Medicaid Fair Hearing Results
In support of
Zeke's Journey
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Zeke's Journey
Denial upheld.
I literally stared at the words for 2 minutes before they actually sunk in. Denial upheld. They aren't going to pay for Zeke's intensive. There is no recourse. We have been denied a service that Zeke's entire medical team has deemed necessary.
When I dove in a little deeper into the document, I realized that they didn't even focus on the LAW I argued, they only focused on "medical necessity" and "progress." The doctor, who orginally I thought his name was Patel is actually Dr. Mittal, was the one that was quoted the most througout the document.
Did you catch that? Dr. Mittal, the person who has never seen my son, never assessed him, does not even know what he looks like, is the person the hearing officer deferred to the most. Instead of listening to Tally, the OT who has been hands on with him for 9 months now, he chose to listen to Dr. Mittal. Not my PCP or any of Zeke's other clinicians. Or, never mind that, what about the legal standing I argued about EPSDT and standard for medical necessity? Nope, not even considered.
Mind-blowing.
Thank God for my time with Him this morning: For who has known the mind of the Lord, or who became His counselor? Romans 11:34
God has not lost control of this situation or the outcome. Dr. Mittal does not have some wild power that is higher than the Lord. I am so grateful to be grounded in the truth of God's Sovereignty. And His Providence. God's ways are greater. Higher. Wiser. And always out of His kindness.
So I prayed.
And I took my next steps, which was to reach out to my State and Federal Representatives. Why did I do this? B/c this ruling shows me that this goes way beyond just Zeke. I truly believe that some of the federal standards that have been set to protect individuals with disabilities - at both the federal and state level - are not being appropriately applied in these fair hearings. I believe this b/c my case is not unique. I hear story after story that mimics what I have seen. This is why people in the disability community refer to these hearings as "unfair hearings."
What I want to ask from you...
(1) Please pray that if indeed standards are not being appropriately applied that it will come to light to the right people? And that changes will be made so that my family and families like mine will be able to receive the services they need?
(2) If you are in Florida, and you have a relationship with a state or federal representative, would you bring this issue to their attention? Feel free to use our names and show them this entry. Or email you representative and ask them to please look into how the EPSDT standard is being applied in Medicaid fair hearings.
As my mom always said, "I don't know what the future holds, but I know who holds the future."
I literally stared at the words for 2 minutes before they actually sunk in. Denial upheld. They aren't going to pay for Zeke's intensive. There is no recourse. We have been denied a service that Zeke's entire medical team has deemed necessary.
When I dove in a little deeper into the document, I realized that they didn't even focus on the LAW I argued, they only focused on "medical necessity" and "progress." The doctor, who orginally I thought his name was Patel is actually Dr. Mittal, was the one that was quoted the most througout the document.
Did you catch that? Dr. Mittal, the person who has never seen my son, never assessed him, does not even know what he looks like, is the person the hearing officer deferred to the most. Instead of listening to Tally, the OT who has been hands on with him for 9 months now, he chose to listen to Dr. Mittal. Not my PCP or any of Zeke's other clinicians. Or, never mind that, what about the legal standing I argued about EPSDT and standard for medical necessity? Nope, not even considered.
Mind-blowing.
Thank God for my time with Him this morning: For who has known the mind of the Lord, or who became His counselor? Romans 11:34
God has not lost control of this situation or the outcome. Dr. Mittal does not have some wild power that is higher than the Lord. I am so grateful to be grounded in the truth of God's Sovereignty. And His Providence. God's ways are greater. Higher. Wiser. And always out of His kindness.
So I prayed.
And I took my next steps, which was to reach out to my State and Federal Representatives. Why did I do this? B/c this ruling shows me that this goes way beyond just Zeke. I truly believe that some of the federal standards that have been set to protect individuals with disabilities - at both the federal and state level - are not being appropriately applied in these fair hearings. I believe this b/c my case is not unique. I hear story after story that mimics what I have seen. This is why people in the disability community refer to these hearings as "unfair hearings."
What I want to ask from you...
(1) Please pray that if indeed standards are not being appropriately applied that it will come to light to the right people? And that changes will be made so that my family and families like mine will be able to receive the services they need?
(2) If you are in Florida, and you have a relationship with a state or federal representative, would you bring this issue to their attention? Feel free to use our names and show them this entry. Or email you representative and ask them to please look into how the EPSDT standard is being applied in Medicaid fair hearings.
As my mom always said, "I don't know what the future holds, but I know who holds the future."
Comments
Tania Kinney 2 months ago
Laura McDonald about 2 months ago