Family of disabled boy sues over refusal of Medicaid benefits
DENVER – The family of a 12-year-old developmentally disabled boy has sued the state, asking a judge to reverse a decision that terminated Medicaid benefits after successful treatment at a Rhode Island hospital racked up a $250,000 bill.A lawsuit filed in Denver District Court on Thursday alleges that Christian Schleusener was terminated from the Children’s Extensive Support program without proper notification, depriving his parents of the information they needed to argue against termination.Steve Tool, executive director of the state Health Care Policy and Financing Department, which administers Medicaid, declined to comment, saying he had not seen the lawsuit.”Part of the frustration here is that the family hasn’t been able to get any definitive answers about this hospitalization,” said attorney Andrea Faley of the Legal Center for People with Disabilities and Older People.Schleusener has Down and fragile X syndromes, which have caused mental retardation and various physical disorders, and he had become prone to violent outbursts in recent years, the lawsuit said. He had been receiving services through Children’s Extensive Support, which is designed to help developmentally disabled children avoid institutionalization, group homes or other out-of-home placements, the lawsuit said.After treatments in Colorado did not work, his family sent him to Bradley Hospital in Rhode Island, one of a few hospitals specializing in such cases, the lawsuit said. He was there from June to December 2005.State officials told the family that Medicaid benefits were terminated because Schleusener was not in Colorado to receive services, the lawsuit said. It said the family was not provided with state rules, regulations or law supporting the decision to terminate services, and that the family’s questions about the decision went unanswered.The lawsuit said the hospital bills could bring the family “financial ruin,” and said the costs should be covered by Medicaid. The lawsuit seeks reversal of the decision to terminate benefits and award the family unspecified financial damages and attorneys fees.
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