Article Review: State Awaiting Feds' OK to Boost Medicaid Payments

Shefali Luthra’s article in The Texas Tribune concerns a provision of the Affordable Care Act's healthcare reform that, at the time of the article’s publishing, had not yet been implemented in Texas and several other states. The provision, which mandates that Medicaid payments made to primary care doctors must rise to the same rate as Medicare’s reimbursement payments, has been delayed because the federal government hasn’t approved the states’ plans for boosting those payments. In Texas’ case, this is partially due to a late filing of paperwork detailing the state’s methodology for managed care. Although Texas received federal approval in May for their plan to increase payments using the fee-for-service system, they submitted their methodology to the federal government in July, three months after the official deadline. A spokeswoman from the Texas Health and Human Services Commission blames the delayed submission on not receiving the final regulations on the rate increase process from the Centers for Medicaid and Medicare Services until November of last year. Family physicians in Texas are unhappy with the delay. Many of them took on a greater number of patients in anticipation of receiving increased payments. Once the state’s plan is approved federally, the state intends to retroactively pay the affected physicians.

This article raised deep concern within me about the ability of the effectiveness of Texas’ government. While the federal government should be working hard to ensure that these rate increase plans are implemented nationwide, the state should be held more accountable for the late submission of their methodology. The state’s Health and Human Services Commission received the federal rate increase guidelines a full six months before the deadline for submitting their managed care methodology, which seems like more than enough time to get a plan together and sent in for review. I hope that the affected doctors receive their payments soon.

Reference

Luthra, S. (2013, August 13). State awaiting feds' OK to boost Medicaid payments. The Texas Tribune. Retrieved from http://www.texastribune.org/2013/08/13/no-timeline-state-boost-doctor-medicaid-payments/