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OAFP Communications and Advocacy
Efforts on Medicaid Payment Parity
Randy Wexler, MD, Advocacy Chair
Ann Spicer, EVP
Medicaid Payment Parity in Ohio
In Ohio, Medicaid PCP reimbursement is
59% of Medicare rates
Real $$ on that table
FPs lacked information on:
Medicaid outreach insufficient
Make OAFP members aware of enhanced
payment and attestation process
Advocate for workable attestation
Help OAFP members with attestation
and payment problems
Early comments of Medicaid personnel:
What’s the big deal?
Mortgaging my children’s future – feds can’t
“You people” are always complaining
Identified Gaps; Sought to Fill
OAFP Maintained Problem List
Ask OAFP members to let us know if
they attested and weren’t on approved
Gave us the ammunition to use to
convince Medicaid director of problems
Medicaid pledged to work with us on
Slow, difficult process
Touched Members in Positive Way
Generated more calls and emails than
any issue in recent memory
Touched members we have not had any
contact with before
Made some loyal friends for life
Ended every conversation with, “thank
you for being an OAFP member.”
Thank you for working so hard on this
and keeping me updated!
Thanks for your assistance,
patience, and hard work. I really
We appreciate the value of OAFP
Thanks for dogging this on my/our
Thank you for your persistence and
assistance with this!
If you are ever in NW Ohio I would be
delighted to buy you an adult beverage.
Thanks for all your help.
Have eliminated most of our problem list
Most have still not received payment
FFS Medicaid paid at enhanced rate
Managed care to receive $ in late Oct. to
Figuring out retroactive payments scheme
Delay is Harmful
Purpose of enhanced payment was to
increase numbers of PCPs seeing Medicaid
Still haven’t been paid so it is likely that
increase hasn’t happened
Will be used against us when we argue for
continuation of enhanced payment beyond
Dec. 31, 2014
Having input into the implementation of
legislation is just as important as having
input into the legislative process itself.
Advocacy journey doesn’t end when a bill
is signed into law.