Effective January 1st, the Affordable Care Act includes a payment increase for Medicaid primary care providers bringing rates up to Medicare levels. The federal government is reimbursing states 100% of the cost of the rate increase for two years. While nationally that averages a 73% rate increase, CT providers will see only 41% increases in primary care rates, according to estimates. A survey by the Kaiser Family Foundation found that CT physician Medicaid rates are already close to Medicare levels. This confirms previous studies which also found that CT Medicaid rates are among the highest in the US. Despite these higher rates, CT is forth lowest among states in physician Medicaid participation. A study by the CT Health Policy Project found that a 2008 significant rate increase had no impact on CT physicians’ likelihood to participate in Medicaid. Barriers included billing issues, delayed reimbursement, administrative hassles, poor communications and poor provider relations. Fortunately, since that study was published last year, DSS has systematically worked to address all the recommendations.