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Physicians to Lose Medicaid Raises in 2015

In 2015, physicians throughout the United States will likely receive less money for treating Medicaid patients. Back in 2010, a law guaranteed federal funding to cover the extremely high rates of Medicaid in 2013 and 2014, and President Barack Obama pledged higher payments to doctors who treat Medicaid payments in the 2015 budget. However, that provision never made it into the most recent spending bill. As a result, the amount of federal reimbursement will drop down to 2012 levels.

In the past, Medicaid, the joint federal-state health program for low-income individuals and families, has not been financially advantageous for doctors. As a result, many physicians refused to treat Medicaid patients. The Patient Protection and Affordable Care Act, however, extended health coverage to nearly 9 million low-income Americans by making it easier to qualify for Medicaid. And to encourage doctors to treat the growing population of Medicaid patients, Congress passed a measure that would allow Medicaid to pay the same rates as Medicare, which generally has higher fees.

As a result of recent budget cuts, Medicaid doctors will see their fees fall by an average of nearly 43 percent, according to the Urban Institute, a nonpartisan think tank. The Centers for Medicare and Medicaid Services, the federal agency that oversees the programs, requires that states only pay enough to ensure patients have “adequate access.” Thus, states are able to set the minimum reimbursement rates for Medicaid without congressional approval if patients are having difficulties locating a doctor willing to take care of them.

At least 15 states plan to keep paying doctors at the higher rates, even without federal subsidies. However, Florida does not plan to continue the fee increases using state funds, meaning that the Medicaid primary fees will fall at a minimum of 50 percent, if not more.  

To learn more about these changes and how they impact patients and physicians alike, consult the knowledgeable Florida Medicaid planning attorneys at the Charles Law Offices.

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