Ensuring Enhanced Access to Primary Care Act

To amend title XIX of the Social Security Act to extend the application of the Medicare payment rate floor to primary care services furnished under Medicaid and to apply the rate floor to additional providers of primary care services. 1. Short title This Act may be cited as the Ensuring Enhanced Access to Primary Care Act 2. Extension of application of Medicare payment rate floor to primary care services furnished under Medicaid and application to additional providers (a) Renewal of payment floor; additional providers Section 1902(a)(13) of the Social Security Act ( 42 U.S.C. 1396a(a)(13) (C) payment for primary care services (as defined in subsection (jj)) at a rate that is not less than 100 percent of the payment rate that applies to such services and physician under part B of title XVIII (or, if greater, the payment rate that would be applicable under such part if the conversion factor under section 1848(d) for the year involved were the conversion factor under such section for 2009), and that is not less than the rate that would otherwise apply to such services under this title if the rate were determined without regard to this subparagraph, and that are— (i) furnished in 2013 and 2014, by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine; or (ii) furnished in the 2-year period that begins on the first day of the first month that begins after the date of enactment of the Ensuring Enhanced Access to Primary Care Act (I) by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine, but only if the physician self-attests that the physician is Board certified in family medicine, general internal medicine, or pediatric medicine; (II) by a physician with a primary specialty designation of obstetrics and gynecology, but only if the physician self-attests that the physician is Board certified in obstetrics and gynecology; or (III) by physician with a primary specialty designation of psychiatry or neurology, but only if the physician self-attests that the physician is Board certified in psychiatry or neurology; . (b) Conforming amendment Section 1905(dd) of the Social Security Act ( 42 U.S.C. 1396d(dd) or furnished during the 2-year period that begins on the first day of the first month that begins after the date of enactment of the Ensuring Enhanced Access to Primary Care Act 2015,

Summary: Ensuring Enhanced Access to Primary Care Act This bill amends title XIX (Medicaid) of the Social Security Act to: (1) extend the application of the Medicare payment rate floor to certain primary care services furnished under the Medicaid program, and (2) apply the same payment rate floor to primary care services furnished under the Medicaid program by certain other providers. A payment rate floor reflects the minimum rate of payment for applicable services. Under current law, the Medicare payment rate floor for primary care services also applies under the Medicaid program to primary care services furnished in 2013 or 2014 by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine. The bill establishes an additional two-year period in which the floor shall apply to services provided a physician with one of these primary specialty designations or with a primary specialty designation in psychiatry, neurology, or obstetrics and gynecology. However, the floor shall apply only if the physician self-attests to being Board certified in the applicable specialty.