Medicaid/SCHIP

Medicaid Parity

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.