loading…
loading…
loading…
the fee-for-service rate for these codes, and adjust managed care 1 capitation rates accordingly; and 2 (d) Not duplicate rate increases provided in subsection (52) of 3 this section. 4 (52) $1,055,000 of the general fund—state appropriation for 5 fiscal year 2025 and $2,046,000 of the general fund—federal 6 appropriation are provided solely to maintain and increase access for 7 primary care services for medicaid-enrolled patients through 8 increased provider rates beginning January 1, 2025. Within the 9 amounts provided in this subsection the authority must: 10 (a) Increase the medical assistance rates for adult primary care 11 services that are reimbursed solely at the existing medical 12 assistance rates on a fee-for-service basis, as well as through 13 managed care plans, by at least 2 percent above medical assistance 14 rates in effect on January 1, 2023; 15 (b) Increase the medical assistance rates for pediatric primary 16 care services that are reimbursed solely at the existing medical 17 assistance rates on a fee-for-service basis, as well as through 18 managed care plans, by at least 2 percent above medical assistance 19 rates in effect on January 1, 2023; 20 (c) Increase the medical assistance rates for pediatric critical 21 care, neonatal critical care, and neonatal intensive care services 22 that are reimbursed solely at the existing medical assistance rates 23 on a fee-for-service basis, as well as through managed care plans, by 24 at least 2 percent above medical assistance rates in effect on 25 January 1, 2023; 26 (d) Apply reimbursement rates required under this subsection to 27 payment codes in a manner consistent with the temporary increase in 28 medicaid reimbursement rates under federal rules and guidance in 29 effect on January 1, 2014, implementing the patient protection and 30 affordable care act, except that the authority may not require 31 provider attestations; 32 (e) Pursue state plan amendments to require medicaid managed care 33 organizations to increase rates under this subsection through 34 adoption of a uniform percentage increase for network providers 35 pursuant to 42 C.F.R. Sec. 438.6(c)(1)(iii)(B), as existing on 36 January 1, 2023; and 37 (f) Not duplicate rate increases provided in subsection (51) of 38 this section. 39 p. 231 ESSB 5187.SL