CMS Rule Proposes to Place Medicaid Rates on Par with Medicare Rates for Primary Care

The Centers for Medicare & Medicaid Services (“CMS”) issued May 8 a proposed rule that would implement a provision of the Affordable Care Act requiring Medicaid to reimburse family medicine, general internal medicine, pediatric medicine, and related subspecialists on par with Medicare rates in 2013 and 2014. The increase in Medicaid payments will be funded entirely by the federal government, with states expected to receive more than $11 billion to improve their Medicaid primary care delivery systems.

The proposed rule provides information about identifying eligible providers and services, how to meet statutory requirements when making payments for services provided through managed care, and how CMS will work with the states to make the increased payments operational.