Those physicians who have attested for enhanced Medicaid reimbursement under the ACA are excluded from this 3 percent rate reduction until January 1, 2015.
For any physicians not receiving the enhanced payment, this 3 percent reduction will affect claims for dates of service on or after October 26. These claims will be processed at the new reimbursement rate, which is 97 percent of the previous rate. This rate cut was to have taken effect on January 1, 2014, but due to difficulties in implementing it with the new NC Tracks system, it was delayed. At some point, the department will reprocess all claims with dates of service between January 1, 2014 and October 26, 2014 at the lower reimbursement rate.
The North Carolina Medical Society (NCMS) is in constant contact with DMA and CSC, which oversees NCTracks, and know that this major reprocessing will not occur in the next few weeks. Watch the Bulletin and the NCMS website for updates on when this reprocessing will take place.