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Provider Payments

Areas of interest under this provision:

  • Improving Payments for Primary Care Services
  • Q & A: Increased Medicaid Payments for Primary Care Physicians
  • Combined State Plan Reimbursement Template for Medicaid PCP Payment Increases and VFC
  • Disproportionate Share Hospital (DSH) Payment
  • Medicaid Emergency Psychiatric Demonstration Project
  • Improvements to the Medicaid and CHIP Payment and Access Commission (MACPAC)

 

Improving Payments for Primary Care Services: Increasing payments for primary care payments for primary care services to equal Medicare Part B payments. States will receive 100 percent federal matching funds for the increase in payments.

Q & A: Increased Medicaid Payments for Primary Care Physicians

Combined State Plan Reimbursement Template for Medicaid PCP Payment Increases and VFC

Template for Medicaid PCP Payment Increases and VFC

 

Medicaid Primary Care Payment Data Collection Template & Instructions

 

Disproportionate Share Hospital (DSH) Payment: Because the number of uninsured is expected to drop due to the eligibility changes in the Affordable Care Act, the law reduces DSH funding over time. For FY 2014-2020, applies a methodology to reduce DSH funding to states with the lowest percentage of uninsured or states that do not target their DSH payments to hospitals with a high volume of Medicaid inpatients and high uncompensated care.

Medicaid Emergency Psychiatric Demonstration Project: Establishing a three-year demonstration project under which states may provide payment to non-publicly owned and operated institutions for mental disease (IMDs) that are subject to EMTALA requirements for purposes of treating Medicaid beneficiaries ages 21-64 who are experiencing a mental health emergency.

Improvements to the Medicaid and CHIP Payment and Access Commission (MACPAC): Providing federal funding for and expands the role of the congressionally-created, independent Medicaid and CHIP Payment Advisory Commission (MACPAC; www.macpac.gov). MACPAC is tasked with reviewing state and federal Medicaid and CHIP access and payment policies and making recommendations to Congress, the Secretary of Health and Human Services (HHS), and the states.