Thursday, May 23, 2013

Snort-worthy: NYS makes EI providers prove financial hardship before they will pay.


Here is some follow-up information for parents who are wondering why their children are on a waiting list for the NY State Early Intervention Program.  As indicated in earlier posts, there are fewer providers available to deliver services because many have left the early intervention system.  The program has directly contributed to a systematic destruction of small businesses operated by therapy providers around the state.  Those who remain are large agencies who are now beginning to be cash-strapped and others who happen to have a level of uncommon/savvy navigation skills that allows them to operate amidst the NY State-generated chaos.  Most early intervention providers have not seen payments since mid to late March and based on current projections they are only now beginning to trickle out partial payments for services that were delivered in the beginning of April.

If you read through the blog you will find a series of entries describing the disastrous implementation of a centralized billing system and absolute mismanagement of the early intervention program.  We received this email gem today, asking providers to write a letter begging for payment if they can prove financial hardship.  Here is the begging template that they want providers to use:



SAMPLE LETTER ONLY: PROVIDER MUST SUBMIT ON OWN LETTERHEAD
Date

Ms Deborah Martins/Mr.Anil Thomas
New York State Department of Health
Medicaid Financial Management
Corning Tower - Room 2739
Empire State Plaza
Albany, New York 12237-0016

Faxed Letter Date _________ to 518-473-8786
Original Mailed Overnight on ____________
MMIS PROVIDER I.D. ________________

Dear Ms Martins/Mr Thomas:
We are requesting an accelerated early release of the system check(s) and remittances dated ____________ and the amount(s) of $ _______________________.  The check(s) and remittances were scheduled to be released on _____________________ (date), and we are requesting approval of its release on _____________________ (date).   If approved, we will have the check and remittances (CHOOSE ONE)
_______ EFT
_______ Pick-Up in Menands New York          or
_______ Federal Express,            or
_______ First Class mail.


As a result of Medicaid billing problems, we cannot wait for the scheduled release date of the check for the following reason(s):

1. Explain the Medicaid Billing Problem,    AND

2. Cash flow or cash flow narrative which clearly shows why you cannot wait for the check to be released on the scheduled date.

As required, attached is a copy of a letter from our bank or financial institution which indicates we have been denied a line of credit, or, we have exhausted our current line of credit (i.e. relatively new line of credit or a “ceiling”  extension on a previous line of credit) and that we are ineligible for any  further assistance.
Sincerely,
xxxxxxxxxxxxxxxxxxxxxx

In order for early intervention professionals to be paid they are now requiring a cash flow statement submitted with the request for early release of payment that proves financial hardship. They state that Medicaid Financial Management will only make payments early if there is a valid and substantiated need for the payment. 

So here is my question back to NY State: Can I demand a cash flow statement and begging letter from you in order for me to send in my payroll taxes and quarterly income tax payments??

Shameful.

Wednesday, May 01, 2013

Tinfoil hat analysis: Crypto-eugenics and the autism community


I believe in science and I also believe in scientific advancement.  I have stated before that I am not a Luddite even though I sometimes take positions that might cause people to question.

I am having another Luddite moment though.

About a year ago I wrote a cautionary post to the autism community, advising them to embrace the DSM-V changes that would make diagnosis more difficult.  In summary the post was a tinfoil hat analysis of eugenics and disabilities and reflected on what we have seen happen in the T21 community.  Today I am thinking that embracing DSM-V changes  is not enough to provide appropriate cover from the crypto-eugenicists.

Well it is time to dust off the tinfoil hats because we have ongoing evidence of more shift toward a death culture that now has the autism community directly in the crosshairs.

Walker et al (2013) just published a study that essentially creates a context where autism risk can be accurately identified via looking at the creases and folds in the placenta.  Apparently, having two or more folds predicted autism at a 92% specificity rate and having four or more folds predicted autism at a 99.9% specificity rate.

The authors are excited about their findings and believe that this discovery can help with early diagnosis and early intervention.

I have no reason to doubt their direct intentions.  But I also have a deep understanding of how these things get started.  You can be certain that there are more than a few crypto-eugenicists who are spinning their wheels over this.  Please recall it was just a year ago that we were all treated to the infamous Giubilini and Minerva (2012) article calling for "after birth abortions."

The issue here is that the death culture will continue to take whacks at this issue in direct or indirect ways - it does not matter how outraged any community may get, and there was an awful lot of controversy on this last year.  The death culture will not be discouraged.

Here is another stunning example of how we slide down the slope - Kouider et al (2013) just published an interesting article that used EEG to analyze facial recognition in infants.  They used the term 'perceptual consciousness' in a rather specific way but the popular culture picks up the information and reports it in a slightly different way.  This popular aggregation site doesn't say 'perceptual consciousness' but rather that 'babies have consciousness at 5 months of age.'  

It does not take much to imagine what horrible positions can be justified when someone uses the argument that babies don't have 'consciousness' yet.

These are important issues for occupational therapists to consider because we are on the front-lines of intervention for children who have disabilities.  I encourage all OTs working in pediatrics to deeply read about these issues and to be on the alert for policies that marginalize people and limit access to appropriate care.  These policies will be the shot across the bow for worse things to come.


References:

Giubilini, A.; Minerva, F. (2012). "After-birth abortion: Why should the baby live?". Journal of Medical Ethics. doi:10.1136/medethics-2011-100411

Kouider, S., et al. (2013). A neural marker of perceptual consciousness in infants. Science, 340(6130), 376-380.

Walker, C.K., et al (2013). Trophoblast inclusions are significantly increased in the placentas of children in families at risk for autism. Biological psychiatry,  (Article in Press DOI: 10.1016/j.biopsych.2013.03.006)