While the change is not required by the Affordable Care Act, Medicaid head Cindy Mann explains that it's meant to anticipate the big expansion of Medicaid in 2014.
"It's not triggered by the Affordable Care Act itself and is not a change to the law," she told reporters on a Monday afternoon call. "It's prompted by the context of states expanding Medicaid."
The rule also allows Medicaid programs to charge a bit more for non-emergency trips to the emergency department. It will allow states to charge some higher income Medicaid recipients (those earning between 100 and 150 percent of the Federal Poverty Line) more for those non-emergent visits. Usually, states would have to seek a waiver to charge different prices for care delivered in different settings (the emergency room instead of the primary care doctor's office, for example).