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September 30, 2014

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Medicaid patients could face $4 co-pay for doctor visits

CARSON CITY — Hundreds of thousands of Medicaid recipients in Nevada could be required to contribute a $4 co-pay for a visit to the doctor’s office starting in 2015.

The U.S. Department of Health and Human Services has released new regulations on what states may impose for co-payments under the Affordable Care Act when it goes into effect.

The state Department of Health and Human Services is analyzing 400 pages of proposed regulations and must submit comments by Feb. 13 to the federal agency.

The state has budgeted $2.4 billion in 2015 for Medicaid, and has projected co-pays would bring in about $2 million. Of that $2 millin, $729,000 would go to the state and the rest would go to the federal government, which bears most of the cost for the program.

There are 317,000 Nevadans covered by Medicaid, and that number is expected to increase to 490,000 by the end of 2014, Willden said.

In his message to the Legislature, Gov. Brian Sandoval said the state “must ask certain Medicaid patients to make a modest contribution towards the cost of their own care.”

Under the proposed federal regulations, individuals in families below 100 percent of the poverty level could be assessed up to $4 for outpatient services.

Individuals in families with income of 100 percent or more of the federal level would be hit with higher fees.

The proposed federal rules say total premiums and cost-sharing may not exceed an aggregate limit of 5 percent of a family’s income in most cases.

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