I have NY medicaid. I recieved emergency medical care in NJ. I made it clear that I was a NY medicaid patient when i arrived in the hospital, and because it was an emergency, NY medicaid has approved coverage for all bills relating to my care. one of the doctors refuses to bill medicaid, and instead is billing me directly.
According to N.J.A.C. 10:74-8.7, even out of network providers are prohibited from billing New Jersey medicaid patients for emergency care. This protection is also afforded to NY medicaid recieving emergency care in NY. Would the interstate mediaid reciprocity agreements afford me the same protections as New Jersey mediaid patients? Or would the protections provided by NY carry over to New Jersey?
I believe you are in the right. If you provided the information, they must process it. Stand your ground.
This response does not constitute the establishment of an attorney-client relationship. It is also not to be taken as firm legal advice as such would be contingent on a full inquiry by the attorney into the complete background of the facts and circumstances surrounding this matter. The response is meant to be a helpful guide to a question in a manner which reflects the limited information provided by the inquirer.
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