In Taylor v. Louisiana DHH the United States District for the Middle District of Louisiana held that a health care provider who accepts Medicaid coverage for services rendered to an accident victim cannot seek to recover the difference between the Medicaid reimbursement rate and the pre-reduction billed amount.
This does not mean that health care providers cannot pursue the at-fault party, his liability insurer or other potentially liable third parties for payment of the full pre-reduction bill, only that a provider cannot “have his cake and eat it too” by accepting payment from Medicaid then pursing the balance that would have otherwise been written off.
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Health care providers have engaged in Medicaid “balance billing” for several years under a Department of Health and Hospitals regulation that explicitly allowed such a practice: “The DHH shall not prevent a provider from pursuing a liable or potentially liable third party for payment in excess for the Medicaid paid amount to a provider for rendered health care services.”
In the recent Taylor decision, the court held Congress did not intend for providers to receive Medicaid reimbursement for patient care and then intercept funds that the patient would otherwise receive and that the LA DHH regulations allowing providers to do so conflicted with Federal Law.
Get Protection from Balance Billing with a Personal Injury Attorney
If you have a car accident injury, slip and fall or offshore incident an experienced Louisiana personal injury attorney can help you navigate the complicated regulatory framework surrounding healthcare billing practices.
In addition to pursuing an at-fault party for the full amount of damages due, an experienced personal injury attorney can maximize your recovery by ensuring that health care providers do not attempt to hijack your settlement funds by engaging in prohibited billing practices such as Medicaid “balance billing”.
If you need help with your personal injury case, please contact Morris Bart, LLC Attorneys at Law today. We offer a free case evaluation with our personal injury attorneys, who will review the details of your case and advise you on the best approach to getting the compensation you deserve for your injuries.
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