The Texas Health and Human Services Commission has postponed implementation of the Medicaid reimbursement increase for primary-care physicians authorized by the Affordable Care Act, according to the Texas Medical Association (TMA).
The state will not be ready to process the increase on Jan. 1. However, HHSC officials said the new rate would be retroactive and physicians would not have to resubmit claims.
The Centers for Medicare and Medicaid Services did not finalize the rate-increase rules until Nov. 1, making it difficult for states to implement the changes, according to Helen Kent David, TMA director of government affairs. The law requires states to increase Medicaid payments to equal those of Medicare reimbursement for pediatricians, family physicians and general internists from Jan. 1 to Dec. 31, 2014. The federal government will pay the increases.
Medicaid pays an average of about 73 percent of Medicare reimbursement and about 50 percent of commercial insurance payments in Texas, according to TMA. Average fees for covered services in Texas will increase 66 percent, compared with 73 percent nationwide, according to the Kaiser Family Foundation.
