Obstetricians, gynecologists and emergency room doctors will be shut out of the higher Medicaid pay that primary care doctors will start collecting in January.
The Obama administration made the ruling late Thursday.
Under the Affordable Care Act, Medicaid rates for primary care doctors will soon be on par with what Medicare pays. The overhaul law included the hike to encourage doctors to see the larger number of patients who will be covered by a Medicaid expansion.
The OB-GYNs and ER doctors sought to be included after regulators released preliminary rules in May saying that internal medicine and pediatric subspecialists, such as pediatric cardiologists, would be eligible for the higher pay when providing primary care services.