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Issue Alert - 03-10-02

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Date:

Oct 06, 2003

Issue Summary:

When a child receives Medicaid as well as private health insurance pursuant to a support order enforced by the Friend of the Court, the state Medicaid agency should not delay Medicaid payment for the child’s health care if the private insurance does not promptly pay.

Persons Affected:

Medicaid recipients who also have private insurance from an absent parent under an order enforced by the Friend of the Court.


Background

Medicaid

What's Happening?

It appears that Michigan does not have a system for identifying the Medicaid recipients who should be protected by the “pay and chase” requirement. The state’s failure to ensure that these claims are promptly paid can result in considerable difficulty for the child and the custodial parent. The child and the custodial parent sometimes get caught in the middle between an uncooperative, absent parent whose private insurance company is not paying for a child’s medical care, and the Medicaid agency which will not pay because private insurance exists. The Center for Civil Justice has contacted the Department of Community Health about this problem but has not yet received a response.

What Should Advocates Do?

Be alert to situations in which Medicaid recipients are being pursued for medical bills that should be paid by Medicaid under the “pay and chase” provision. Contact the Center for Civil Justice if you encounter clients with this problem (see contact information above).

What Should Clients Do?

Seek legal advice if you have Medicaid and are billed for medical services that should be covered by Medicaid.

Finding Help

Most legal aid and legal services office handle these type of cases, and they do not charge a fee. You can locate the "free" legal services or legal aid office that serves your county on the Michigan LawHelp website (www.MI.LawHelp.org) or look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.