Managed Care for Children’s Mental Health is a Bad Idea

It’s only a matter of time before we learn that some insurance company reviewer decided the treatment Adam Lanza needed, the treatment that might have saved dozens of lives, wasn’t “medically necessary” and refused funding. Too few know that Medicaid funding for children’s mental health treatment has been available for decades to children with disabilities in Connecticut, and thirty-five other states, regardless of family income. State Medicaid Agencies and the Managed Care Organizations they support do their best to ration and restrict access to those funds. Adam was eligible for funding through the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) mandate in Connecticut, which could have enabled him to receive treatment for his socialization and communication deficits. Having that treatment might have helped him just like it has been helping children in Pennsylvania with similar challenges for decades. In Pennsylvania, knowledge of Medicaid’s EPSDT funding potential has been more widely distributed because of a series of lawsuits that pulled back the curtain. Parents throughout the US need to learn that Medicaid funding for in-home and in-school mental health treatment exists so their children can get early, effective, intensive in-home and in-school treatment, which can make all the difference in the world. In fact, it’s a Civil Right in the Social Security Act.

Watch this video to learn how EPSDT funding for mental health treatment of children can be secured in all 50 states.

Here is a link to a summary of Federal regulations that explain how Medicaid-eligible children have enforceable rights to EPSDT funding for the treatment of their mental illness symptoms.



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