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Medicaid Payment Parity

The AMA believes that all physicians seeing Medicaid patients should be paid at least the Medicare rate to ensure adequate access.

Research studies have demonstrated that low Medicaid reimbursement rates can significantly affect a physician’s ability to accept new Medicaid patients into his or her practice. Congress has recognized that low provider participation in Medicaid can negatively affect access to health care, and took action to increase Medicaid payments for certain primary care services to be not less than the Medicare payment rates for 2013 and 2014.

On July 30, 2014, Senators Sherrod Brown (D-OH) and Patty Murray (D-WA) introduced S. 2694, the “Ensuring Access to Primary Care for Women and Children Act.” This legislation would extend the application of the Medicare payment rate floor to primary care services provided by primary care physicians under the Medicaid program beyond 2014, when the enhanced payment rate is scheduled to expire under current law. AMA supports this legislation.

Co-sponsorship List

In addition, Rep. Kathy Castor (D-FL) introduced H.R. 5723, the "Ensuring Access to Primary Care for Women and Children Act," on November 17, 2014. This legislation would extend Medicaid payment rates under current law for certain primary care and immunization services to at least the level of Medicare through 2016. AMA supports this legislation.