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Lane
Lane, JD, CFP, MBA, CRPS
Category: Finance
Satisfied Customers: 10152
Experience:  Law Degree, specialization in Tax Law and Corporate Law, CFP and MBA, Providing Financial & Tax advice since 1986
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I was just accepted with Medicaid. My regular doctor's office

Customer Question

I was just accepted with Medicaid. My regular doctor's office is telling me that my doctor can not see me any more. Not even if I want to pay cash for the visit. And, they say that my doctor is not allow, by law, to write prescriptions for me. Is this true? And, WHY? I want to pay cash to see my regular doctor and have Medicaid pay only for my prescriptions. Is this possible?
Submitted: 1 year ago.
Category: Finance
Expert:  Lane replied 1 year ago.
Hi,So sorry - but the problem comes with the agreement betwen medicaid-mediare and the Doctors..See this from CMS.gov:"Q2. We are a doctor's office and heard that we cannot bill people with both Medicare and Medicaid, even if we do not participate in Medicaid. Is this true?A2. For services that are covered under Medicare, you cannot bill a Qualified Medicare Beneficiary (QMB), even if your office does not accept Medicaid. A QMB is someone whose income does not exceed 100% of the Federal Poverty Limit and who is eligible for Medicaid paying Medicare premiums, deductibles, and coinsurance for both Part A and B.Even if the person signs a document accepting liability for any treatment costs, you still cannot bill them, as QMBs cannot waive this right under Medicare. Providers who bill a QMB for costs above the Medicare and Medicaid payments (even when Medicaid pays nothing) are subject to sanctions.".You can probably find someone to write the prescription and the someone else to SEE MAYBE, but you'd be hiding nthe fact that you have the coverage,.SO sorry ... we see this a lot . Medicaid is being very aggressive in santioning Dr's since the advent of ACA. Obamacare)

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