If you have your own health insurance --
Posted: Tue Aug 15, 2006 10:52 am
If you have your own health insurance
The Dirty Secret of Child Welfare Fraud
www.profane-justice.org/CPSfraud_.pdf
The other form of medicaid fraud involves instances where the parents have their own health
insurance coverage on the child and the agency practice of artificially escalating the health care
needs of children in foster care. AFAC has received many reports of parents who have attempted to provide thecaseworker with their health insurance information at the time the child was removed from the
family home. The caseworker usually declines to accept that information. If the caseworker were
to accept the child’s existing health insurance, she would be required to take the child to providers
within that insurance network. The resultant examination and evaluation findings and
recommendations would be less likely to conform with the diagnoses and recommendations that
the caseworker needs to justify the child’s removal. Consequently, the caseworker will enroll the child in medicaid and take the child to theagency’s preferred providers. Many times, these providers never obtain the child’s past medical
records. The caseworker routinely provides her version of the child’s medical and mental health
history based on her biases, and misdiagnoses are common. Consequently, the resultant treatment
is frequently unnecessary, inappropriate and excessive. It rarely address the source of the problem,
but simply masks or blocks the symptoms.
- - - - - - - - - - - - - -
We have advised clients that if their child is placed in foster care, that they shouldimmediately call medicaid and advise them that their child has other health insurance. Medicaid
will then refuse payment for that child’s treatment until the primary insurance pays first. Since the
treatment services for these children are routinely provided by out-of-service providers, the
primary insurance also refuses to pay. Few parents are even aware of this fraud since they lose all
control over their child’s medical and psychological treatment while he is in foster care.
_________________
The Dirty Secret of Child Welfare Fraud
www.profane-justice.org/CPSfraud_.pdf
The other form of medicaid fraud involves instances where the parents have their own health
insurance coverage on the child and the agency practice of artificially escalating the health care
needs of children in foster care. AFAC has received many reports of parents who have attempted to provide thecaseworker with their health insurance information at the time the child was removed from the
family home. The caseworker usually declines to accept that information. If the caseworker were
to accept the child’s existing health insurance, she would be required to take the child to providers
within that insurance network. The resultant examination and evaluation findings and
recommendations would be less likely to conform with the diagnoses and recommendations that
the caseworker needs to justify the child’s removal. Consequently, the caseworker will enroll the child in medicaid and take the child to theagency’s preferred providers. Many times, these providers never obtain the child’s past medical
records. The caseworker routinely provides her version of the child’s medical and mental health
history based on her biases, and misdiagnoses are common. Consequently, the resultant treatment
is frequently unnecessary, inappropriate and excessive. It rarely address the source of the problem,
but simply masks or blocks the symptoms.
- - - - - - - - - - - - - -
We have advised clients that if their child is placed in foster care, that they shouldimmediately call medicaid and advise them that their child has other health insurance. Medicaid
will then refuse payment for that child’s treatment until the primary insurance pays first. Since the
treatment services for these children are routinely provided by out-of-service providers, the
primary insurance also refuses to pay. Few parents are even aware of this fraud since they lose all
control over their child’s medical and psychological treatment while he is in foster care.
_________________