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Important Notice for Primary Care Providers

Thursday, April 4, 2013

Important Notice for Primary Care Providers

Information for Primary Care Providers on increased payment rates for CY 2013 and CY 2014

The District of Columbia is implementing provisions of the Affordable Care Act that increase payment rates for certain primary care services. To qualify for the increased rates, physicians must have a specialty designation of family medicine, general internal medicine or pediatric medicine and complete the Medicaid Primary Care Practitioners Self-Attestation Form.

Enhanced payment rates will be paid for claims submitted on or after the date upon which DHCF receives the self-attestation form from an eligible provider. To be eligible for enhanced payment rates for claims retroactive to January 1, 2013, an eligible provider must submit the self-attestation form no later than July 1, 2013.

NOTE:  Enhanced payments (including retroactive active payments) will not be made until DHCF received needed approvals from the Centers for Medicare and Medicaid Services (CMS). DHCF estimates this will occur in late summer, 2013. DHCF has developed an FAQ and a Power Point Presentation that contain important information about this program.

Questions? Please call Provider Services at (202) 698-2000.

Information, including the Medicaid Primary Care Practitioners Self-Attestation Form, the list of eligible codes and the rates will also be posted on the Provider Portal at https://www.dc-medicaid.com/dcwebportal by April 19, 2013.