We regret to inform you that our practice is not currently a Medicaid provider. As a result, we are unable to provide treatment to individuals who are covered under Medicaid, even if they are willing to pay for services out of pocket. Our understanding, based on discussions with Medicaid representatives, is that individuals covered by Medicaid are not permitted to receive care from non-Medicaid providers, regardless of payment preference. Conversely, as non-Medicaid providers, we are obligated to adhere to these regulations and are unable to treat Medicaid recipients. While we did not establish these guidelines, we are obligated to comply with them. If you are covered by Medicaid, we recommend contacting Medicaid directly for a list of approved providers who can accommodate your needs. For more information about the regulations see the Code of Colorado Regulations 8.012.2 PROVIDER LIABILITY:
8.012.2.A. Providers are explicitly prohibited from collecting payment, or attempting to collect payment through a third party, from a recipient or the estate of the recipient for the cost or the cost remaining after payment by Medicaid, Medicare, or a private insurer of Medicaid covered items or services rendered to Medicaid recipients.
8.012.2.B. Providers shall be liable to a recipient or the estate of the recipient if the Provider knowingly receives or seeks collections through a third party of an amount in payment for Medicaid covered items or services.
8.012.2.C. Providers are prohibited from collecting, or attempting to collect, payment from recipients for Medicaid covered items or services regardless of whether Medicaid has actually reimbursed the Provider and regardless of whether the Provider is enrolled in the Colorado medical assistance program.
8.012.2.D. Providers shall be liable for the amount unlawfully received, statutory interest on the amount received from the date of receipt until the date of repayment, plus a civil monetary penalty equal to one half of the amount unlawfully received.