Lawmakers in Maryland and California seek to extend the temporary Medicaid primary care pay increase included in the Affordable Care Act.
The health reform law increased Medicaid pay for primary care services to the higher rate Medicare pays for the same services; the pay bump runs for 2013 and 2014.
Physicians’ groups, including the American College of Physicians, the American Academy of Family Physicians, and the American Academy of Pediatrics, have sought unsuccessfully to get the pay raise extended, at least through 2016.
Maryland’s Gov. Martin O’Malley, a Democrat, proposed in his fiscal year 2014 budget to extend the higher pay rates through June 2015, whether or not the federal government extends the program. Maryland is different in other ways: In January 2013, state law extended the Medicaid pay bump to all physicians – not just primary care physicians – who billed evaluation and management codes.
More than 108,000 Maryland residents are expected to gain Medicaid coverage in fiscal 2014 under the Affordable Care Act (ACA), bringing the state’s total number of Medicaid and Children’s Health Insurance Program recipients to about 1,077,000.
Gene Ransom, the chief executive officer of MedChi, The Maryland State Medical Society, says that Gov. O’Malley’s proposals are likely to be approved by the majority Democrat state legislature, which is in session until early April.
A MedChi survey conducted last fall showed that the pay increase was encouraging physicians to accept more Medicaid patients, Mr. Ransom said. Forty-six percent of the Maryland doctors who did not accept Medicaid said they were reconsidering, and 57% of those who did accept Medicaid said they planned to increase the number of Medicaid patients they would see.
The initial pay boost was covered by an increase in the tobacco tax, Mr. Ransom said.
Physicians in California are hoping that state legislation will help increase Medi-Cal rates in that state. Dr. Richard Pan, a Democrat representing the state’s 9th district, has introduced AB-1759, which would extend Medicaid pay parity indefinitely, as long as the federal government extends Medicaid parity.
"Without adequate payment, Medi-Cal becomes an empty promise of coverage without actual access to care," Dr. Pan said in a statement. Dr. Pan also serves as chairman of the assembly’s Health Committee.
According to Dr. Pan’s office, more than 8.5 million Californians are on Medi-Cal. That number is expected to rise with new enrollees under the ACA.
"Patients in our communities are already having a difficult time finding access to care," said Dr. Richard Thorp, president of the California Medical Association, in a statement. Dr. Pan’s legislation "will help to ensure that patients have real access to care as millions of new patients are enrolled in Medi-Cal," he said.
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