- Starting Aug. 1, primary care physicians in Alabama will not receive enhanced payments for services they provide to Medicaid patients.
- The Alabama Medicaid Agency (AMA) estimates the move, which will revert payments to pre-2013 levels, will save the state $14.7 million million, AL.com reports.
- Facing the reduced rates are pediatricians, family physicians, internists, general practitioners and certain other practitioners.
In a Tuesday alert to providers, the AMA offered some examples of the how the rates will change. For instance, payment for a 25-minute office visit will be $67, down from $101. Payment for a 70-minute hospital visit will drop from $194 to $113.
The change also affects immunizations. For example, payments for administering the HIB and hepatitis A vaccines, would drop from $19.79 to $8.
According to the AMA, the cuts are needed to deal with a budget crisis after the state legislature approved $700 million in funding for Medicaid — $85 million less than requested. Gov. Robert Bentley vetoed the budget, but lawmakers passed it over his veto.
The move could have implications for Alabama’s health system statewide. With access to care for Medicaid enrollees reduced, some physicians might close up shop, driving up healthcare prices for all.
Enhanced payments were mandated by the Affordable Care Act to align Medicaid payments with those for Medicare, and funded by that law in 2013 and 2014. Alabama opted to continue the enhanced payments after 2014.