Medicaid Service Orders

[i61164]

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Has anyone been asked to sign these? Apparently, NC Medicaid won't pay for a therapist unless an MD signs a "service order.". So private practices made up of mostly therapists with only a few prescribers are asking prescribers to sign these even for patients that the MD has never laid eyes on (I.e. The therapy-only patients). Does this not seem fraudulent or risky for the MD? Should the MD expect to be reimbursed for this service?

 

[nitemagi]

I believe it's only ethical to charge for this if you actually evaluate the patient. Otherwise it's basically fee splitting, which is considered unethical.

 

[i61164]

Fee splitting is the payment of a commission to the referrer with the express intention of ensuring that the referring doctor directs referrals of patients to the payee. The difference is that I would not be referring these patients to the therapist. In fact, I would never even see these patients. It seems odd to me that Medicaid requires an MD signature. It's like I'm being asked if psychotherapy is really necessary for these patients, without ever seeing them.