Contact agency about Medicaid, Medicare fraud or abuse

January 28, 2012 12:00 am

An 82-year-old woman in Northwest Indiana recently called for an ambulance to get her to the hospital for her dialysis and chemotherapy treatments. She is confined to a wheelchair.

The ambulance service -- the only one in town that offers wheelchair transport -- is threatening not to take the woman because she cannot afford to pay the driver the co-pay at the time of service.

The co-pay was $1.

Before you judge and say, "It's just a dollar. Surely she can find that in her couch cushions," know this: The woman is on Medicaid because of her health and financial situation. She is too sick to work.

But more important, Medicaid clearly states in its provider manual that a patient cannot be denied services for not having the money at hand. The ambulance service can bill her for the co-pay, which it admits to not having tried.

We understand that ambulance services are for-profit businesses, and we are grateful to all those that provide caring, prompt service in many places throughout Indiana where service otherwise couldn't be obtained.

However, companies that sign up as Medicaid providers must understand the rules -- and follow them.

A person's life might be at stake.

If you have questions about Medicaid or Medicare fraud or abuse, contact your local Indiana Association of Area Agencies on Aging (IAAAA)/SMP office or call (800) 986-3505.

- Tamra Simpson, SMP (Senior Medicare Patrol) Program Director, Indianapolis

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