Follow-up for Medicaid Patients

October 1, 2004

A competing group at another hospital has been seeing Medicaid patients in the ER. When the patients call that group's office for follow-up appointments, they are told that they cannot be seen because that group does not participate in Medicaid. The patients are then being referred to my group. Isn't the first provider responsible for some period of time after initiating treatment?

Question: A competing group at another hospital has been seeing Medicaid patients in the ER. When the patients call that group's office for follow-up appointments, they are told that they cannot be seen because that group does not participate in Medicaid. The patients are then being referred to my group. Isn't the first provider responsible for some period of time after initiating treatment?

Answer: Unfortunately, no, they are not responsible to provide continuing care to patients they meet in the ER. This is a real problem in communities across the country, particularly as more surgeons cut ties with low-paying payers. More than 50 percent of surgeons do not accept all insurances.