AAFP Joins Effort to Speed Implementation of Medicaid-Medicare Parity Provision

Sign-On Letter Urges Immediate State Action

February 08, 2013 05:45 pm News Staff

The AAFP and several other physician-led organizations are urging state governments to take immediate measures to implement a provision in the health care reform act to bring Medicaid payment rates for primary care services up to Medicare levels for the next two years.

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In an AMA sign-on letter sent to the nation's governors and Medicaid directors, the AAFP, AMA, American Academy of Pediatrics, American College of Physicians and American Osteopathic Association are calling on states to file a required state plan amendment with CMS as quickly as possible to implement the Medicaid-Medicare parity provision. In addition, the organizations are asking states to streamline the process for physicians to self-attest that they are board-certified in family medicine, internal medicine or pediatrics, a requirement for the enhanced payments.

In the letter, the AAFP and the other groups ask state governments "to allow physicians sufficient time to complete the attestation process and remain eligible for payment increases retroactive to Jan. 1."

It also is imperative for "states to engage in an active communications campaign to inform all physicians about the primary care payment increase, especially physicians who have not previously participated in Medicaid."

"This will maximize physician participation in the program," says the letter. "As part of this effort, we urge you to reach out to the organized physician community in your state, including the undersigned organizations and/or their state affiliates."

The Patient Protection and Affordable Care Act requires states to submit a state plan amendment outlining how they will implement the parity provision -- whether they will make increased payments on a monthly or quarterly basis, for example. States have until March 31 to submit their plan amendments; CMS then has 90 days to approve, disapprove or ask for more information about the plans. States are responsible for paying physicians who qualify for the program retroactively to Jan. 1.

"We request states give physicians at least this (March 31) time frame to complete their self-attestation and still receive payment increases retroactive to Jan. 1," says the letter.

Most state Medicaid programs are not ready to implement the parity provision. Although states have until March 31 to file their state plan amendments, the earlier they complete the process, the sooner federal funds will begin to flow.