May 9, 2012
Health care law increases payments to doctors for primary care
Primary care providers received additional Medicare payments in 2011; will receive boost in Medicaid funding in 2013 and 2014
Primary care physicians serving Medicaid patients would see their Medicaid payments rise under a proposed rule announced today by Health and Human Services (HHS) Secretary Kathleen Sebelius. Thanks to the Affordable Care Act, the increase would bring Medicaid primary care service fees in line with those paid by Medicare. The boost would be in effect for calendar years (CY) 2013 and 2014. States would receive a total of more than $11 billion in new funds to bolster their Medicaid primary care delivery systems.
Secretary Sebelius also announced today that, in 2011, over 150,000 primary care providers nationwide received almost $560 million in higher Medicare payments thanks to the Affordable Care Act. This is another way the Affordable Care Act rewards doctors, nurse practitioners, physician assistants, and other primary care providers who are central to our health care system.
“Promoting high-quality primary care is a pillar of the Affordable Care Act, and this proposed rule helps States and physicians provide every American, no matter where they live, access to the care they need to stay healthy,” Secretary Sebelius said. “This new rule can help improve health and reduce costs by preventing illnesses before they happen and catching small problems before they turn into big ones.”
Today’s proposed rule would implement the Affordable Care Act’s requirement that Medicaid reimburse family medicine, general internal medicine, pediatric medicine, and related subspecialists at Medicare levels in CY 2013 and CY 2014. The increase in payment for primary care is paid entirely by the federal government with no matching payments required of States.
“The payment increase proposed today will be an important tool for States to ensure their primary care networks are prepared for increased enrollment as the health care law is implemented,” said Marilyn Tavenner, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS). “Today’s action will help encourage primary care physicians to continue and expand their efforts to provide checkups, preventive screenings, vaccines, and other care to Medicaid beneficiaries.”
Today’s announcement is another piece of the Obama Administration’s efforts to support the primary care workforce and ensure every American has high quality affordable care, including preventive services. It comes shortly after Secretary Sebelius announced Affordable Care Act grants to help build and expand community health centers across the country.
The health care law also includes other initiatives to bolster primary care and support the primary care workforce, including efforts to boost primary care residency slots, physician assistant and nurse practitioner training, and the National Health Service Corps.
For more information about today’s proposed rule visit: