Medicaid Proposes a Plan to Close Funding Gap; Physician Medicaid Reimbursement not Affected

The Office of Health Transformation (OHT) has released information showing that the Medicaid physician fee schedule will not be impacted by the Kasich Administration’s proposal to close a funding gap which was created in the 2017/18 budget. An initial proposal called for a 5%-7% across-the-board cut in Medicaid provider rates, including the physician fee schedule. However, the administration will be implementing a 5%-cut to hospital inpatient/outpatient services, increase the Medicaid Managed Care Organization (MCO) withhold by 2%, and synchronize the Medicaid Fee-for-Service/MCO payment schedule. In addition, nursing homes will not receive their legislatively approved rate increases, since Gov. John Kasich vetoed that language from the budget.

Another item of note is that the administration has proposed to partially continue the Comprehensive Primary Care (CPC) pilot program. The program will continue for existing participants and others that meet the initial qualifications (ie, more than 5,000 Medicaid patients and national certification), but it will not be expanded to smaller practices.

For more information about the plan to close the funding gap, click here.



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