Expansion of the Medicaid Physician UPL Supplemental Payment Program

InsightsClient Alert

In a memorandum dated January 25, 2018, from John Upchurch, the Georgia Department of Community Health (DCH) announced it is seeking approval from the Centers for Medicare and Medicaid Services (CMS) to expand the Physician UPL program to include the following:

  1. All physician practices affiliated with a public teaching hospital enrolled in Georgia Medicaid.
  2. Medicaid‐eligible services provided by eligible physicians and mid‐level providers.

Participation in the Physician UPL program is voluntary. According to the memorandum, the physician practice must be able to secure a commitment from a hospital authority, or other government body, to make an intergovernmental transfer (IGT) of funds to DCH to finance the state share of the supplemental payment.

Upon CMS approval, the Physician UPL program will be effective retroactively to July 1, 2016. NOTE: Physicians and mid‐level providers receiving supplemental UPL payments will not be eligible for the higher Medicaid fee schedule paid to attested primary care physicians.

The following required documents must be completed and submitted by the dates listed.

  • Attestation Statements are due by Monday, February 19, 2018.
  • Excel Templates are due by Monday, February 26, 2018.

The required documents and details regarding submission may be accessed at https://dch.georgia.gov/physician‐upl.

If you have any questions or would like assistance related to the Physician UPL program, please contact our Albany office at (229) 883‐ 7878 or our Atlanta office at (404) 220‐8494. edit button to change this text.