continue hike

A coalition of primary care physicians is calling on Congress to act quickly to extend higher Medicaid payments before federal funding runs out at the end of the year.

Medicaid pay parity, which pays physicians at Medicare rates for providing certain primary care services to Medicaid beneficiaries, is part of the Affordable Care Act. The federal government provided the funding for the pay increase in 2013 and 2014, but has yet to authorize a continuation of the program.

Without congressional intervention, primary care physicians in many parts of the country will see significant cuts to their Medicaid payments. On average, states pay only 59% of Medicare rates for the same primary care services when delivered under Medicaid.

The rollback could prompt physicians to limit the number of new Medicaid patients they see, creating access barriers, according to a coalition that includes pediatricians, family physicians, and internists.

“This could wipe out the progress of ensuring that low-income Americans have access to primary medical care,” Dr. Robert Wergin, president of the American Academy of Family Physicians, said in a statement. “We know from research that when Medicaid beneficiaries cannot find a physician who accepts new Medicaid patients, they face the same access problems as those who have no insurance. They are less likely to have a usual source of care, which contributes to unnecessary fragmentation and duplication of services.”