Letter from the Editor #650

Last week CMS finally issued guidelines temporarily increasing primary-care physician payments from Medicaid. The new Medicaid Rule (click here for the complete PDF) which implements a provision of the Patient Protection and Affordable Care Act, details the extent and target of the increase, which takes effect in January and lasts through 2014.

The provision is designed to match Medicare rates, which sounds good but the rule specifically covers only the difference between the Medicare rate and states’ Medicaid rates as of July 1, 2009. The additional federal funding may not be enough to increase the rate to Medicare levels because some states have enacted Medicare provider rate cuts since mid-2009.

According to HHS Secretary Kathleen Sebelius, "The healthcare law will help physicians serve millions of Americans across the country." She went on to say that, "By improving payments for primary-care services, we are helping Medicaid patients get the care they need to stay healthy and treat small health problems before they become big ones."

The American Academy of Family Physicians, in a news release, hailed the increase as a way to keep more physicians from joining the nearly 20% who have stopped accepting new Medicaid patients. However, according to Dr. Jeffrey Cain, president of AAFP, "the temporary nature of the increase will limit its benefits, and Congress needs to do something long term."

Part of our three-part morning routine for diabetes and weight control includes 2-3 minutes of exercise within the first hour of awakening and we would like to have our patients do that before they eat. Now a new study from the Glasgow University’s Institute of Cardiovascular and Medical Sciences shows that Exercising Before Breakfast Increases Fat Loss. Maybe you should have your patients give this a try. 

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Dave Joffe, Editor-in-chief