Four major physician groups have asked federal health officials to take action to keep states from making cuts to Medicaid rates now in anticipation of the implementation of a final Equal Access rule.
In a letter to the Centers for Medicare & Medicaid Services, the physician groups cited "the disturbing trend" of states cutting Medicaid payment rates in anticipation of the agency's October 1 start date for a new rule that will require states to assess how payments impact access to care. The letter was sent by the American Academy of Pediatrics, the American College of Physicians, the American Medical Association and the American Osteopathic Association.
In March and April, Oklahoma and North Dakota proposed cutting Medicaid payments by more than 25 percent and 47 percent respectively, to close gaps in their state budgets, the groups said. "Drastic cuts such as these will harm children, adolescents and adults and almost certainly cause clinicians to stop accepting Medicaid enrollees into their practices," the letter said.
The states may be making such cuts as a way to disguise how much future payment cuts would affect Medicaid beneficiaries. Last year, CMS issued a final rule that mandates states track and analyze the impact payments have on providers' interest in caring for Medicaid patients. The rule requires states to establish a monitoring and review plan by October 1.
The physician groups asked that CMS require that states use 2014 payment rates as a baseline to analyze access to care. "Otherwise states have the incentive to cut Medicaid payments now, before their state access plans are due to CMS, thereby creating a new, much lower baseline," the letter said.
The physician groups said that cutting Medicaid rates will result in fewer providers available to care for patients, many of them children. When North Carolina cut rates by 23 percent in 2015, a survey of pediatricians found that about 25 percent began limiting the number of new Medicaid patients they would accept, the letter said. Some pediatricians cut services, including the closing of an asthma clinic and one-third of those surveyed said they laid off staff and left other positions vacant because of a lack of funds.
In Alabama, where 500,000 children rely on Medicaid, drastic cuts are being proposed. A survey of pediatricians found almost half say they will stop accepting Medicaid or decrease the number of patients in their practice if the cuts occur. Other pediatricians say they will close their offices, retire early, or move out of state, the letter said. In fact, states that increase Medicaid payments have been able to ensure more providers accept Medicaid.
To learn more:
- read the letter