By Andy Miller in the Atlanta Journal-Constitution:

A lawsuit filed by Georgia legal-aid attorneys alleges that hundreds of people, including many with disabilities, have faced illegally long waits for hearings as they attempted to appeal Medicaid rejections of their medical services.

State officials acknowledged a backlog of appeals, but declined to comment on the lawsuit. The Department of Community Health issued a statement saying that “the department is committed to taking steps to address this issue, including adding additional attorneys and legal support.”

Advocates said federal Medicaid rules require a decision within 90 days of an appeal, and that many appeals filed in 2007 have not been heard.

From the Atlanta Journal-Constitution:

A recent federal court ruling in Atlanta, coupled with a new Georgia law, are seen as hopeful signs that state-paid services for Georgians with disabilities could be restored.

Advocates say Georgia has cut medical services for hundreds of children in recent years. One example is eleven-year-old Rachael Eaves, whose Medicaid-funded home nursing care was reduced from 60 hours a week to 40.

Fighting a state decision can be tough. Michelle Eaves said the state letter that reduced her daughter’s nursing hours didn’t explain why. The contact number on the letter didn’t work. Despite filing an appeal within 10 days, she said she had to wait a year and a half for a hearing.

Similar battles are being played out in a handful of other states.

Earlier post here.

In an editorial in the Atlanta Journal-Constitution, Maureen Downey praises a U.S. District Court decision that prohibits the state of Georgia from overruling doctors in determining the care children receive under Medicaid. The state has consistently created barriers that needlessly stress parents and prohibit kids from getting the care they need. Doctors should stand up for the right of children to receive the services they’re entitled to get, she says.

Medicaid is a joint federal-state matching program that pays for medical assistance for children from low-income families and those with disabilities.

Earlier post here.

From The Atlanta Journal-Constitution:

A U.S. district judge in Atlanta has ruled that the state does not have the discretion to deny services prescribed by a treating physician for children receiving Medicaid.

Georgia child health advocates hope the decision will stop the state from denying medical services to children who receive Medicaid.

Advocates say the state has a long history of reducing or denying care ordered by physicians and paid for through the program that is jointly funded by the state and federal government

The decision came in the case of a girl whose doctor prescribed 94 hours of private duty nursing care a week for her, but the state Department of Community Health approved only 84 hours.

An estimated 700,000 children in Georgia are eligible for Medicaid.

From the Wall Street Journal:

Members of Congress are expressing concern and scheduling hearings about a Medicare plan to use competitive bidding for products such as wheelchairs and walkers, in a sign that lobbying by medical-equipment companies is gaining traction.

Currently, companies receive a government-set fee to distribute such equipment for patients’ home use. Under the competitive system, companies bid on how low a fee they would be willing to accept. Medicare then limits distribution rights for a particular geographic area to several low bidders.

… Officials at the Centers for Medicare and Medicaid Services say competition could ultimately save $1 billion a year … Critics in Congress and elsewhere say service for the elderly will suffer if the bidding system drives some operators out of business. “We are very concerned about a decrease in quality and access and choice of provider,” says Peter W. Thomas of the Consortium for Citizens With Disabilities.

Son qualifies, but Missouri has no money for services

St. Louis Post-Dispatch columnist Bill McClellan writes again about Richard and Donna Schnurman, who are trying to get adult services for their son Brent. Despite the assistance of a state representative, the Schnurmans are caught on a “journey into the rabbit hole of the Missouri mental health system where nothing is quite as it seems.”

After many phone calls, the Schnurmans get some good news: Brent qualifies for “crisis” services under Medicaid waivers. But there is also bad news: he won’t receive the services because funds are not available.

Another parent tells McClellan he was in a similar situation and successfully sued for the Medicaid services. “I’ve been lied to so many times I don’t trust anybody in state government. The Department of Mental Health should be my son’s advocate, not his adversary,” he says.

Meanwhile, the Schnurmans are tired, and desperate for help. “It does not speak well of Missouri that we have no help to give,” McClellan writes.

Earlier column here.

Associated Press story on Fox News:

At least 20 disabled activists, most of them in wheelchairs, were arrested outside Sen. John McCain’s offices Tuesday after being refused a meeting with the GOP presidential nominee-to-be over a bill to expand Medicaid coverage to more people who want in-home care.

“If he should be president, it would be ironic that he comes from a party that talks a lot about family values,” said Bob Kafka, national organizer for ADAPT, a group advocating for passage of the bill. Without the legislation, many disabled and elderly people don’t have the choice to apply coverage to anything other than institutional care, he said.

“Families are devastated because they don’t have a choice to keep people at home,” Kafka said.

Earlier, from the Los Angeles Times: John McCain gets tax-free disability pension