Under the ACA, beginning in 2014, millions of uninsured Americans will gain Medicaid in states that implement the Medicaid expansion. To help ensure access to meet expected higher demands for care in Medicaid, the health reform law requires states to pay certain physicians Medicaid fees at least equal to Medicare's for many primary care services in 2013 and 2014. The idea behind the fee increase is to boost physician participation in Medicaid and to provide increased support for physicians who already participate and who might expand their Medicaid service. The fee increase is federally funded. On November 6, 2012, CMS published a Final Rule outlining how states are to implement the higher fees. This brief explains major elements of the statute and rule.
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