If you have your own health insurance --

A place to discuss the many medical issues that may come up during the course of a CPS case.

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If you have your own health insurance --

Postby Marina » Tue Aug 15, 2006 10:52 am

If you have your own health insurance

The Dirty Secret of Child Welfare Fraud


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.

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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.

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Postby alleycat1965 » Wed Aug 16, 2006 10:51 am

When they took my daughter away, they tried to get the person that kept her for us to sign her up on medicare/medicade and she told them no, that we had insurance. The worker didn't like that very much.

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Postby tnradmom » Sat Feb 24, 2007 4:51 pm

we actually have both private and medicaid on the kids. Or I should say TennCare... there is a difference. What it does do is forces DCS to take J to our doctors. That is a huge thing alone.

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Postby 4what? » Tue Jul 24, 2007 11:31 am

Oh my! That happened to me... I had paid medical insurance for them that was never used. :? They also had dance school that was paid for too. DSS never took them.

I wish I would of seen this sooner.

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Postby Frustrated » Tue Jul 24, 2007 4:38 pm

I remember a while back where a CPS Worker asked a Family to give them Medical Insurance information so that she can take it to the Foster Care Parents for caring that child. I guess the State don't want to pay Medical Insurance so instead, they come in and steals yours.

I remember also, the CPS worker had to convince a family to sign over Medical Release (Consent Forms) just so that the worker can get complete medical files released to CPS. I mean the entire files. Even yours.

This is a violation to your privacy right, and that's why they want to bypass the Hippa Laws just so that they can use anything in these medical files against you.

Do not give up Medical Insurance to them, tell them to get them court ordered. After all, you paid for them, why give them the right to steal your money?> it is very much the same thing. (almost)

I remember in toronto where a CPS Worker had to steal a Debit Card that the Mother had made out for the Child to use, and attach to the Stuffed animal and gave it to the CPS Office, then the CPS Worker eyed the card, and stole it and she used it to buy gifts for herself. Not for the Child. I believe it was 25 or 50 bucks. These days, it was a Christmas gift, so people called her the Grinch Lady. The Worker was charged for the stealing and went to Prison for it. I hope we can see more of these charges brought on the Workers more often. such as pejury, stealing, fabricating reports and so forth. :wink:
It is easy to steal from poor people. But don't do it. And don't take advantage of those poor people in court. The Lord is on their side. He supports them and he will take things away from any person that takes from them.~ Proverbs 22:22

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Re: If you have your own health insurance --

Postby devastatedmom » Thu Feb 17, 2011 3:41 pm

We have private insurance on our kids, and our caseworker never asked for our information...they just somehow got our insurance info and we started getting insurance statements showing that our youngest daughter has been taken to the doctor twice, and has had a neuropsych eval done. We have been told we cannot have copies of the neuropsych eval, siting the reason that Children's Division paid for it. But our insurance actually paid 55% of the bill for it - Medicaid picked up the remainder, after an 11% discount because of it being an in-network provider.

what I want to know is whether or not we have the right to copies of that eval...they won't even tell us the diagnosis given to our daughter. i want to just ask my insurance company to get us a copy, but I don't want to do anything that's going to get me in trouble, either.

We live in Greene County MO...

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Re: If you have your own health insurance --

Postby treytrey1 » Sat Feb 26, 2011 10:37 am

I dont know about your state but in my state you do have the right to know about all medical records and school records.
Our state also requires that all children in Dcs or cps custody be on state insurance.

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Re: If you have your own health insurance --

Postby LindaJM » Sat Feb 26, 2011 1:46 pm

I don't want to do anything that's going to get me in trouble,

How much more trouble can you get into? They have your child. They've already torn your heart out.

I would file for a state administrative hearing to request the medical records on the basis that your insurance is paying for this as well.

If you're afraid to rock the boat a little they'll assume you're a doormat they can walk all over.
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Please keep in mind that none of us are lawyers and we can't give legal advice. We are simply telling you what we would do in a similar situation. It is to your advantage to get a lawyer.

"Evil flourishes when good men do nothing." - Edmund Burke ... so try to do something to change the system ...

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Re: If you have your own health insurance --

Postby Debski32 » Sat Sep 03, 2011 4:13 pm

If you have the name of the provider, the Freedom Of information Act, or whatever it is called in your state as each state gives a different name, will
allow you access to those records as you are the parents. It is not based on who pays for the bill. Do not rely on caseworkers to tell you what the law is
as they do not know it nor do most comply by them. Many CPS workers give out legal advice but the courts have already decided that, doing so is
a violation of law and against your best interest.
I also agree to the people who are afraid to rock the boat. If they have your children...they have almost everything so do not be afraid to start making a stand
and claim them back. They (CPS) are not afraid to upset you or your kids and definitely not afraid to rock anyone's boat. Do not be a doormat for them.

Most times to claim your rights you have to rock the boat or you will be left with no rights at all.

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