AAFP Creates Map of Medicaid Parity Provision Implementation
(HealthDay News) – Most states have implemented the Affordable Care Act's Medicaid parity measure for certain primary care services, according to a report published by the American Academy of Family Physicians (AAFP).
Noting that the parity provision in the Affordable Care Act states that family physicians who offer specific primary care services to Medicaid patients are eligible for a payment boost to Medicaid levels, the AAFP has produced a map to allow family physicians to track the progress their state has made in implementing this provision. In order to qualify, physicians have to self-attest to be board certified in primary care specialties and show that >60% of the evaluation and management codes submitted to Medicaid were for primary care services.
According to the map, which was based on data from an American Medical Association/AAFP chapter survey, most states have started paying at enhanced rates. However, in at least seven states, fee-for-service Medicaid programs, but not managed-care Medicaid programs, have been implemented. No payments have been reported in an additional seven states.
Medicaid parity is a complicated provision, and it's important to keep in mind that it's "not entirely straightforward who gets defined as a 'primary care provider' and which services get defined that way," said Matt Salo, executive director of the National Association of Medicaid Directors, according to the AAFP article.