Re: Medicaid Question

[Guest guest]

What state do you live in?

Sent from my Verizon Wireless BlackBerry

[ ] Medicaid Question

and others,

I took the information I learned from this list last year and have

spent the last 12 months trying to make changes in my state. My state

was/is most definately violating EPSDT (and it certainly wasn't limited

to HBOT denials).

We now have a Medicaid lawyer ready to start a class action suit. I

would like to hear opinions on how to proceed considering the dismal

economic state of the country. Basically our state is slashing

services to children with disabilities left and right, however, they

are not attempting to cut the one service they are forced to provide

because they already lost a lawsuit over it. They were forced to

provide prescribed diapers to Medicaid recipients because not doing so

is of course a violation of EPSDT. So what I am seeing happen is that,

despite lack of funds, they are not limiting the amount of diapers a

child gets in an attempt to balance the budget, instead they are

limiting everything else (everything they can get away with). This

makes me wonder what the state's responsibilty is to abide by EPSDT

when they feel they cannot afford to do so? If they have no money,

will going to court and winning force them to come up with the money

(ie: reprioritize their spending) or are they at some point suddenly

off the hook? Also will the state likely retaliate by changing the

waiver and reducing the amount of children who are Medicaid eligible?

Our state is currently generous in this area. Medicaid is granted to

anyone in " immediate danger of being institutionalized " regardless of

income. I know some states use income to determine eligibility and

some even use a lottery system. I'm trying to figure out if initiating

a class action suit that (based on EPSDT) we would/should win is worth

the effort considering the state may have the power to insure it is a

Pyrrhic victory!

Those who have fought this battle, please chime in!

Thanks,

PS -- we are not only attempting to make Medicaid changes thru

litigation, we are also working on legislation.

[Guest guest]

Arizona

-

>

> What state do you live in?

> Sent from my Verizon Wireless BlackBerry

>

> [ ] Medicaid Question

>

>

> and others,

>

> I took the information I learned from this list last year and have

> spent the last 12 months trying to make changes in my state. My

state

> was/is most definately violating EPSDT (and it certainly wasn't

limited

> to HBOT denials).

>

> We now have a Medicaid lawyer ready to start a class action suit.

I

> would like to hear opinions on how to proceed considering the

dismal

> economic state of the country. Basically our state is slashing

> services to children with disabilities left and right, however,

they

> are not attempting to cut the one service they are forced to

provide

> because they already lost a lawsuit over it. They were forced to

> provide prescribed diapers to Medicaid recipients because not doing

so

> is of course a violation of EPSDT. So what I am seeing happen is

that,

> despite lack of funds, they are not limiting the amount of diapers

a

> child gets in an attempt to balance the budget, instead they are

> limiting everything else (everything they can get away with). This

> makes me wonder what the state's responsibilty is to abide by EPSDT

> when they feel they cannot afford to do so? If they have no money,

> will going to court and winning force them to come up with the

money

> (ie: reprioritize their spending) or are they at some point

suddenly

> off the hook? Also will the state likely retaliate by changing the

> waiver and reducing the amount of children who are Medicaid

eligible?

> Our state is currently generous in this area. Medicaid is granted

to

> anyone in " immediate danger of being institutionalized " regardless

of

> income. I know some states use income to determine eligibility and

> some even use a lottery system. I'm trying to figure out if

initiating

> a class action suit that (based on EPSDT) we would/should win is

worth

> the effort considering the state may have the power to insure it is

a

> Pyrrhic victory!

>

> Those who have fought this battle, please chime in!

>

> Thanks,

>

> PS -- we are not only attempting to make Medicaid changes thru

> litigation, we are also working on legislation.

>

>

>

>

>

>