Medicaid Market Explodes as Primary Care Doctors Face Major Cut in Fees for Services

The market is flooded with millions of people who have new Medicaid coverage at the same time primary care physicians (PCP) who care for this population face a major cut in pay.

The Affordable Care Act (ACA) authorized the federal government to fund a temporary increase in fees paid to PCPs who render services to people with Medicaid. PCPs began receiving the increase a few months into 2013, but the increase will expire on December 31, 2014. Now, those 27 states that chose to expand Medicaid under the ACA and added about 9 million new Medicaid enrollees to the market are facing the challenge of deciding if they have the resources to pay these increased fees to PCPs when the temporary increase expires at the end of this year. Congress could secure a temporary extension of the increase, but the chances of that seem slim considering the ongoing dispute in Washington over the fate of "Obamacare." Some PCPs will see upwards of a 52% decrease in reimbursements if the increase is eliminated.

PLDO will be watching this issue closely and provide updated information as it unfolds, as well as information on other important ACA topics. If you have questions about the ACA or other health care-related issues, please call Attorney Jillian Jagling at 401.824.5100 or email [email protected] We welcome your comments, questions and suggestions.

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