Ensuring Access to Primary Care for Women & Children Act

Ensuring Access to Primary Care for Women & Children Act

Amends title XIX (Medicaid) of the Social Security Act (SSAct) to require that the primary care services furnished in the two years after enactment of this Act by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine be paid at a rate that is not less than 100% of the payment rate that applies under Medicare part B (Supplementary Medical Insurance), but only if the physician self-attests as being Board certified in those areas.

Extends this 100% of Medicare payment floor, subject to certain conditions, to the following providers: (1) physicians with a primary specialty designation of obstetrics and gynecology, and self-attesting they are Board certified; (2) advanced practice clinicians; (3) rural health clinics, federally-qualified health centers, or other specified health clinics; and (4) nurse practitioners, physician assistants, or certified nurse-midwives.

Excludes from coverage of primary care services any such services provided in an emergency department of a hospital.

Prescribes additional requirements for any contract between a state and a Medicaid managed care organization.

Directs the Government Accountability Office to examine the use of alternative payment models in state Medicaid programs and identify opportunities for disseminating successful payment models among them.

Amends SSAct title XI to: (1) extend funding for development of adult health quality measures; and (2) direct the Administrator for the Centers for Medicaid and Medicaid Services and the Director of the Agency for Healthcare Research and Quality to develop such measures specific to adult individuals with disabilities and include them in the Medicaid Quality Measurement Program.