Attestation for Medi-Cal Primary Care Rate Increase to Begin in July; FAQs Included July 9, 2013 Medi Cal, Medicaid, Payment, Physician Resource, Primary Care Primary Care Physicians, Affordable Care Act, Medi-Cal provider attestation 0 The Centers for Medicare & Medicaid Services (CMS) released regulations in November 2012 implementing rate increases for primary care physicians who treat Medicaid patients. The goal of the increase is to recruit more physicians to treat low-income patients who will be newly eligible for health coverage under the Affordable Care Act (ACA). Under the ACA, primary care physicians will see their reimbursement rates raised to Medicare levels in 2013 and 2014. According to CMS, states must also incorporate the increased payment rates into their contracts with managed care plans so that primary care physicians contracting with Medi-Cal managed care plans see the higher rates. The rate increase applies to evaluation and management codes 99201 through 99499 and vaccine administration codes 90460, 90461 and 90471-90474. The California Department of Health Care Services (DHCS) indicates that it expects to implement the rate increase in fall 2013 pending approval from CMS on the State Plan Amendment, which details California's proposed payment methodology for both fee-for-service and managed care payments. Once the SPA is approved, the increases will be retroactive to January 1, 2013. To qualify for enhanced payments, providers will first be required to self-attest eligibility. The attestation will be available through the Medi-Cal website in late July. Physicians will be required to complete the attestation online; paper copies will not be accepted. For more information on which specialties qualify for the increase, see SFMS’ July targeted member eblast about Medi-Cal Physician Rate Increase FAQs or our April blog post. Comments are closed.
