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    Milestone: Update Medicaid payment levels as required by the ACA

    The ACA makes changes to payments for some Medicaid-covered services that can affect Medicaid beneficiaries’ access to providers and services.


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    The ACA makes changes to payments for some Medicaid-covered services that can affect Medicaid beneficiaries’ access to providers and services.

    *Milestone details:

    *Full name: Update Medicaid payment levels as required by the ACA.

    *Relevance to the ACA:

    The ACA requires some specific changes to Medicaid payment levels, including the following:

    HCERA §1202 – Requires Medicaid agencies to pay at least the same amount that Medicare would pay for primary care services delivered by primary care providers, and provides 100% FMAP for the increased cost from 2013 until 2015.

    HCERA §1203 – Sets a formula for reductions in State Medicaid DSH allotments based in part on how states target DSH payments to hospitals. The largest reductions are imposed on states that do not target their DSH payments to hospitals with high volumes of Medicaid inpatients or high levels of uncompensated care.

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