In my prior post I highlighted some of the problems with Medicaid, the joint state and federal health coverage for the poor. In case you might think that physicians won’t participate simply because the reimbursement is so poor (which would certainly be reason enough), check this out, from my state medical society today:
The WSMA has complained to both the Centers for Medicare and Medicaid Services (CMS) Region X and the Washington Department of Social and Health Services (DSHS) about the egregiously burdensome requests made of physicians’ practices by the Audit Medicaid Integrity Contractor (MICs). CMS has awarded the Medicaid audit contract for Washington to Health Management Services (HMS) of Irvine, Texas.
HMS is making unrealistic requests of practices in preparation of “field audits:” An eight page detailed request for information on each of the practice’s “providers,” with a 15 calendar day deadline; complete medical records on claims selected for audit, in some cases hundreds of records, and for records dating back to January 2004. Even worse, the lengthy list of records requested does not include patients’ names, only identification numbers and dates of birth!
So, let’s see: Medicaid pays far less than the cost of providing care, and often take 6 months to pay that poor pittance. For those dwindling number of physicians foolish enough to remain in this system, they pursue aggressive audits which require enormous amount of practice resources in response, and then, after such an audit, almost certainly will require large “refunds” of money “fraudulently” paid to physicians, who have failed to master the Byzantine and inscrutable regulations which no mere mortal can understand, much less comply with.
Is it any wonder that physicians are are heading for the lifeboats of this sinking vessel?
So, let’s move the uninsured in large numbers into this very same system, shall we?
4 comments so far ↓
Joe // Mar 19, 2010 at 1:41 PM
Well, if President BO gets his way, and if Nancy Pelosi and Harry Reid get theirs, we will.
They do not care about the people or the citizens’ health care. They only care about their power.
Rosemary A. // Mar 21, 2010 at 3:02 PM
May God have mercy on us all.
QuietObserver // Mar 24, 2010 at 3:39 PM
Hi Dr Bob,
I find it very interesting and enlightening reading your insights on the problems with our healthcare system. I am beginning to understand some of the problems which are being raised regarding the current healthcare bill, and I see how it might actually exacerbate some problems.
I am curious, though, what are your views on the mandate regarding insurance? The first post by you that I read supported mandatory catastrophic health insurance. (http://doctorisin.blogspot.com/2004/09/hospital-charges-for-uninsured.html) Isn’t the mandate similar to that?
I hope you understand that I am not trying to make some point or other, although I am rather in favor of the healthcare bill. The name-calling and hysterics that I am hearing from both sides are really neither informative nor helpful to someone just trying to get an idea of exactly what is good or bad about all the policies being thrown around.
Texan99 // Apr 6, 2010 at 9:48 AM
The bill not only does not make catastrophic insurance mandatory, it actually makes it illegal. I’ve carried catastrophic coverage for my household for many years, independent of any employer. Now I’ll be subject to a fine because it doesn’t qualify as insurance coverage for purposes of the mandate. My insurer probably will continue to offer it for a little while, but won’t be permitted to write new policies. Gradually customers will drop out as the fines grow. My coverage will disappear, and I’ll be forced to buy expensive first-dollar coverage I neither want nor need.
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