From the February 20 Special Medicaid Bulletin 3% Physician Rate Reductions

*Please note this message applies only to Physicians and Providers who bill for Physician Services.

The 3% fee reduction in accordance with North Carolina Session Law 2013-360, Section 12H.18 (b) will be implemented on March 2, 2015. The reduction was announced in the January, 2014 Medicaid Bulletin. (See link below)

3% rate reduction for Primary Care Physician who attested for ACA Enhanced Payments
·      Subject to the 3% fee reduction enacted under Session Law 2013 – 360
o The reduction was effective Jan. 1, 2015 and will be implemented March 2, 2015.
o NCTracks will reprocess claims from Jan. 1, 2015 through March 1, 2015 at a later date.
 
3% rate reduction for Physician Services (physicians, midwives, nurse practitioners, physician assistants and certified registered nurse assistants)
·      Subject to the 3% fee reduction enacted under Session Law 2013 – 360
o The reduction was effective Jan. 1, 2014 and will be implemented March 2, 2015.
o NCTracks will reprocess claims from Jan. 1, 2014 through March 1, 2015 at a later date.
 
 
FAQ
Are physicians in North Carolina still receiving ACA Enhanced Payments?
No, enhanced payments ended for all services provided on or after January 1, 2015.
 
Why did the 3% fee reduction not apply to ACA primary care physicians until Jan. 1, 2015 when it applied to all other services effective Jan. 1, 2014?
North Carolina Session Law 2013 – 360 instructed that ACA primary care physicians were to be exempt from the 3% rate reduction until Jan. 1, 2015.
 
Current fee schedules have been adjusted to reflect the 3% fee reduction and have been posted to the DMA website. DMA will alert providers through Medicaid bulletins, NCTracks email blasts and in the NCTracks provider portal as more information is available.
 
REMINDER: Pending CMS approval, all providers will be subject to a 1% fee schedule reduction effective January 1, 2015 as enacted by Session Law 2014 – 100.