Technical Error Involving PCP Supplemental Payments

It has come to the attention of AMS that many Medicaid primary care physicians were not fully reimbursed for their quarterly Medicaid PCP Supplemental Payments that processed in July.

To address the issue, Medicaid is generating payments to the physicians in the amounts they are due. The payment date was September 4. The error occurred due to a technical issue created by the larger-than-expected volume of data. To resolve the problem, DHS is now using a more stable platform using newer technologies that were not available when the program began. The new system configuration will allow Medicaid to handle the larger volume of data.

On a different note, beginning in October and moving forward, physicians who participate in the PCP Supplemental Payment program may notice a change in their reimbursement rates for claims with 2014 dates of service due to newly published CMS rates. CMS did not publish these rates within a time frame that would allow DHS to update their computer system to pay participating physicians correctly beginning in 2014. All previously paid claims for 2014 dates of service could be affected by reduced or increased rates and may require payment adjustments.