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. Please visit this page for a list of other providers.