Overview: Proposed Federal Rules for Increased Medicaid Payment for Primary Care Providers

by Rebecca Farley on May 17, 2012

On Wednesday, May 9, 2012, the Department of Health and Human Services (HHS) released proposed language for implementing the Medicaid primary care rate increase under Section 1902(a)(13) of the Affordable Care Act (ACA). The purpose of the provision is to encourage physicians to participate in Medicaid, and thereby promote access to primary care services for current and new Medicaid beneficiaries to be served via coverage expansion in 2014. The proposed rule is intended to provide states with appropriate direction for implementing this provision within both managed care and fee-for-service delivery systems.

This fact sheet prepared by the Center for Health Care Strategies (CHCS) provides an initial overview of HHS’ planned regulatory approach and briefly outlines next steps for states. It was developed through Leveraging the Medicaid Primary Care Rate Increase, a national initiative made possible by The Commonwealth Fund, with additional support from the New York State Health Foundation. Look for further analyses and tools from CHCS in the future to help states and other Medicaid stakeholders prepare for the rate increase

Read the Fact Sheet.


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