Ensuring Enhanced Access to Primary Care Act

Ensuring Enhanced Access to Primary Care Act

This bill amends title XIX (Medicaid) of the Social Security Act to: (1) extend the application of the Medicare payment rate floor to certain primary care services furnished under the Medicaid program, and (2) apply the same payment rate floor to primary care services furnished under the Medicaid program by certain other providers.

A payment rate floor reflects the minimum rate of payment for applicable services. Under current law, the Medicare payment rate floor for primary care services also applies under the Medicaid program to primary care services furnished in 2013 or 2014 by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine. The bill establishes an additional two-year period in which the floor shall apply to services provided a physician with one of these primary specialty designations or with a primary specialty designation in psychiatry, neurology, or obstetrics and gynecology. However, the floor shall apply only if the physician self-attests to being Board certified in the applicable specialty.