Increased Med-QUEST Doctor Reimbursement Rates Extended for Six Months

Med-QUEST will extend its increased reimbursement rate through June 30, 2015 . Courtesy photo.

By Maui Now Staff

The Med-QUEST Division (MQD) of the state Department of Human Services has announced that it will extend its increased reimbursement rate through June 30, 2015 for certain services provided by qualified primary care physicians (PCPs). The previous two year provision of increased reimbursements ended on Dec. 31, 2014.

The MQD will follow the same reimbursement method used over the last two years per Section 1202 of the Affordable Care Act. During this time in Hawai‘i, 1,039 PCPs received a total increase of about $44 million for services rendered to Medicaid patients.  Section 1202 requires that Medicaid programs increase reimbursement for specific primary care services provided by qualified PCPs.

The current six month extension was granted by the Hawai‘i State Legislature after the MQD requested an appropriation for reimbursements in fiscal year 2014. The federal matching rate for the increased reimbursement starting in 2015 will be 52 percent, compared with 100 percent federal funding under the Affordable Care Act over the last two years. However, the new state appropriation will cover the difference.

Qualifying physicians must practice family medicine, general internal medicine or pediatric medicine, or specialty fields recognized by the American Board of Medical Specialties, the American Osteopathic Association, or the American Board of Physician Specialties. Physicians who have already been receiving the increased reimbursements will continue to qualify.

After June 30, 2015, the reimbursement rate for Medicaid PCPs will be dependent upon available funding. Expanding the increased rate to other Medicaid providers like psychiatrists, neurologists, obstetrician-gynecologists, and APRN’s (advanced practicing registered nurses), will also depend upon funding availability.

For more information about MQD PCP reimbursement and steps to qualify, call (808) 692-8099 or visit the MQD website.