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The chair of the health policy department at George Washington University has warned of the potential “spill-over” effect into other state programs run with federal funds if the Supreme Court interprets too widely the Administration-backed policy paper on Medicaid submitted May 26. So who would be hurt if this happens, and everybody in state . . . → Read More: Who will be hurt and who makes out from the Administration’s new Medicaid policy? Our children could lose the right to challenge the medical decisions made by their Medicaid providers if an Administration-backed brief submitted to the Supreme Court is allowed to become policy. According to a legal analysis published today, the brief asserts “that beneficiaries of Medicaid and other safety net laws should no longer be permitted . . . → Read More: Could the Administration’s war on Medicaid be the death knell for EPSDT? Our survey asks families if various elements of the “full EPSDT benefit” have been denied their children. One example: ten of twenty-five respondents have never been told that EPSDT entitles their child to visits to out-of-state specialists. Everything is paid for, from the airfare, to hotel, ground transportation and even a daily food allowance. . . . → Read More: Building your child’s medical advocacy team After receiving three separate complaints from Georgia moms unable to get diapers from Medicaid, I went to find somebody in Georgia would could provide direct help. The Georgia Advocacy Office sent the following email back, with direct contact information for anyone else in Georgia needing similar help. Your email was forwarded to me for . . . → Read More: Help for parents who can’t get Medicaid to pay for diapers Federal laws state, in no uncertain terms, that your state Medicaid provider cannot deny, limit or reduce what your physician says is “medically necessary.” I’m going to start by saying I am not a lawyer. I’m a mom, of an eleven year old girl who has severe brain damage and non-stop seizures. In 2002, . . . → Read More: Letters of Medical Necessity: When your doctor becomes a partner in advocating for your child A discussion recently came up on a mailing list I belong to about how many mic-key buttons the kids were getting through Medicaid. It ranged from twelve a year down to two per year. For those who don’t know, a mic-key button is a two inch long piece of plastic with an inflatable balloon . . . → Read More: What federal law entitles our children to By Summer Harrison, on December 17th, 2009 Two court decisions handed down by a US Federal District Judge in Georgia have essentially made a civil crime out of denying our children their medical legal rights. The bottom line effect of these decisions is to give parents and caregivers a level of control over deciding . . . → Read More: Major court victories for our kids’ legal medical rights By Summer Harrison, on December 31st, 2009 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 . . . → Read More: EPSDT and “Medical Necessity” By Summer Harrison, on February 22nd, 2010 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 . . . → Read More: Understanding EPSDT and the rights it gives your child By Summer Harrison, on January 31st, 2010 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 . . . → Read More: Diapers are a covered service under EPSDT |
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