12/03/14
Informational Notice
To: Participating Primary Care Physicians (PCPs)
Re: Enhanced Payments for Eligible Primary Care Services Scheduled to End December 31, 2014
This informational notice provides information as part of the enhanced payments for eligible primary care services which is scheduled to end with dates of service beginning January 1, 2015.
Section 1202 of the Affordable Care Act (ACA) required Medicaid programs to pay fees to designated physicians that were no less than the Medicare fee schedule in effect for 2013 and 2014 or the fee schedule rate that would result from applying the 2009 Medicare physician fee schedule conversion factor to the 2013 or 2014 Medicare payment rates, whichever is greater. These enhanced reimbursement rates applied to payments for dates of service January 1, 2013 through December 31, 2014.
Due to the lack of continued federal funding for these enhanced reimbursement rates, the department will discontinue the payment of the enhanced rates for dates of service beginning January 1, 2015.
HFS will continue to monitor activities by Congress regarding a continuation of the enhanced reimbursement rates for dates of service on or after January 1, 2015. In the event that Congress approves the enhanced federal funding for these services, HFS will notify providers of the process for continued reimbursement.
Theresa Eagleson, Administrator
Department of Medical Programs
