Working with Medicaid/Medi-Cal patients

[Guest guest]

Hi All,I am really confused by the idea that it is illegal for us to charge someone on Medicaid (State funded medical).  That makes absolutely no sense to me and seems to me it would violate thier right to choose who they see.  I work with moms all the time who are on California's Medi-Cal program and medicaid.  They pay me out of pocket.  They are not obligated to ONLY see who the state wants them to see.  If they want to pay someone out of pocket for health care of any sort it is their choice and right to do so.  I have a number of moms who are on the state medical program and yet they will go see a particular Dr in town because he is a naturopathic Doc.  He will not vaccinate, he does not take insurance.  He does some CST.  ALL his patients pay him directly.  He pratices medicine in a holistic manner and they save to pay for that.

So...my point being that there should be ZERO issue for us to see anyone regardless of what medical coverage they have (or don't have).  If they choose to pay us privately it is THEIR right and THEIR choice. 

Warmly,Jaye

[Guest guest]

So true Jaye. The problem comes when someone accepts Medicaid, but still wants payment – either they plan to reimburse the patient what the state sends them (months later) or they don’t like the payment from the state and want more on top of the state payment. So the state sees it as being paid twice for one service. A local hospital got in a lot of trouble because the anes. didn’t like how little Medi-Cal paid them for labor epidurals and demanded $400 cash upfront before they would do one. Then they billed Medi-Cal for the epidural, double billing is illegal.

Felicia Henry, BCCE, IBCLC

Oxnard, CA

From: Jaye Simpson, IBCLC

Sent: Friday, November 11, 2011 6:51 AM

To:

Subject: Working with Medicaid/Medi-Cal patients

Hi All,I am really confused by the idea that it is illegal for us to charge someone on Medicaid (State funded medical). That makes absolutely no sense to me and seems to me it would violate thier right to choose who they see. I work with moms all the time who are on California's Medi-Cal program and medicaid. They pay me out of pocket. They are not obligated to ONLY see who the state wants them to see. If they want to pay someone out of pocket for health care of any sort it is their choice and right to do so. I have a number of moms who are on the state medical program and yet they will go see a particular Dr in town because he is a naturopathic Doc. He will not vaccinate, he does not take insurance. He does some CST. ALL his patients pay him directly. He pratices medicine in a holistic manner and they save to pay for that.So...my point being that there should be ZERO issue for us to see anyone regardless of what medical coverage they have (or don't have). If they choose to pay us privately it is THEIR right and THEIR choice. :)Warmly,Jaye__________ Information from ESET Smart Security, version of virus signature database 6622 (20111111) __________The message was checked by ESET Smart Security.http://www.eset.com

[Guest guest]

So I can decide not to become a Medicaid provider, and I can accept Medicaid-eligible mothers who are willing to pay me themselves. But am I allowed to offer a discounted rate as long as they show proof they are eligible for WIC or Medicaid? Is that the equivalent of a sliding scale?

Dee Kassing

Subject: Re: Working with Medicaid/Medi-Cal patientsTo: Date: Friday, November 11, 2011, 3:23 PM

So true Jaye. The problem comes when someone accepts Medicaid, but still wants payment – either they plan to reimburse the patient what the state sends them (months later) or they don’t like the payment from the state and want more on top of the state payment. So the state sees it as being paid twice for one service. A local hospital got in a lot of trouble because the anes. didn’t like how little Medi-Cal paid them for labor epidurals and demanded $400 cash upfront before they would do one. Then they billed Medi-Cal for the epidural, double billing is illegal.

Felicia Henry, BCCE, IBCLC

Oxnard, CA

From: Jaye Simpson, IBCLC

Sent: Friday, November 11, 2011 6:51 AM

To:

Subject: Working with Medicaid/Medi-Cal patients

Hi All,I am really confused by the idea that it is illegal for us to charge someone on Medicaid (State funded medical). That makes absolutely no sense to me and seems to me it would violate thier right to choose who they see. I work with moms all the time who are on California's Medi-Cal program and medicaid. They pay me out of pocket. They are not obligated to ONLY see who the state wants them to see. If they want to pay someone out of pocket for health care of any sort it is their choice and right to do so. I have a number of moms who are on the state medical program and yet they will go see a particular Dr in town because he is a naturopathic Doc. He will not vaccinate, he does not take insurance. He does some CST. ALL his patients pay him directly. He pratices medicine in a holistic manner and they save to pay for that.So...my point being that there should be ZERO issue

for us to see anyone regardless of what medical coverage they have (or don't have). If they choose to pay us privately it is THEIR right and THEIR choice. :)Warmly,Jaye__________ Information from ESET Smart Security, version of virus signature database 6622 (20111111) __________The message was checked by ESET Smart Security.http://www.eset.com