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OurcoverStory!

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Casualties Of Policy

     Hello friends and neighbors!

How often have you had to ask yourself this question?

Do I have a doctor that takes good care of me?

(No, you say you donít have a Physician?)

So youíre trying to find a doctor to accept you as a patient?

One that has a good reputation, is very knowledgeable, understanding, wise, and one that you can build a lasting professional relationship with so you receive the best possible care for you and/or your family?

Almost tough as nails isnít it?

     Finding a good doctor isnít an easy task. Especially one that accepts your particular medical insurance, has reasonable rates, and genuinely cares about their patientís health.

     (Now, letís complicate this process even more and for those that do not know what perils face the less fortunate in our community, letís add the following to the equation.)

One that will accept Indiana Medicaid!

OH NO!

     If you are lucky, very lucky, you will be able find one that is within a distance you are able to travel. If you are not, you will have to travel up to 50 miles or more just to find one, as I have heard from some Iíve talked to. Most do not have the finances or are healthy enough to make this trip. (Thatís why they are on Medicaid remember, lack of funds and poor health?)

     Finding a Physician that meets the above criteria, if youíre on the Indiana Medicaid program, will become even harder and itís going to become a nightmare reality by yearís end.

     It seems that the State Of Indiana, in itís infinite wisdom, has decided to award itís Medicaid contracts to three companies, (Anthem, Managed Health Services, and MDWise), and deny an existing Medicaid contractor (Harmony) to continue to provide care for individuals on the Medicaid program.

      They will be paying the same money to these three as they are paying to Harmony. So, it wonít cost the state any more in expenditures. This is all fine and good for business purposes and no foul there.

     One of the questions that need an answer from the Government is ďIf it isnít costing any more money than is currently being spent and the service provided by Harmony is satisfactory then why are you denying them a contract and limiting the tools available to our less fortunate citizens?Ē

     Personally I have long lived with the motto ďIf it isnít broke, donít fix itĒ and it seems like they are doing just that (or are they?)

What would be the repercussions of this action?

Letís examine some potential outcomes from this decision.

     The biggest one on the agenda is the decreased amount reimbursed to the Physicians by these new companies.

     Harmony has worked with the physicianís offices so they can at the least break even for operating costs.

     The new companies want to lower their reimbursement amount. This is kind of a kick in the teeth to the doctors for caring about their less fortunate patients. It is also going to be a big boot to the pants of the patient when they find out that they can no longer continue to see their doctor or find a new one as most doctors will be forced to discontinue accepting Indiana Medicaid.

     I mean, think about it from a business standpoint. If you canít break even and you lose money on a business transaction doesnít that defeat the purpose of the business? I donít have a degree in business or anything, but even I know you canít conduct business that way.

     As a side point, another roadblock the good doctors face is the medications they can prescribe under Medicaid rules. Remember, the patient has a lack of money available to buy medicine. So doctors have to prescribe medicines covered by Medicaid or the patient has to pay full price. Unless you are extremely wealthy no one can pay full price for medicines. Another problem with this is that the list of approved medicine changes so rapidly that they canít keep up with it. So, whatís covered today might not be tomorrow.

     Getting back to repercussions, if the amount of available physicians decrease any further, in some of the more rural areas and smaller towns, it will be emergency room only on finding a doctor to accept your Medicaid as payment and if you have to get it approved by the MCOís before you go, you will be out of luck in most instances. So the second question for the Government should be ďWho will take care of the medical needs of my family if Physicians are forced to stop accepting Medicaid as payment?Ē

     This means that the third question should be ďIs this some sort of business move to shrink the ranks of Medicaid by making it so hard to find a physician that accepts Indiana Medicaid that most are forced to move to another state just to receive proper medical care?Ē (And that they canít afford to do already. So they will not only have no way to seek appropriate medical help in Indiana, but be homeless and without medical coverage as they move to another state only to try to get on the programs of that state.)

      This also brings another question to mind, with all that we hear these days about lobbyists, ďWhich lobbyist paid the right person enough to get this passed in the state government?Ē (Ok, that was a little paranoid sounding)

     Still, the desperation of those on the ranks of Medicaid are exactly that real.  Itís bad enough that they have no money to pay for services, no real money to pay for medications, and most are on the Food Stamp program and other assistance also. This action by the State Of Indiana will make it almost impossible for them to find a Doctor that will accept them. The oneís that will still take Medicaid will be so overwhelmed with patients that the quality of care received will diminish to an unhealthy and unacceptable level. Not to mention how many will be turned away simply because they just canít accept anymore patients.

     Iím not trying to sound like Chicken Little here and go around yelling ďThe Sky Is FallingĒ, but this is a very serious problem and a very detrimental decision.

     I was alerted to this problem last week when I went into my physicianís office and saw a form letter laying on the counter that all Medicaid patients we being asked to fill out and sign.

     I have placed a link to a generic version of the letter for all around the State Of Indiana to download and mail. Furthermore, I have placed a download link for a generic version of the letters that people may send in if they are NOT! on Medicaid. In the downloads you will find copies to send to your Governor, Family & Social Services Administration, State Representative, and Senator.

     Please help if you can, even if you arenít on Medicaid. Download the letter you need, fill it out, and send it. Because, believe it or not, at some point in the future, someoneís life may actually depend on your decision today.

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Downloadable Word Doc Letters

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Letter to Governor

Letter to Senator

Letter to IFSSA

Letter to State Representative

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Download the files below if you are NOT!

on Medicaid and would like to help out by writing.

Letter to Governor

Letter to Senator

Letter to IFSSA

Letter to State Representative

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     (I am not privileged to information on how much the contract awards are for, whether or not it gives better care to the patients, and any other information that may explain the stateís decision so I can not post it here. I can however state that I have been informed of this problem by an un named source. These the three companies with new contracts will be decreasing the amount of money they will pay the physicians for their services. Furthermore, the amount the State pays for say an office visit to these companies for example, will remain unchanged.)

 

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