Doctors Demand Better Medicaid Reimbursements

Janice Simmons, for HealthLeaders Media , January 13, 2010

Several major primary care physician groups, plus the AFL-CIO and Consumers Union, are among the 118 groups that sent a letter Tuesday to congressional leaders in the House and Senate urging them to support "equality of Medicaid and Medicare rates" for primary care services.

The groups are calling for the lawmakers to "ensure meaningful access to care under the proposed Medicaid expansion" by adopting in the reconciled House Senate health reform agreement the initial House provision that would bring Medicaid reimbursement rates for primary care "in line with comparable Medicare rates within four years."

They added that Medicaid rates, which average 66% of Medicare rates for primary care services, have been "woefully inadequate" in covering the cost of providing care. Among those who rely on Medicaid to meet their healthcare needs are millions of low income women, children, minorities, and individuals with disabilities.

Medicaid rates are "woefully inadequate" to cover the cost of providing care. If the Medicaid reimbursement levels are not addressed in conjunction with the Medicaid expansion, the U.S. may face the prospect of leaving poor and medically vulnerable residents behind "despite the promise offered by healthcare reform,” according to the groups.

"We are very concerned that failure to address reimbursement disparities will weaken an already fragile network of Medicaid providers at a time when the demand for their services will be growing," ACP President Joseph W. Stubbs, MD, FACP, said in a statement. "It is critical that while we provide access to care for so many more low income Americans, we also adjust payments for primary care services so they are equal to Medicare rates."

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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