Medicaid Rules in Different States?


(Lissa Lubinski) #1

I just had my first Medicaid patient sign up. Before I confirm her membership I wanted to ask for some guidance. She listed her insurance as “Texas Medicaid,” though to my knowledge she has lived in WA at least as long as I have (over 2 years), if not much longer. My understanding in WA is that we opt of Medicare only, not Medicaid. But what about accepting a patient with another state’s Medicaid? Does that state’s Medicaid rules apply? Do I really need to pay my Seattle lawyer $425/hr to sort this one out. Along those lines, can anyone recommend a reasonably priced, reliable, DPC-aware lawyer??


(Robin Dickinson) #2

Hi @lklubinski

Every state is different. I’m honestly surprised she has Texas Medicaid. They didn’t expand Medicaid so almost no one has it compared to other states that did. I’m wondering if maybe she doesn’t have it.

But you can’t accept Medicaid outside a particular state so I know that doctors, pharmacies, etc all just bill cash. In my state, you cannot charge a patient who has Colorado Medicaid so it’s not just a matter of opting out, it’s completely illegal.

@appalenia is a fabulous DPC lawyer though I don’t remember which states she is licensed in…but I’d love your opinion on this one @appalenia :slight_smile:


(Appalenia Udell, Esq.) #3

@lklubinski, I am a health lawyer specializing in DPC and I am licensed in WA state. I’m happy to talk through this with you: 303.740.4895 (o), 510.682.0766 ©, law@appalenia.com. @Robin_Dickinson, thanks for thinking of me. <3


(Lissa Lubinski) #4

Thank you both! Appalenia, I will be contacting you at some point!