North Carolina originally planned to expand Medicaid coverage, but the Supreme Court ruling and the later election of the North Carolina government entirely by Republicans caused North Carolina to withdraw from Medicaid expansion.<\/p>\n
Last fall, Republican Gov. McCrory was making statements to the Heritage Foundatiom that North Carolina may have to expand Medicaid to get Federal reimbursement even though we don’t want to.<\/p>\n
The reason is another provision of the affordable care act. The law requires that when a person shows up at a hospital and is not insured – the hospital or clinic may do some preliminary screening and then submit bills for the patient to apply for Medicaid under the basis of presumptive coverage. If the patient fails to actually be covered by Medicaid, the state is still required to pay the costs of the treatment for up to two months.<\/p>\n
http:\/\/www.charlotteobserver.com\/2013\/10\/23\/4410230\/gov-mccrory-says-north-carolina.html<\/p>\n
For example, a woman may claim to be pregnant and therefore be eligible for Medicaid. But she might not be pregnant, she might terminate the pregnancy, she might not be a US citizen, she may just never apply for Medicaid or actually not be eligible \u2013 so when that is determined, the Medicaid coverage is revoked, but not the bills.<\/p>\n
North Carolina Medicaid (without the expansion) is fairly limited in who can get it. Not only do you have to be poor, you have to be in a category that is eligible for it \u2013 pregnant, disabled, blind, families with children and Medicare recipients. Presumptive coverage only applies to pregnant women \u2013 but the Feds have said that hospitals apply for other categories of patients, even though North Carolina doesn’t have a law requiring the state to cover them and hasn’t funded it.<\/p>\n
Once you find this out, it becomes much clearer why hospita
\nS want to bill for an entire treatment of a very expensive drug (like TPA to daissolve bold clots causing a stroke) because until Medicaid pulls the plug, the hospital has a blnk check to bill. The only good part is the reimbursement rates are so low, there is not much incentive to farm patients for cash.<\/p>\n","protected":false},"excerpt":{"rendered":"
North Carolina originally planned to expand Medicaid coverage, but the Supreme Court ruling and the later election of the North Carolina government entirely by Republicans caused North Carolina to withdraw from Medicaid expansion. Last fall, Republican Gov. McCrory was making … Continue reading