Re: OB: Medicaid and Insurance
From: Anna Meenan, MD (annam@uic.edu)
Fri Jul 16 20:29:16 2004
Come to Illinois. Rural medicaid pays better than many insurance
companies, without all the hassles of precertification, etc. We kinda
like it when they get on medicaid. Of course, if you come to Illinois
your malpractice premiums will go through the roof. It's a trade-off.
--
Anna Meenan, MD
At Fri, 16 Jul 2004, Geff Klein wrote:
>
>Has anyone else had this problem lately?
>
>I am having a rash of patients who present for their first pregnancy
>visit with health insurance. Then at some point during the pregnancy
>they drop the insurance and get on Medicaid. They generally do this as
>they become aware of the large out of pocket expenses associated with
>continuing as an insured patient.
>
>The problem is that now I had been providing services under a global fee
>and had not collected anything other than an OB deposit. Now I am
>obligated to refund this to her. In addition Medicaid reimbursement
>is substantially less than I would have otherwise gotten for her care.
>I am also now subsidizing her care with my tax dollars.
>
>The insurance company must love this. They have collected premiums and
>will now not have to pay for the delivery. If I were a conspiracy
>theorist, I would suggest that insurance companies intentionally have
>designed the system to force patients into this type of behavior.
>
>The patient is ok with it if she will not have any out of pocket
>expenses.
>
>I, however, take a big hit. If one or two patients did this it would
>have little impact on revenue. However, it is getting to be almost
>epidemic in scope. If it continues, it could very well endanger the
>ability of my practice to sustain itself. (in addition to the rising
>overhead and overall lower reimbursement).
>
>My feeling is that this really is fraudulent. Public assistance is for
>folks without resources, not for people who don't feel like paying
>medical bills. There really should be some sort of regulation against
>this type of maneuvering. It is costly for the public and wastes tax
>dollars. It is harmful for medical practices. I say that patients
>should not qualify for Medicaid if they have voluntarily discontinued
>their insurance during pregnancy.
>
>Has anyone else encountered this? How are you dealing with it?
>
>Geffrey H Klein, MD
>450 Blossom Suite C
>Webster, Tx 77598
>832 553 5430
