What is my recourse if physicians are refusing to accept retroactive Medicaid coverage?

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What is my recourse if physicians are refusing to accept retroactive Medicaid coverage?

I was recently at an in-patient facility for drug and alcohol rehabilitation. After returning home, I applied for Medicaid and was approved for retroactive benefits for the previous 2 months. My case manager advised me that I should have all of my previous period under the months retroactive coverage was granted bills sent to the Medicaid office. I informed the rehabilitation facility that I had been approved for retroactive Medicaid and they are saying that they do not accept Medicaid. From what I understood based on what the case manager said that even if a physician does not accept Medicaid, they should accept retroactive coverage. Is this true or can physicians and institutions refuse Medicaid payments for retroactive coverage? I am confused because I am getting conflicting information between the Medicaid office and the rehabilitation provider.

Asked on July 29, 2018 under Insurance Law, Arizona

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 years ago | Contributor

Medical care providers are NOT required by law to accept payments from Medicaid unless they signed an agreement (a contract) with the government to do so; otherwise, they are free to refuse Medicaid payments, which generally are at a much lower rate than the care providers actually bill. You can't force them to take Medicaid; if you want to use Medicaid, yo have to make sure up front, before receiving the services, that they will take it.


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