Medical Issues Affecting Special Needs Children-Key Issues 

Ø      Mandatory enrollment in managed care-Aid to Families with Dependent Children and Temporary Assistance for Needy Families enrolled and next were blind, aged, and disabled populations.  Voluntary enrollment vs. autoassignment, exemptions, being assigned correct PCP are concerns.

Ø      “Dual eligibles”-eligible for both Medicaid and Medicare.

Ø      Access to pediatric specialists.

Ø      Private insurance concerns:  in-network/out-of-network deductibles and out-of-pocket expenses; inconsistent payments; charge-backs for claims “paid in error”; “medical vs. educational”; families unaware of extended school year program for therapy; denials as not “medically necessary”; cover rehabilitative therapies for adults, not habilitative services for children; lifetime caps used up or changed upon diagnosis; families “dropped” by insurers; birth defects denied as  “pre-existing” conditions; “coordination” of benefits-if primary pays same as secondary, secondary pays nothing.

Ø      Educational issues:  medical evaluation eliminated for classification, “neurologically impaired” redefined, homebound instruction program revised.

Ø       Supplemental Security Income regulations revised:  need  “marked and severe” conditions, discontinued Individual Functional Assessment, 80% who lose SSI may still keep Medicaid, Association for Children in NJ provided free legal representation,  N.Y. Times article cited NJ one of states with large restoration of benefits, NJ also 1 of 2 states with an SSI Alliance.

Ø      Children’s health insurance programs, Kidcare:  expansion of Medicaid; uninsured previous 12 months, legal immigrants still eligible, enrollment goal is low so doing outreach.

Ø      Managed care legislation:  The Health Care Quality Act-insurers must disclose PT, OT, speech coverage; parity for mental health coverage (N.J. Alliance for the Mentally Ill also working on this); may not retroactively deny claims/charge back.  Key legislators-Sen. Torricelli, Sen. Sinagra, Assemblywoman Vandervalk, Assemblymen Talarico and Corodemus.

Ø      If families or professional have questions regarding children with special health care needs, Family Voices can help.

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