If your state is an official Medicaid provider (in other words, your state has the ability to bill your state Medicaid department), and your child is receiving physical therapy, occupational therapy, speech therapy, para-professionals, autism services, behavioral or mental health services from the school, then you need to make sure your child is signed . . . → Read More: Parents: Kids Getting OT, PT, Speech, Para Services from School Need to Get Signed Up For Medicaid
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Yesterday, CDREA filed a class complaint with the DHHS Office for Civil Rights alleging that differences in EPSDT policy from state to state were violating the civil rights of children with disabilities. Here is part of the text of that complaint: EPSDT is currently being enforced to different sets of standards in different states. . . . → Read More: Civil rights complaint filed with OCR over state to state differences in EPSDT enforcement The primary function of the Early Periodic Screening, Detection and Treatment program (EPSDT) is to ensure all kids on Medicaid get appropriate medical care, including all the normal baby exams, vaccines and the like. But for children with disabilities, EPSDT also includes a wide, sweeping civil right to what the child’s doctor says is . . . → Read More: Understanding EPSDT and the rights it gives your child CDREA President Summer Harrison announced on her blog yesterday that the federal Office for Civil Rights of the US Department of Health & Human Services has opened an investigation into whether Hawaii’s cuts in Medicaid home and community services are civil rights violations. While we know that similar cuts in Medicaid services have been . . . → Read More: Are your child’s civil rights being violated by Medicaid? A federal court decision in Florida last week has highlighted the fact that some states are still refusing to provide diapers to children covered under EPSDT. Diapers are a medically necessary service under EPSDT. All you need is a prescription from your doctor and letter of medical necessity to present to your Medicaid provider . . . → Read More: Diapers are a covered service under EPSDT If your child is under the age of 21 and receiving Medicaid, then your child is covered by the civil rights to medically necessary care defined under EPSDT. In order to obtain EPSDT services for your child you need the following items: 1. an assessment showing the service or item is appropriate AND/OR 2. . . . → Read More: How to use EPSDT to advocate for your child’s medical civil rights CDREA has been posing the question to federal regulators for the past couple of weeks of the extent to which EPSDT could be considered as providing civil, constitutional rights to children with disabilities. The response has just come back in writing: yes, there are civil rights issues related to EPSDT. The implications of this . . . → Read More: EPSDT as Civil Right under the Americans with Disabilities Act The definition of retaliation under the Americans with Disabilities Act is important for important for parents and caregivers to understand. Here it is, directly out of the ADA: Sec.36.206 Retaliation or coercion. (a) No private or public entity shall discriminate against any individual because that individual has opposed any act or practice made . . . → Read More: What the Americans with Disabilities Act calls “Retaliation” Medical necessity is the defining factor for all Medicaid services accessed through EPSDT (for children on Medicaid under 21) or any participants in a state’s 1115 or 1915 Medicaid waiver programs. The tendency over the past years has for states to try to exert control over determination of medical necessity in order to control . . . → Read More: EPSDT and “Medical Necessity” In December of 2008, Hawaii’s Developmental Disability Division of the Department of Health sent a letter out to participants in the state’s DD waiver program, announcing an across the board cut of 15% in home and community based services. The written decision issued by the Department of Health in a Kauai child’s appeal of . . . → Read More: Hawaii DOH appeal decision opens the door for restoration of Medicaid waiver cuts |
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