[tobeafamily]

I believe Federal law compels in-hospital physicians such as anesthesiologists, radiologists and pathologists to automatically participate with all plans, including Medicare, Medicaid and CHAMPUS/TRICARE. This is primarily BECAUSE the patient has no 'choice' as to which provider they use - it's whoever is covering service or is contracted by the hospital.

Bmom should contact the California State Medicaid/Medical Program Ombudsman, the State Insurance Commision and the hospital. If she was eligible for and covered by the state's medicaid program, than this should include anesthesiology, radiology and pathology service. They cannot 'balance bill' her either for charges beyond what Medicaid/Medical pays.

As to whom is responsible, morals vary by person. If the afamily didn't agree to pay medical expenses, than that's that. Legally, if this woman was a Medicaid/Medical beneficiary/enrollee, that program is responsible. In my days working for managed care, I saw MANY a physician attempt to collect fees beyond what they were entitled, knowing full well that they shouldn't, with the attitude that if they got the money, great. If they got caught, they'd stop IN THAT INSTANCE only but continue with others. Eventually, fraud & abuse comes after them, but only after many complaints and many people paying money they don't owe.

HTH,

Regina, AMom to Ryan Joshua Thomas