Medicaid Rate Adjustments Debated

The Department for Health and Human Services (DHHS) is moving quickly to make changes to achieve the $76 million in provider rate savings mandated by the NC General Assembly this year.  A number of proposals for how to achieve that target are still being discussed.  DHHS is considering multiple proposals that would make adjustments based on a physician’s specialty and other proposals that would that would create variable cuts to individual reimbursement codes.  Both of these solutions would cause massive divisions within the physician community that could threaten the stability of NC Medicaid. 

After careful consideration of the issue, the NCMS Board recently directed staff to investigate building a coalition of specialties that would support an alternative, fair and reasonable solution.  As the October 1 deadline for state plan amendments approaches, watch for additional alerts informing you about the progress being made on this issue.  You can find regular updates at your NCMS website

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  • Our Medicaid participation has grown from 14% to 24% within the last year. As a small practice in a rural area, we are the only specialy of our kind. Further cuts alnong with ever increasing costs would force us to stop accepting Medicaid. This would mean the patients would have to travel to larger metro areas,hours away for care.

  • I have 3 primary care physicians. If cuts continue we will not be able to continue to provide care to the Medicaid recipients. This is a great concern as a business director.

  • Benson Timmons

    Would like to be kept updated, as a surgeon I am very worried about recent developments. Our practice provides care for medicaid patients but we are very worried about further reductions as we feel that this would no longer cover overhead.