The Dangers of Liveblogging

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Michael Ditmore, MD – We are contemplating expanding Medicaid coverage and have not considered the consequence of these actions. Even now we do not have enough physicians enrolled to provide adequate care in this system, let alone quality and preventive care. This is because of inadequate reimbursement to providers and therefore lack of participation. You see this in the ER’s being overwhelmed because patients can not find a participating physicain. There are other reasons but that is a primary cause.

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Another issue in providing care based on “best practice” is a little discussed part of the Medicaid regulation that states a state program must provide “medically necessary” care. The courts have elected to interpret that to mean that if any physician states that a procedure is medically necessary the program must cover the procedure.

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Again, before we expand a broken, expensive program we must fix the problems we already know about.