And what if they don't turn around and pay for the service. What's the hospital going to do, spend the next few months sending bill collectors after the person? You think hospitals would like that? The reason Medicaid pays the bills directly to the provider is because neither the state nor the provider trusts the recipient to spend the check on the service. And you'd be creating an even greater delay in the provider receiving payment. Hospitals are already up in arms about slow payments from insurance companies, Medicare, and Medicaid. Just imagine how annoyed they'll be when they have to wait even longer for Johnny Welfare to get around to paying the bill.