|What do providers need to do to qualify for the 2013-2014 federal primary care rate increase?|
Please attest using the secure attestation form. Only providers who attest using this form will qualify for the increased FFS rate.
Providers who do not attest will not qualify for the increased FFS rate.
Providers who only bill an OHP health plan, but not DMAP, must attest with the health plan.
|When will DMAP apply the 2013-2014 primary care rate increase?|
DMAP will apply the FFS federal primary care rates based on the dates qualified providers submit their attestations. Only services rendered on or after Jan. 1, 2013 qualify for the new rates:
Increased FFS rate will apply to
qualifying services rendered on or after:
Jan. 1 to Mar. 31
Apr. 1 to June 30
July 1 to Sep. 30
Oct. 1 to Dec. 31
Note: DMAP began paying the FFS federal primary care rates in early July. We are planning to reprocess additional eligible claims to retroactively pay the federal rate increase (details to be determined).
|Which provider types are eligible for the 2013-2014 primary care rate increase?|
Physicians with a specialty designation of family medicine, general internal medicine, or pediatric medicine; or
Nurse practitioners and physician assistants billed through, and working under the supervision of, a qualified physician.
|Where can OHP health plans learn more about the 2013-2014 primary care rate increase?|
|Where can health care providers learn more about the 2013-2014 primary care rate increase?|
|Is Oregon's definition of primary care provider changing?|
No. Oregon is not changing its definition of Medicaid primary care provider. Instead, Oregon will add the federal definition alongside Oregon's definition in order to identify primary care providers who qualify for the new two-year reimbursement increase.
The CMS definition only determines which providers may qualify for the two-year reimbursement increase; it does not reduce or change reimbursement for other providers or programs. Oregon's primary care providers who meet CMS's definition will receive an enhanced rate for two years, those who do not will receive their existing Oregon primary care rate
|Why is Oregon increasing reimbursement rates for some primary care providers?|
In November, the Centers for Medicare and Medicaid Services (CMS) announced that practitioners who meet their new definition of primary care provider would see an increased Medicaid reimbursement rate for two years under section 1202 of the federal Affordable Care Act (ACA).
CMS revised sections 1902(a)(13), 1902(jj), 1905(dd) and 1932(f) of the Social Security Act to require increased payment for certain Medicaid primary care services provided in calendar years 2013 and 2014.
|What services are eligible for the federal primary care rate increase?|