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Re: OB: Medicaid and InsuranceFrom: Braun, R. Daniel (rbraun@iupui.edu)Mon Jul 19 06:26:05 2004
Indiana would have to rank fairly high. But don't everybody move here. We got enough Docs. Dan "Sound is like water. If you drill one hole in the wall the sound will leak right through." - JAY BRAUN, a band member by love, a soundproofer by necessity. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Charlie Chambers Sent: Friday, July 16, 2004 10:32 PM To: Multiple recipients of list OB-GYN-L Subject: Re: OB: Medicaid and Insurance Along the lines, what US state would people consider the best to practice medicine? Not in terms of living environment, but just considering state medical assistance, malpractice insurance, etc. I know Oregon would not be at the top of that list. Any other opinions? ************************************************************************ **=20 Charlie Chambers=20 Hood River, OR USA cchamber@alumni. rice. edu "I'm a goin fishin. Yeah, I'm goin fishin And my baby's goin fishin too!" Taj Mahal ************************************************************************ On Jul 16, 2004, at 6:31 PM, Anna Meenan, MD wrote:=20 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
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