Dr. Nitta, an obstetrician-gynecologist, provided primary care services for patients in rural areas 60 percent of the time and billed Medicaid at a higher rate under a law designed to encourage physicians to provide primary care, according to the AMA. However, the state’s Department of Human Services said the physician needed to pay back the Medicaid payments he received and could not continue billing at a higher rate because he is a specialist, not a primary care physician.
The state Supreme Court found the payments to Dr. Nitta were consistent with the 2010 law, which was created as part of the ACA to encourage physicians to provide primary care to Medicaid beneficiaries.
“Congress clearly intended the enhanced payments as incentives for the provision of primary care services, regardless of a physician’s other practice areas,” Hawaii’s Supreme Court said, according to AMA.
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