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 Post subject: frigging WI medicaid
PostPosted: Wed Jan 12, 2011 10:39 pm 
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Wisconsin recently changed their rules about buprenorphine (and other medications) so that if a patient is seeing a doc who does not accept medicaid as full payment, Medicaid (Badgercare or Forward Health) will NOT cover the cost of the prescription.

The simple answer, I know, is to ask docs to accept Medicaid. The problem is that Medicaid pays about $30 for the visit, and the doc is forbidden from accepting any additional payments. For practices like mine that spend considerable time during appointments, $30 per patient will not cover the costs of the practice-- the rent, utilities, malpractice insurance, etc-- let alone salaries.

This hits many patients, but it hits addicts the hardest because of the shortage of docs who prescribe buprenorphine already.

To my patients-- I'm sorry, and I will do what I can to lobby for change. I'll be writing to several elected officials this weekend, for what it is worth-- and I recommend that others do the same.

JJ


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PostPosted: Thu Jan 13, 2011 12:08 am 
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That is TOTALLY outrageous! It just seems things are all headed in this direction. The problem I encounter is that the insurance prices keep going up and I keep getting letters from the doctors that they no longer accept our insurance and really, only the icky doctors seem to take all the insurances. I have happened to get connected with some of the best doctors in the area. Good doctors cost good money. Bottom line. It's one thing for insurance not to cover it, but it is a whole different story for them to tell you no additional payments can be accepted. So what? Our system is bankrupt and instead of fixing it, we will just pass the buck onto a minute percentage of the population and essentially expect the doctors to treat these people out of the kindness of their hearts? Seriously? Last I checked......people worked to get a check and pay the bills. I don't care who they are and most doctors don't get paid that much anyways. Especially not considering how much money they owe by the time they become doctors. Gah!

Cherie

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PostPosted: Thu Jan 13, 2011 10:39 am 
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I think the real problem is government intervention! Price controls never solve anything, they simply shove the costs elsewhere. Its basic economics....limiting payments for services leaves others to pay costs that aren't covered.


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PostPosted: Thu Jan 13, 2011 12:03 pm 
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One of my main concerns is whether they are picking out Suboxone to do this, or whether they are applying it to all patients. A couple of my patients went to the pharmacy expecting to pick up their Suboxone for the usual copay, and without any warning they were told that they need to pay $400 to get it. Does anyone at the state realize the consequence of that?

I want to know if they are doing that to other patients as well. For example, the person taking a blood pressure medication, or some other life-sustaining med-- are those people being hit with huge bills as well? Will they make THOSE people go off their meds and get sick, or are they only making addicts go through it-- using them in a game of 'chicken', knowing that they will then go back an pressure the doc.


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PostPosted: Thu Jan 13, 2011 12:46 pm 
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Thanks for sharing this news with us. I would agree that anyone living in WI should start writing letters to their elected reps as well as lots of op-ed letters to the newspapers. And I'd like to thank you, again, Dr. J, for sticking up for us addicts using this live-saving treatment. We could use a couple dozen more doctors like you. I sincerely hope they haven't singled out suboxone for this mistaken lack of coverage. That would just be wrong on so many levels.

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PostPosted: Thu Jan 13, 2011 12:52 pm 
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Good questions, doc! I suspect the bureaucrats driving this *are* targeting addicts, letting their "logic" to be driven by stigma: ie: "they've chosen to use drugs, are morally deficient" yada, yada. I despise the way otherwise sane individuals still subscribe to the "substituting addictions" and "giving addicts what they want" garbage.

This doesn't even get into the topic of "the government 'should give free ORT' discussion!


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PostPosted: Thu Jan 13, 2011 8:17 pm 
I wonder how many sub patients will go the route of methadone if things like this continue. You can get MMT for around $300 a month no matter what the dosage and say you are on 24mgs suboxone that is like 720$ for pills and then give or take another 100$ for the doctor visit so over 800$ a month to be on it. I dont know anyone who can afford that, thats almost 2 months rent for an average apartment around here.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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