The Affordable Care Act (ACA) included a critical provision to increase Medicaid payment rates for certain evaluation and management and vaccine administration services in 2013 and 2014. While implementation of this provision has taken time, pediatricians in a number of states are beginning to see increases in their Medicaid payments.

Peter Pogacar, M.D., FAAP, of East Greenwich Pediatrics in East Greenwich, R.I., is one of those pediatricians.

“Our Medicaid payments for a routine visit have essentially doubled,” said Dr. Pogacar. “This reinforces our ability and commitment to care for children enrolled in RIte Care (Rhode Island’s Medicaid managed care and Children’s Health Insurance Program). We are finally being paid appropriately for our services.”

Historically, state Medicaid payment rates have been inadequate, leading pediatric practices to make difficult decisions as to whether they should accept Medicaid patients or increase their numbers. The Academy has long sought an increase in Medicaid payment...

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