Finance & Enjoyment Blog

Medicaid, the health program for eligible individuals and families with low incomes and resources will undergo several changes resulting from the Health Care Reform Act of 2010. The majority of these changes will be seen by the provider and are:

  • Providers are allowed to be recognized as Accountable Care Organizations and share in cost savings on both the federal and state levels.
  • Payment rates to primary care physicians will equal 100% of the Medicare payment rate in 2013 and 2014, this will be funded solely by the federal government.
  • One new rule resulting from the act is that providers must have documented compliance programs.
  • Effective in 2014, the disproportionate share hospital payments will be reduced to reflect higher levels of insured. With an estimated $14.1 billion saved by 2020.
  • Also, a project will be established to study bundled payments.

Since Medicaid is jointly funded by the state and federal government, changes being made by these payers include:

  • States are being encouraged to fully cover preventive services and immunizations.
  • They are required to cover individuals and families at or below 133% of Federal Poverty Level.
  • The government funding schedule consists of 100% from 2014 to 2016, 95% in 2017, 94% in 2018, 93% in 2019, and 90% in 2020 and beyond.

Posted in Rules and Regulations »

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