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 In 2013, the NC General Assembly included a 3% “withhold” for all Medicaid services with the intention of using that money as the foundation of a shared-savings program.  After difficulty developing the program, the “withhold” was redrafted as a cut the following year with an effective date of January 1, 2014.  That cut has not been implemented due to delays in NCTracks. 

Doctors treating Medicaid patients now face a requirement to pay back 3% of everything they have been paid by Medicaid for the last 14 months.  Every day that passes increases this financial and administrative burden. We know this money has already been spent on staff salaries, office overhead, and other basic requirements of serving the Medicaid population. 

Call or email your representative/senator and tell them how much you will have to send back to Medicaid, and what it will mean to you and your practice. Tell your legislator that you cannot afford a massive recoupment at the same time as you are being asked to transform the entire way we deliver health care to the Medicaid population. 

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NOTE:  Primary care physicians who received enhanced Medicaid payment rates in accordance with the ACA will not be subject to the 3% reduction in 2014. However, those same PCPs will be subject to the reduced rates and a recoupment of payments made for January and February 2015 dates of service.

 
 

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3 Comments

  • Emille Eason

    Our practive cannot afford a massive recoupment at the same time as we are being asked to transform the entire way we deliver health care to the Medicaid population.

  • 60% of our practice are NC Medicaid recipients. Further cuts in our reimbursement for the largest protion of our patients is crippling to our practice and completely discourages our practitioners from accepting and caring for this population. NC Medicaid already has many more rules and requirements to receive payment for seeing these patients. Too continue to pay providers less will absolutely affect the ability of these patients to receive care as we who are providing care begin to be unable to see them due to increasing financial pressures.

    Dr Clapp

  • Will there still be the opportunity to recoup some of this money in the Shared Savings Plan? NC DHHS has not informed us of how that will happen. Senate Bill 402, Session Law 2013-360.

 
 

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