ORONO – For years, University of Maine system students enrolled in the state’s publicly funded Medicaid program have been unable to use the plan to pay for health care services received on campus.

Now, it seems a bureaucratic misunderstanding may be to blame for the situation, and university officials have pledged to look into eliminating the obstacle to health care access for students.

Dr. Mark Jackson, director of Cutler Health Center on the Orono campus, said Tuesday that the health center currently does not participate with any insurance companies’ plans other than the one that provides optional coverage to university students. This year, that company is MEGA Life and Health.

Students with any other type of coverage, or with none, must pay out of pocket for the care they receive. If a student has private insurance, he or she may then send the bill to the insurance company for reimbursement.

But a student on MaineCare, as the Medicaid program for low-income residents is called here, cannot be reimbursed, because MaineCare only pays bills that come directly from doctors and other providers.

So, MaineCare students who want or need the convenience of being treated on campus must pay out of pocket for services at Cutler. Or, as many do, they must seek care at other facilities in the area. Both options make it less likely that students will seek either routine preventive care or prompt treatment for illnesses or injuries.

The number of university students enrolled in MaineCare is not known, but children of low-income parents can be covered through age 21 in some cases, and many older students may qualify as well.

Jackson said Tuesday that the health center doesn’t participate with MaineCare or other plans because it would require the clinic staff to see any and all patients enrolled in those plans, including those from outside the university community.

“So anybody with Aetna or Blue Cross or MaineCare could pick Cutler as their health care facility,” Jackson said.

Jackson pointed out that services at Cutler are priced well below average, with a basic office visit costing just $20. And, he said, many UMaine students, with and without insurance, have taken advantage this year of a new optional program that costs $240 a year and covers most health services available on campus, including office visits, X-rays, lab work, ambulance transport and other procedures.

But, he agreed, low-income students with MaineCare’s comprehensive benefits should not have to purchase this additional coverage.

John Diamond, a spokesman from the University of Maine System office in Bangor, said health clinics on campuses in southern Maine and Farmington also do not bill students’ insurers.

Other residential university campuses in Fort Kent, Presque Isle and Machias contract with existing clinics in their communities, so billing is not the schools’ problem.

But state health directors Wednesday said Jackson and other university officials are mistaken in their understanding of the situation. MaineCare routinely pays for health care delivered to students in Maine’s public elementary and secondary schools, noted Christine Zukas-Lessard, deputy director of the Bureau of Medical Services in Augusta, which oversees the MaineCare program.

School-based clinics are under no obligation to serve anyone other than their own students, she noted – “So to me, that’s not an impediment.” Zukas-Lessard said she and her staff have been unaware of the MaineCare problem at the university clinics.

Maine’s superintendent of insurance, Alessandro Iuppa, said the state does not require clinics to open their doors to any and all enrollees in any private company’s health plans. Access agreements between clinics and insurers are variable, but are negotiated as part of each contract, he said.

Robert Dana, dean of students at the University of Maine, said allowing campus clinics to bill MaineCare would make life easier for many low-income students, many of whom, he noted, have enough to worry about without wrestling with unnecessary health bills.

“Any bureaucratic obstacle that can be set aside to achieve better and more affordable health care should be,” Dana said. He said he hopes the university will be able to move quickly to rectify the MaineCare participation issue at Cutler Health Center.

Dr. Jackson, more cautious, said it will take time to work out important details, such as what are acceptable rates of reimbursement, how soon the state must remit payment, and how to keep the University’s centralized business office from getting bogged down with the complexities of medical billing.

At the system office Wednesday afternoon, spokesman Diamond said a meeting between state and university officials has already been set up for later this month to begin the process of getting university health clinics contracted to serve students with MaineCare coverage.