In May 2012, the Department of Health and Human Services (HHS) released proposed regulatory language for implementing the Medicaid primary care rate increase under Section 1902(a)(13) of the Affordable Care Act (ACA). The provision was designed to encourage physicians to participate in Medicaid, and thereby promote access to primary care services for current and new Medicaid beneficiaries to be served via coverage expansion in 2014. The proposed rule was intended to provide states with appropriate direction for implementing this provision within both managed care and fee-for-service delivery systems.

This fact sheet, developed by the Center for Health Care Strategies (CHCS), provides an overview of HHS’ planned regulatory approach and outlines next steps for states. It was developed through Leveraging the Medicaid Primary Care Rate Increase, a national initiative made possible by The Commonwealth Fund, with additional support from the New York State Health Foundation.