WTF???!!!!

Medical assistance in my state can restrict you to one hospital, one doctor, even one pharmacy.  It can be for a couple of reasons.  They can assign you to an HMO and you have to pick a hospital.  Probably the biggest reason is because you are a, shall we say, frequent user of hospitals.  In your frequent hospital use, you tend to go from hospital to hospital.  I would imagine the most common reason you go from hospital to hospital is because you are looking for narcotics, but then thats just my personal experienced opinion...I mean if you don't get what you want at one place, try another, right?

Of course, people always act like they are shocked, albeit horrifed,
(what the fuck???!!!!), that they are restricted to one hospital, and lo and behold, it isn't this one.  Either they are stunned or they say, "Oh I changed all that, I'm now assigned to this hospital".   No.  No you aren't.  Sorry.  Nice try though. A for effort.

I don't know if the ER gets paid for the visit or not.  I understand that they don't get paid if they are admitted
inpatient.

Here's the thing, people on medicaid are not stupid, even if we think they are.  They know the system.  They know we can't refuse them, with EMTALA and all.  So why should they give a shit if they are restricted. We are going to see them and our doctors are going to treat them, like they would treat anybody else, including give them narcotics.  So in effect, this program is a joke.  It no doubt employs an office full of people who run it who get a paycheck, but other than that it is completely useless.

I'm glad we are employing people to do this.  This, along with the office full of people who make sure 25 year old healthy adults on medicaid get their taxi rides too and from the ER helps me sleep at night.