Florida accident victims can’t find doctors due to Medicaid cuts

According to a New York Times article, Nicole R. Dardeau, 46, a nurse “could not work because of unbearable pain in her right arm. Doctors have found three herniated discs in her neck and recommended surgery, but cannot find a surgeon to take her as a Medicaid patient.”

This is all too often the problem with finding a medical specialist who will accept any insurance payment for providing much needed care. Accident victims face the exact same challenge—doctors don’t want to take Medicare or Medicaid if they don’t have to.

The Medicare Secondary Payer Laws: Per 42 U.S.C. 1395y (b) (2) and 1862 (b) (2) (A) (ii) of the Act, Medicare is precluded from paying for a beneficiary’s medical expenses when payment “has been made or can reasonably be expected to be made…under a Workers’ Compensation plan, an automobile or liability insurance policy or plan (including a self-insured plan) or under no- fault insurance.”

Accident victims have traumatic injuries and are in need of critical care, closer in time to their traumatic event. Many times, medical specialists such as neurologist, orthopedics, neurosurgeons, and the like are needed rapidly to respond to the sudden chronic injury from a traumatic event such as a car wreck or a fall down stairs.

The medical needs from trauma usually differ from those with chronic medical problems that develop over months, years, or a lifetime. The care and maintenance issues for these chronic issues, such as diabetes or blood pressure problems, are usually not as urgent as those who have suffered a debilitating car wreck, and are in agonizing suffering and pain.

The insurance industry and the Florida Legislature are trying to impose Medicare rates as the standard of reimbursement for innocent victims of negligence. Insurance company lawyers routinely attempt to present evidence in Court of Medicare and Medicaid reimbursement, as the standard by which medical expenses should be paid, and what should be paid for medical care that is reasonably certain to be incurred in the future.

These so called “medical billing experts” wish to present evidence of what Medicaid pays as a basis for what is a reasonable rate of reimbursement for a doctor’s service.

Unfortunately, I cannot ask a judge, jury, or insurance adjuster if they will agree to reimburse injury victims for the difference as to what it will actually cost to care versus the legislative fiat of imposing a flat rate. Perhaps that is why the vast majority of medical practitioners in the U.S. decline to accept Medicaid for services rendered to their patients.

Source: Cuts Leave Patients with Medicaid Cards, but No Specialist to See.” Pear, Robert. NY Times. April 2 2011.

About The Author

Michael Steinger

Michael Steinger

The Florida BarFlorida Bar Young Lawyers DivisionMillion Dollar Advocates ForumMillion Dollar Advocates ForumBest Workers Compensation Attorneys in MiamiBest Car Accident Lawyers in MiamiLawyers of distinction

MICHAEL S. STEINGER, founding partner of Steinger, Greene & Feiner, believes in representing real people, not big businesses. Since the firm’s creation in 1997, Steinger, Greene & Feiner has never represented an insurance company or large corporation, and he vows to keep this promise. Over the course of his career, Michael has handled thousands of Florida accident cases, recovering millions of dollars for his clients and earning him membership into the Multi-Million Dollar Advocates Forum. Staying up-to-date on the ever-evolving laws protecting injury victims and their families, Michael is an active member of the American Bar Association, the Palm Beach, and St. Lucie Bar Associations, and sits on the Auto Insurance Committee of the Florida Justice Association.