TMA Asks Legislature to Increase Medicaid, CHIP Payments for Physicians

TMA and 17 state specialty societies called on the Legislative Budget Board (LBB) asking for action to increase "utterly inadequate physician payment rates" in Texas Medicaid and the Children's Health Insurance Program (CHIP). 

In testimony regarding physician Medicaid and CHIP payments, TMA and the other organizations ask the LBB specifically for the following: 

  • Maintain Medicare parity in the 2016 to 2017 budget for primary care physicians currently receiving the higher rates. Congress enacted and funded the higher rates, but without legislative or congressional action, the rates will expire Dec. 31, 2014. At least six other states, including Alabama, have voted to sustain the higher payments to ensure an adequate physician network for their Medicaid beneficiaries.
  • Extend the parity payments for primary care to services provided to CHIP.
  • Establish competitive Medicaid and CHIP payment rates for physician specialties that are not included in the Medicaid to Medicare parity increase. 
  • Reverse the 8-percent payment reduction for physician assistants and advanced practice registered nurses practicing under physician supervision. The cut, which will take effect in early 2015, will undermine Texas' efforts to promote team-based models of care, an essential element of reforming the Medicaid delivery system. 

The testimony cites preliminary data from TMA's 2014 physician survey, which indicates only 34 percent of physicians accept all new Medicaid patients, a 33-point decrease since 2000, when 67 percent of physicians said they would accept all new Medicaid patients. In the letter, TMA says "grossly inadequate payment is the single overriding reason physicians cite for why they or their colleagues limit or no longer participate in Medicaid." 

The letter stresses physicians want to participate in Medicaid "as a means to provide health care to vulnerable, low-income Texans," but acknowledges that "as owners of small businesses, facing ever more costly and demanding federal and state regulatory burdens, many just cannot afford to stay in a program that pays less than half their costs."

TMA also asked the LBB to support the Department of State Health Services' requests for funding for women's health, mental health, chronic disease prevention, tobacco prevention, substance abuse services, community mental health initiatives, and improvements to the state hospital system.  

"TMA strongly urges the Legislative Budget Board to seize this opportunity to invest in Texas' public health infrastructure as it relates to these costly issues and prevent paying an even higher price in the future," the letter states.

Action, Oct. 1, 2014

Last Updated On

October 10, 2014

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