Medicaid Primary Care Providers--We Need You in the ACC!
The ACC Program is Medicaid's primary health care delivery model. ACC Primary Care Medical Providers (PCMPs) are key to the success of the ACC. As a PCMP, your practice acts as a medical home for Medicaid clients and coordinates their health needs across specialties and along the continuum of care.
How are PCMPs reimbursed?
The ACC is currently a managed fee-for-service (FFS) program. Enrolled PCMPs receive:
- The usual FFS payments for medical services provided to ACC clients
- A per-member-per-month (PMPM) for each enrolled client to support medical home services
- Quarterly perfomance incentive payments based on regional success on key quality measures
Who qualifies to be a PCMP?
You must be an enrolled Medicaid provider who meets any of the criteria below:
- An individual physician, advanced practice nurse or physician assistant with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics, or obstetrics and gynecology, OR
- A Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC) or a clinic or other group practice with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics, or obstetrics and gynecology.
How do I sign up?
Just one more step: After you’ve contracted with a RCCO, please log in to the Provider Web Portal and follow these step-by-step PCMP Online Contract Instructions to complete a Provider Agreement with the Department. Instructions start on page 10 of the MMIS Provider Data Maintenance User Guide and on page 36 of the Provider MMIS User Training.
It’s simple…contracting with one RCCO means that your practice can serve ACC clients from any RCCO in the state. You do not have to contract with multiple RCCOs. For questions about your PCMP contract, please contact ACC contract manager Matthew Lanphier (303) 866-2078.
How are Medicaid clients enrolled into the ACC?
Our ACC Client Selection page can help you learn how clients are selected for enrollment. Once selected, clients are sent an enrollment letter which includes the opportunity to pick their own PCMP or to opt-out of the ACC program. Here is an example of an enrollment letter:
Important Communication to Providers
- Letter regarding providing services and submitting claims for ACC clients
- PCMP Provider Rate Table
- Letter to urgent care providers
PCMP: Enhanced Primary Care Factors
- Enhanced Primary Care Factor Definitions
- Enhanced Primary Care Forms of Documentation
- Enhanced Primary Care Factors - Year One Results
For updates on all of the Department's programs, please see the Provider Bulletins.