Guest guest Posted October 11, 2008 Report Share Posted October 11, 2008 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2008 Report Share Posted October 12, 2008 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. > > > > > > Quote Link to comment Share on other sites More sharing options...
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