More Audits, Less Health Care Providers Who Accept Medicaid!

In my profession, I come across so many health care providers…of all sorts….dentists, psychiatrists, speech therapists, general practitioners, etc. Many of these providers and most of my clients, despite the audits, despite the immense paperwork, despite the low reimbursements, despite the lack of communication with the Division of Medical Assistance (DMA) and all agents, most providers still want to serve Medicaid recipients, even after the horrible events the providers are dragged through.

But, today, I had two potential clients receive a consultation.  When I asked, “Is your goal to get your Medicaid contract back?” Potential clients answered (paraphrasing), “Heck no!!!!”

These potential clients were quality health care providers.  Like so many other providers, these potential clients committed no fraud.  All they did was provide quality health care services to Medicaid recipients and fell victim to paperwork nitpicking by DMA and agents (Managed Care Organizations (MCOs) and Recovery Audits Contractors (RACs)).

But these potential clients were sick of it. They were continuing their practices, but without Medicaid recipients.  So when they open their doors and Medicaid recipients come for help, there will be two more health care providers saying, “Sorry. We don’t accept Medicaid.”

Recently, I have watched Gov. McCrory and Director Wos in interviews.  I seem to remember Director Wos saying, in an interview, that she wanted North Carolina to be the best place for providers to practice health care and accept Medicaid.

I think, if memory serves me right, that part of making providers want to accept Medicaid recipients in NC, would be to not harass providers by conducting audits in a an erroneous manner (by contracting out to minimum wage,  non- knowledgeable “contractors”), would be to not terminate Medicaid contracts without due process and without real cause, would be to not cause quality health care providers to force Medicaid recipients to be discharged from care.

If Gov. McCrory and Director Wos truly want to make health care providers want to accept Medicaid in NC, (which I actually believe) then what about what is happening right now?? I understand that, in the future, providers may be happy in NC, but, right now, providers are losing their businesses because of ridiculous audits with ridiculous outcomes.  We are worried about providers NOW.  I beg of all politicians with pull to save these Medicaid providers, please use that pull now.  One week from now, 3-9 providers could be out of business. Two weeks from now, 6-18 providers could be bankrupt.

Worry about now. Fix now. Help these providers, before these quality providers go out-of-business.

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on April 17, 2013, in Division of Medical Assistance, Harassment, Health Care Providers and Services, MCO, Medicaid, Medicaid Audits, Medicaid Contracts, NC DHHS, North Carolina, Petitions for Contested Cases, Prepayment Review, Provider Medicaid Contracts and tagged , , , , , , , , , . Bookmark the permalink. Leave a comment.

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