July 31, 2014

State of Alabama
Press Release: Medicaid

Stabilizing physician workforce is basis for "bump" extension

Medicaid-enrolled primary care physicians who qualify for enhanced payments known as the “bump” will continue to receive those payments through September 30, 2015, State Health Officer Dr. Don Williamson announced.

The “bump” refers to the Affordable Care Act requirement that state Medicaid programs increase or “bump” up in payments to certain physicians for specified primary care services beginning January 1, 2013 through the end of 2014.

While the additional payments were originally triggered by the Affordable Care Act, the decision to extend the payments for an additional nine months was more about ensuring that the state had an adequate number of primary care physicians as it prepares to implement major Medicaid program reforms, Dr. Williamson said.

Physician participation in the Medicaid program is a concern, he said, because approximately 22 percent of enrolled primary care physicians now receive 90 percent of all claims payments. The other problem is that Alabama has health professional shortages in 62 of its 67 counties.

“This limits your ability to do a lot of other things,” he said. “If you’re going to move patients out of the emergency room into physicians’ offices or into other care sites, you have to engage that other 78 percent and make reimbursement reasonable so that they will participate. The 'bump' came along at a time to help us stabilize our physician workforce as we are trying to undertake a major transformation of our Medicaid system," he said.

Funding for the additional payments in 2015 is included in the Agency’s 2015 budget approved by the state Legislature. Eligible physicians include board-certified family medicine, pediatric medicine, general internal medicine and related specialties or eligible physicians who can verify that 60 percent or more of the Medicaid codes they billed in the previous year were primary care codes and certain codes associated with vaccine administration listed in ACA. Health departments, federally-qualified health centers (FQHCs) and rural health clinics are not eligible for the fee increase.  

  • For more information, visit http://medicaid.alabama.gov
  • For more state-wide press releases, click here