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Ob-Gyns Excluded From Medicaid Pay Increase Under Affordable Care Act

Ob-Gyns Excluded From Medicaid Pay Increase Under Affordable Care Act

November 6, 2012 — Ob-gyns will be ineligible for the higher Medicaid reimbursement rates primary care physicians will begin receiving in January under the Affordable Care Act (PL 111-148), according to a final rule issued by the Obama administration last week, Kaiser Health News' "Capsules" reports.

The higher rates are aimed at encouraging more doctors to treat Medicaid beneficiaries. In general, Medicaid reimbursement rates are much lower than what doctors receive through Medicare and private health plans. The higher rates will mean an average 64% increase in Medicaid reimbursement for providers who are included, according to a report by the Urban Institute.

Ob-gyns, along with emergency department doctors, pushed to be included in the increase after federal regulators said in May that internal medicine and pediatric sub-specialty physicians would be eligible.

The change takes effect Jan. 1, but states have until March 31 to file paperwork with CMS detailing how they will implement it. As a result, it likely will be several months until doctors start receiving higher payments (Galewitz, "Capsules," Kaiser Health News, 11/2).