Enter the Feds

We serve Medicaid patients. Always have. It was fairly traditional in our area to start a practice with Medicaid patients and gradually withdraw as the private patients built up. We took a different tack and just kept them and added practitioners. It fit our social responsibility agenda, and I don't think we lost money on it. I think we still manage a very modest margin.

Part of what we do is give vaccines. There, we really lose money. There is no mark up on the Vaccines For Children program "free" vaccines, and the immunization administration fee is only $9.50. By contrast, for private patients we have a markup on the vaccines of a certain percent that covers our overhead for ordering, storing, keeping track of temperature, etc. etc. It's considerable work, and for the Medicaid patients, we get nada for this. The official Medicare values for vaccine administration would be $25 for most vaccines. So giving our Medicaid vaccines is a considerable loser for us.

The problem with government is that you agree to treat Medicaid patients at a very reduced fee and they treat you like a criminal. We just got a notice on Monday that the Inspector General - must be the Feds, I don't yet know for sure - will be coming to our office on Thursday and has a list of 24 policies, temperature logs, etc., that they want on a CD to give to them.

"Will be coming," no "May I." No explanation. No niceties. No nothing. It's a wham-bam without the "thank you, M'am."

The Feds! I'm going to tell them to visit the land where the sun don't shine. Twenty-four items! For the privilege of losing money.

Honest to God. These people.

Budd Shenkin