As the Law Center has witnessed over and over again in our years of working to increase access to healthcare, the low payment rates that States offer providers who accept Medicaid patients, which are too low to entice a sufficient number to participate, create one of the greatest barriers to care for millions of low-income children. Recognizing this, the Affordable Care Act mandates that, from 2013-2014, States must raise Medicaid rates for certain primary care procedures to match federal Medicare levels. The federal government will cover the cost of the increase during this time period.
In preparing their comments to the Center for Medicare & Medicaid Services’s proposed rule for carrying out this provision, the Florida Pediatric Society called upon the Law Center’s Jim Eiseman. Mr. Eiseman counseled the Society on whether the provision would apply to not only primary care physicians and pediatricians but to pediatric specialists, a factor in determining whether the provision will be effective in increasing access to care, as specialists sometimes provide primary care services. Mr. Eiseman concluded that the provision would apply to specialists when they are acting in this capacity; his conclusion contributed to the Florida Pediatric’s Society enthusiastic support of the rule. While a more permanent solution is needed to ensure lasting, system-wide access to care, the Law Center joins the Florida Pediatric Society in their support of the rule.