As legislated by the North Carolina General Assembly in 2013 and approved by the Centers for Medicare and Medicaid Services (CMS) in June, the 3 percent rate reduction for all Medicaid physician services will be implemented beginning October 26, 2014, according to the North Carolina Division of Medical Assistance in a recent NC Medicaid Special Bulletin.
Those physicians who have attested for enhanced Medicaid reimbursement under the ACA are excluded from this 3 percent rate reduction until January 1, 2015.
For any physicians not receiving the enhanced payment, this 3 percent reduction will affect claims for dates of service on or after October 26. These claims will be processed at the new reimbursement rate, which is 97 percent of the previous rate. This rate cut was to have taken effect on January 1, 2014, but due to difficulties in implementing it with the new NC Tracks system, it was delayed. At some point, the department will reprocess all claims with dates of service between January 1, 2014 and October 26, 2014 at the lower reimbursement rate.
The North Carolina Medical Society (NCMS) is in constant contact with DMA and CSC, which oversees NCTracks, and know that this major reprocessing will not occur in the next few weeks. Watch the Bulletin and the NCMS website for updates on when this reprocessing will take place.
at 8:32 pm
What is the rationale for continuing the enhanced payments to those providers who have attested if the system will ultimately reprocess all 2014 claims and recover the 3%?
at 7:46 pm
Penalizing doctors for seeing medicaid patients. Many will opt out. So more patients will end up in the ED at many times the cost of this miserable 3% pay cut. And the 2 year medicaid parity with medicare is also going down the drain. Watch how many medicaid patients- mostly adults but even some children- lose access to primary care.