Urge Congress to Preserve Medicaid Patient Access!

This is an alert to doctors to pay attention to the message from the American Psychiatric Association regarding the preservation of Medicaid patient access and urging them to contact their legislators, asking them to support and cosponsor The Enhanced Access to Medicaid Services Act (H.R. 1831/S.755).  Details about the bill and its background are at link, https://jajsamos.files.wordpress.com/2013/05/05-08-2013-m-m-leavebehind-docx.pdf.

Physicians can “click here” at the APA Action Center TAKE ACTION! link, APA Congressional Action Network | psychiatry.org : click “Issues and Legislation”, click “Legislative Alerts and Updates”, then click “Preserve Medicaid Patient Access” and sign a prepared letter designed to be sent to their local legislators.

The letter will look like mine below. My letter was sent to Representative Dave Loebsack and Senators Chuck Grassley and Tom Harkin.

James Amos, MD

May 8, 2013

As a psychiatric physician and your constituent, I write to ask that you support H.R. 1838, the Enhanced Access to Medicaid Services Act.

Introduced in the Senate by Amy Klobuchar (D-MN) and Susan Collins (R-ME), and in the House by Steve Stivers (R-OH) and Jim Moran (D-VA), this critical legislation adds psychiatry, neurology, and OB/GYNs to the list of medical specialties eligible to receive the Medicaid Bump for 2013-14.

As you may know, the Affordable Care Act (ACA) increases Medicaid fees for certain primary care services to match Medicare rates for 2013 and 2014. Although this provision was originally intended to target primary care alone, CMS ultimately expanded the definition of eligible specialties to include all subspecialists accredited by the American Board of Internal Medicine (ABIM). Psychiatry, neurology, and OB/GYNs were excluded simply because they are not ABIM subspecialties. CMS stated that “although we recognize the role that other specialty physicians play in providing primary care services, the authority does not exist to extend the payment to other categories of physicians.”

Psychiatrists, neurologists, and OB/GYNs all provide services critical to ensuring continuity of care for Medicaid patients, and each physician is fully recognized by the American Board of Psychiatry and Neurology or the American Board of Obstetricians and Gynecologists.

Without Congressional action to expand CMS’ statutory authority, the current rule stands to have a negative impact on access to care for Medicaid patients. For example:

• A child with neurological condition such as autism or epilepsy can go to

a pediatrician who will receive 100% Medicare rates, yet a pediatric neurologist – who received additional training to treat these conditions –

will not. • A Medicaid eligible woman who is pregnant can see a family

care physician who will receive Medicare rates or an OB/GYN who will

receive lower Medicaid rates for the same services. • A child or adult

with mental illness may be treated by a generalist physician who will receive Medicare rates, but a highly trained psychiatrist would still receive Medicaid rates.

H.R. 1838 ensures that Medicaid patients have appropriate and fair access to all physicians, including psychiatrists, neurologists, and OB/GYNs. I urge that you support this legislation and its swift passage.

Thank you for your close consideration of this important initiative.


James J. Amos, MD