The Affordable Care Act (ACA) established temporary bonus payments for primary care physicians in some specialties. To qualify, you must have attested that at least 60 percent of your Medicaid-billed codes were “qualifying codes.”
However, Indiana Medicaid is reminding physicians and other providers who self-attested in 2013 as qualifying under the provision that you are required to self-attest each calendar year the ACA rate increase is in effect. However, one attestation will serve both fee-for-service (FFS) Medicaid and risk-based managed care (RBMC) programs.
Therefore, physicians who self-attested under the 60 percent provision during 2013 should be aware their qualification for the increased payment ended Dec. 31, 2013. You must re-attest for 2014. Services provided during any lapses in time between the end of the calendar year and re-attestation will not be eligible for the rate increase.
Find the ACA Physician Self-Attestation Form on the Forms page here.
Learn more about these payments in a recent Banner Page article here.
Update on bonus payment
A Family and Social Services Administration (FSSA) official answered the following questions for the ISMA regarding the status of promised Medicaid bonus payments and managed care entities (MCEs):
- Is one attestation all you need if you contract with the MCE’s and Traditional Medicaid?
- It is one per year, but the attestation applies to both the FFS and RBMC programs
- When the monies are distributed, will the funds come from each particular MCE?
- Each MCE will distribute payments based upon the utilization for each plan.
- Have the funds been released to the MCEs yet?
- The funds have not been released to the MCEs. The contracts have recently been approved by the Centers for Medicare & Medicaid Services (CMS) and fully executed through the state’s signatory approval process. FSSA was finalizing the bonus payment calculations and was expected to submit the information and funds to the MCEs by the end of December. The MCEs will be responsible for issuing payments to providers in 2014.