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Senior Journal.com
Leading Medical Groups Urge Congress to Stop Steep Medicaid Cuts
Doctors treating Medicaid patients face big pay cut in 2015, way below pay for treating Medicare patients

Oct. 27, 2014 - Doctors representing four major physician organizations are knocking on doors in Washington today to try and preserve the current law of payment parity for primary care and immunization services under Medicaid for at least two years. The law, set to expire at the end of this year, mandates that doctors treating Medicaid patients – the poorest patients – be paid the same as what is paid doctors treating Medicare patients with the same procedure.

If this pay parity is not extended, the nation’s primary care physicians say they will face an average pay cut of 41 cents on the dollar for providing primary care services, such as office visits for the treatment of chronic diseases like high blood pressure and diabetes to the more than 65 million Americans enrolled in Medicaid.

Collectively representing nearly 423,000 physicians, the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP) and American Osteopathic Association (AOA) representatives are meeting with dozens of congressional offices on Capitol Hill today, with hundreds more meetings taking place as part of a daylong AAP advocacy training.

As a national average, physicians treating Medicaid patients have been historically paid 59 percent of what is paid by Medicare for the same primary care service. This payment disparity can force pediatricians, family physicians and internal medicine doctors to limit the number of new Medicaid patients they can afford to take on, creating barriers for children and families in search of access to medical care.

This access barrier is especially problematic, according to the medical groups, because Medicaid serves low-income families as well as children and adults with special health care needs; access to health insurance is especially important for these vulnerable populations.

Current law increases Medicaid payments for primary care and immunizations services to Medicare levels for calendar years 2013 and 2014, but funding for this policy expires on Jan. 1, 2015.

Leaders from the AAP, AAFP, ACP and AOA are in Washington today to urge support for a bill sponsored by Senators Sherrod Brown (D-Ohio) and Patty Murray (D-Wash.), the Ensuring Access to Primary Care for Women & Children Act (S. 2694), which would extend Medicaid-Medicare payment parity for two more years.

“Since children make up nearly half of all Medicaid patients, increasing Medicaid payments for primary care services helps improve access to care for children,” said AAP President James M. Perrin, MD, FAAP.

“The improved Medicaid payment rates over the last two years have already helped pediatricians better address the needs of children in their communities by providing the resources and support they need to give the best possible care to their patients. In order to sustain improved access to care for children in Medicaid, the parity payments must be extended.”

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