On April 20, the Ohio Academy of Family Physicians wrote to Ohio Department of Medicaid (ODM) Director Maureen Corcoran to request the state submit a waiver to the Centers for Medicare and Medicaid Services (CMS) asking that Ohio be allowed to provide accelerated payments to physician practices both for fee-for-service (FFS) Medicaid and for Medicaid managed care. This would be similar to the accelerated payments that CMS has allowed for Medicare FFS patients.
To date, Oregon is the only state that has actually implemented accelerated payments but under new CMS directives, this is something that CMS will approve if states submit a waiver request. The Ohio State Medical Association supports this request.
Below is the letter sent to Director Corcoran:
On April 2, 2020, CMS issued a Frequently Asked Questions (FAQ) document that outlines how states can submit State Plan Amendment (SPA) requests to provide accelerated or periodic interim payments (PIPs) to providers in response to the COVID-19 pandemic. These accelerated payments or PIPs will be critical to helping family medicine practices on the front lines stay solvent and accessible to Medicaid beneficiaries during and after the pandemic, especially in underserved areas.
The OAFP urges ODM to submit an SPA request to CMS to provide accelerated or PIPs to physician practices in both FFS and managed care arrangements consistent with the FAQs issued on April 2 and with similar actions taken in the Medicare program. CMS has stated it will expedite these SPA requests, which we believe are critical to prevent the premature closure of practices serving Medicaid beneficiaries – as their health needs will continue (and perhaps be greater) following the pandemic.
Primary care physicians and providers on the frontlines of the COVID-19 pandemic are not only caring for the growing population of individuals infected, but are also maintaining access to and continuity of care for the ongoing needs of their communities. Unfortunately, these providers face severe and growing financial difficulties due to a range of factors including cancelled appointments and increased use of telemedicine where state coding, coverage, and payment for services vary.
OAFP member practices play a critical role in the care continuum for Medicaid beneficiaries as illustrated by the fact that Medicaid has steadily become a growing share of the payer mix for family medicine. In 2017, practices responding to a member survey reported that Medicaid comprised nearly 20% of their payer mix. At the same time, the American Academy of Family Physicians has reported that nationwide practice closures could be 4 to 6 weeks away without financial assistance – especially independent and small practices in rural and/or underserved areas that may be even more reliant on Medicaid payments.
We appreciate your consideration of this request and stand ready to partner with ODM to ensure access to care for Medicaid beneficiaries during the COVID-19 pandemic and beyond.