Medical Assistance

When I opened my private practice, I was committed to seeing patients with Medical Assistance (Minnesota’s Medicaid program), regardless of their ability to pay me. I planned to offer them a sliding fee scale, including charity care (free care) for those in limited financial circumstances. In my mind, this would be similar to doctors who donate their time to free clinics and law firms representing certain clients pro bono.

Unfortunately, my well-intentioned plan violates the terms of the Medicaid program. My lawyer, who is a very experienced health care attorney, advised me that I can offer a sliding scale and charity care, however, Medicaid patients are prohibited from privately paying for medical care. Moreover, Medicaid patients are prohibited from receiving free medical care. That last bit doesn’t make any sense to me—I’m just a doctor, not a government bureaucrat—but rules are rules.

Some of my patients with Medical Assistance have successfully petitioned to receive out-of-network services (visits) with me. This requires a prior authorization (PA) from your insurance company (managed care organization [MCO]). Patients are responsible for initiating the request and completing necessary paperwork.

An easier solution is to seek care from an in-network provider. Organizations that I recommend include:

Allina Health
Fairview Health Services
HealthEast Care System

These medical boards and professional organizations maintain provider directories:

American Board of Addiction Medicine
American Board of Preventative Medicine  (addiction medicine)
American Board of Psychiatry and Neurology (addiction psychiatry)
American Academy of Addiction Psychiatry
American Society of Addiction Medicine

Finally, the Substance Abuse and Mental Health Services Administration and Indivior maintain these directories specific to treatment for opioid addiction:

Buprenorphine Treatment Practitioner Locator 
Opioid Treatment Program Directory
Treatment Providers