With coverage expansion under the Affordable Care Act (ACA), Medicaid is expected to serve up to 80 million Americans by 2019. Ensuring sufficient provider participation is a key concern for states and the federal government as the Medicaid population expands. On November 1, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final regulations governing the implementation of the Medicaid primary care rate increase to Medicare levels for 2013 and 2014 — a provision that is intended to encourage greater provider participation in Medicaid.
This technical assistance brief reviews the final regulatory language and identifies key questions and operational steps states should consider in implementing this provision. It is a product of the Leveraging the Medicaid Primary Care Rate Increase initiative and the fourth in a series of papers designed to help states translate CMS guidance and implement the payment increase.