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New Mexico Medicaid Call to Action for Autism Treatment

New mexico By Laura Bruening

Over a year ago I set out on a quest to recover my child Michael from Autism.  I have had many ups and downs, but have seen great progress..  I have always fought hard to get things paid for. I have spent countless hours on the phone each month seeking donations and finding alternative ways to get services and products paid for our son Michael.   Many companies have sent donations to our son over the last year to help us in our effort to recover our son.

We like a great portion of the families in my state have Medicaid.  New Mexico has several different versions of Medicaid.   First we have Medicaid Exempt- Only available to Native Americans in our state, or to new clients going on Medicaid. New Clients can only be on Medicaid exempt for 30 days. At the end of their 30 days, they must choose an HMO.  Then we have a list of HMO’s : Lovelace Salud, Presbyterian Salud, Molina Salud, and BlueCross Salud.  All these different Salud’s and Medicaid exempt are supposed to offer the same exact services.   There is supposed to be absolutely no difference in them, but there is.  This difference is not just a small one, but rather significant with some pretty large gaps in coverage.  These gaps don’t even include our Disability waivers….Don’t even get me started there…

It seems as though our great state of NM is not paying attention to what Medicaid is approving and what the HMO’s are approving as far as medically necessary benefits. Now I do understand that everyone is entitled to their opinion, but how can there be such a huge difference? 

It was this very question that got me thinking and making some phone calls to our State Medicaid office and the department of benefits’.  These conversations on Friday with the State Medicaid office put into question this:  Why are children in NM, who are seeking coverage for HBOT,  supplements’, and labs for  children on the spectrum continually being denied these services when they are available to their children.   Here are two examples:  HBOT- Medicaid exempt will pay for it under the diagnosis code…99183 / Physician attendance.   Supplements’ – these fall under nutritional benefits’,  and do not need to be approved by the FDA, or need the NDC code #. 

Most denials from our Medicaid programs are based on “Experimental” .  If these treatments are so experimental, then why is our state Medicaid exempt program paying for them?  Why are the various Medicaid programs using “Experimental” for denial? Why are two patients who have the same diagnosis ( not using Autism diagnosis either),  and different forms of Medicaid in NM receive different answers to the same request for HBOT or other services?

Here in NM we want answers. Every child has the right to proper medical care, the right to choices, and a proper diagnosis.  New Mexico here is your call to Action:

Call and leave a message or talk to Rose Armijo at The New Mexico State Medicaid office. Tell her your concerns and let her know what you are being denied and why. Tell her you want Answers.  If you can’t call, Fax her.  Flood the state Medicaid office with your phone calls and faxes.  Do this every Thurday until we see action.

To all other states…let’s make this a tea party…Call your local state Medicaid offices and get some answers.  Call the Office of civil Rights if you have to.  Make this not only a NM event, but a nationwide event.
 
Rose Armijo 
PH#  505-827-6200
Fax 505-827-3196
 
Linda Baca
Ph# 505-827-3137
 
One small voice is weak, many are heard…an Army of Mother Warriors are stronger.  Rise Up Mother Warriors and take the call to action!
 
With Hope Comes healing,
 
Laura Bruening
New Mexico mother warrior
 

Comments

mike ryan

I would like to get more involved in legislation for Massachusetts. But, I don't know where to begin. Does anyone in Massachusetts have any advice? Mike at mryanone@gmail.com, 978 290 3472.

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