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FL Medicaid Doctors to get 105% Raise

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Florida is one of five states that pay primary-care doctors so little for treating Medicaid patients that those doctors will get a raise of more than 100 percent when a federal subsidy kicks in on Jan. 1, according to a new study.

The raise, which brings Medicaid pay up to the level of Medicare for two years, is part of the  Patient Protection and Affordable Care Act. The idea is to lure more doctors into primary care and make it worth their while to care for those insured by Medicaid, the joint state and federal program for the very poor.

The federal government pays for Medicare, the program for the elderly and disabled, and determines the regional pay rates. But states determine the reimbursement rates for Medicaid by deciding how much to contribute.

The study, by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, looked at the difference between Medicaid and Medicare pay in all the states to see how much difference the PPACA pay raise will make.

The researchers found that when all the states are considered, Medicaid physicians are now averaging pay of about 59 percent of the Medicare rate.  For primary care, the average is 66 percent.

But that's the average. In two states -- Alaska and North Dakota -- the Medicaid pay rate is already higher than Medicare. In nine states, the pay rates are relatively close, within 25 percent.

At the other end of the scale are the states that pay so little for Medicaid treatment, doctors will see their checks more than double. In addition to Florida, they are California, Michigan, New York and Rhode Island.

See the study for more details.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.