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The Florida Society of Ophthalmology

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Florida Docs to See Higher Medicaid Rates


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THE CAPITAL, TALLAHASSEE, December 4, 2012.........While Florida Republican leaders grapple with carrying out the federal Affordable Care Act, the state's primary-care physicians are poised to get a raise Jan. 1 if they treat Medicaid patients.

The health law, better known as Obamacare, will lead to the federal government paying the full cost of increased Medicaid reimbursements for primary-care physicians in 2013 and 2014. Though Florida Republican leaders have balked at other parts of the law, state officials this week said they consider the increased doctor pay a requirement.

The Legislature has not taken steps to change the state budget to reflect the requirement. But Katie Betta, a spokeswoman for Senate President Don Gaetz, R-Niceville, said the state Agency for Health Care Administration already has funding authority that will allow it to move forward with the higher payments Jan. 1.

"The increased payment is mandatory and the kind of change that can happen automatically,'' Betta said in an email.

Shelisha Coleman, an AHCA spokeswoman, said state officials are working to determine how to handle the budget details, but that "we will be implementing the increase per federal law."

The increase will be at least a short-term victory for physician groups, such as the Florida Medical Association, that have long argued that low payment amounts have dissuaded many doctors from treating Medicaid patients. The federal law will lead to primary-care doctors getting reimbursed at levels similar to the Medicare program --- which are significantly higher than the amounts paid by Florida Medicaid.

"The FMA has been on record for many years advocating for an increase in Medicaid payment for all physicians,'' said Timothy Stapleton, FMA executive vice president. "We believe that increasing Medicaid physician payment rates will improve patients' access to care, lead to healthier Floridians, and save money in the long term by ensuring that fewer patients seek treatment in costly settings, like hospital emergency rooms."

An August report by state analysts estimated that the increased physician payments would cost about $425 million during the final six months of the 2012-13 fiscal year, which ends June 30. The federal government will funnel money to the state to pay those costs, as it will through 2014.

If Florida leaders want to keep the increased payments in place beyond 2014, however, the state would have to pay a share of the costs --- like it does with other parts of the Medicaid program.

Information released during a Senate committee meeting Monday indicates the change would increase state Medicaid costs by $174 million during the final six months of the 2014-15 fiscal year. The federal government would pay the full tab for the first six months of that fiscal year.

Lawmakers, meanwhile, are expected to spend the next few months deciding whether to carry out other parts of the law. That includes whether to expand patient eligibility for the Medicaid program, an issue that is separate from the higher physician payments.




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