Companion Bill Introduced in House to Extend Medicaid Pay Parity

Ensuring Access to Primary Care for Women & Children Act
Identical Bills Now Pending in Both Chambers

November 18, 2014

(Washington) -Rep. Kathy Castor (D-Fla.) Monday introduced House legislation, the Ensuring Access to Primary Care for Women & Children Act (H.R. 5723) to ensure continued access to vital primary care services. David A. Fleming, MD, MA, MACP, president of The American College of Physicians (ACP), noted that, "ACP applauds Rep. Castor's leadership in the House on this key issue, which will extend current-law payment rates under Medicaid for certain primary care and immunization services to at least the level of Medicare through 2016."

Companion legislation to H.R. 5723 is also pending in the Senate, as introduced by Sens. Sherrod Brown (D-Ohio) and Patty Murray (D-Wash.) in July.

As outlined in a letter today from ACP in support of H.R. 5723, Dr. Fleming pointed out "This will help ensure access to vital primary care services delivered by primary care and related subspecialty physicians for many of this nation's most vulnerable citizens. It will ensure sufficient payment for primary care services and vaccinations, and to the physician specialties and subspecialties that deliver them, is essential to providing access for the 65 million women, men, adolescents and children enrolled in Medicaid."

This legislation will extend and ensure continued funding of what is often referred to as the Medicaid Primary Care Pay Parity Program under current law. It ensures that physicians practicing in the specialties of family medicine, pediatrics, and internal medicine as well as related internal medicine and pediatric subspecialists continue to receive Medicare-level reimbursement rates for providing primary care and immunization services to patients enrolled in Medicaid.

This legislation also includes physicians practicing obstetrics and gynecology as qualified specialists, subject to the eligibility requirement that at least 60 percent of their Medicaid billings consist of primary care services as defined under current law.


The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.


David Kinsman, (202) 261-4554
Jacquelyn Blaser, (202) 261-4572