Dangerous Healthcare Gaps For Illinois Kids

medicare children

Delays in Treatment and Missing Medication Follow New Health Care Plan for Illinois Foster Kids on Medicaid

On February 1, 2020, nearly 2,500 children and young adults provided care through the Illinois foster care system lost their healthcare coverage due to what a Department of Healthcare and Family Services spokeswoman for the agency that runs the state Medicaid program, described as a “glitch” in a computer program. Although the state started transitioning its Medicaid program in 2011 from a traditional fee-for-service model to managed care, the move has remained troublesome for more an estimated 19,000 former foster children and approximately 17,000 more. The sensitive population in need of medical care through physician visits, therapies, and medication includes children who are victims of abuse and neglect, many of whom have highly complex physical, mental and behavioral health issues, but also those born with cognitive and physical disabilities.

According to several Illinois news reports:

  • State officials have intended to move foster children groups into managed care for years, but the official launch date has been delayed several times.
  • Under the managed care, the state contracts with a number of private insurance companies and pays them a flat monthly fee for each patient they enroll.
  • In turn, the companies, known as managed care organizations (MCOs), are supposed to support those patients’ care by:
    • making sure they have complete health screenings
    • scheduling regular checkups
    • coordinate care between the patient’s primary doctor and any specialists they need
    • provide access to therapies, prescription drugs, devices and medical supplies
  • Finally, the state announced last monththat former foster children would be shifted into managed care on February 1, 2020. Still, current foster children would not be moved into the new system until April 1, 2020.
  • Since the latest move, there have been multiple reports of MCOs denying claims and delaying payments, often because enrollment with the MCO wasn’t completed correctly or the provider that a patient went to see wasn’t in-network.
  • Dangerous examples of gaps in care reported to the state include MCOs who refused to speak with parents about a child’s health condition unless the child executed a power of attorney and life-saving medication and supplies not provided. Some of the children were as young as two years old.

Many Illinois lawmakers have remained skeptical of the managed care system and say the foster children deserve better quality health care with coordinated services and support. Illinois State Senator Julie Morrison chairs the Human Services Committee and has suggested that the integrity of the state’s foster care system in now “on the line.” At Levin & Perconti, we couldn’t agree more.

Working with Chicago’s Top Medical Malpractice and Personal Injury Attorneys

If you or your child has experienced medical malpractice or a delay in treatment caused a greater personal injury or illness due to these coverage changes in Chicago or throughout Illinois, take action immediately as time limits do apply. Levin & Perconti is a nationally renowned law firm concentrating in all types of personal injury, medical malpractice, and wrongful death lawsuits. There is no risk to you in calling to speak to one of our Chicago personal injury lawyers. You can reach us by calling 312-332-2872 or toll-free at 877-374-1417.

Also read: Department of Public Health Plans to Remove License from Chicago Lakeshore Hospital, Federal Funding Revoked

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