Due to the ongoing advocacy effort of a coalition of state medical societies, N.C. Medicaid has abandoned a rate cut that has been pending since Jan. 1, 2015. NCMS estimates that approximately $28 million in physician payments have been preserved.
You may recall that the General Assembly approved a 1 percent rate reduction in late 2014. The North Carolina Medical Society (NCMS) opposed the cut in the legislature and continued working to prevent its implementation while under review by the Centers for Medicare and Medicaid Services (CMS). NCMS teamed up with the NC Pediatric Society and the NC Academy of Family Physicians to show CMS the cut’s potential negative impact on the ability of Medicaid patients to access care.
Now more than two years later, NC Medicaid is no longer seeking approval from CMS for the 1 percent cut, and the reduction will not be implemented now or retroactively. Had the cut been applied, physicians would have been required to repay 1 percent of their Medicaid payments from the last two years. Beyond the lost revenue, the recoupment effort likely would have affected cash flow and business operations for many Medicaid practices.
Read the memo updating the State Plan Manual with this change here.