Is a Medicaid waiting game leaving special needs kids in the middle?

Advocates for children with special needs say they’re concerned about a problem with Medicaid that could affect the therapy those children need.

Last year, Florida made changes to the way therapy centers work with Medicaid. The Agency for Healthcare Administration, or AHCA, started a review of how it processes Medicaid cases to crack down on fraud. The review led to several changes for health care and treatment providers.

Jasmin Elicier, the program director at Santiago & Friends Family Center for Autism, said her center and others like it are struggling to make sure vital services aren’t interrupted.

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For example, the center met a Dec. 31st deadline for behavioral technicians to submit required documentation.

“We were still suspended,” Elicier said. “So we’ve been rending services since the last two weeks of December without being reimbursed. All claims to Medicaid are being suspended.”

And with no money from Medicaid, many centers are forced to tap reserves.

“We’re fronting payments, we’re fronting salaries, we’re paying people hourly for services they’re rendering,” Elicier said.

Elicier is worried about how long the center can hold out before the reimbursements start coming.

“Once we break that routine for the children, we’re creating chaos for the families. We’re creating chaos for children and we’re talking about potentially leaving people without jobs,” said Elicier.

“This is going to have a huge impact on kids statewide,” said Florida State Rep. Rene Plasencia, who is meeting with AHCA officials this week in hopes of keeping important services running. “We have 8,000 providers across the state of Florida.”

In a statement, an AHCA spokesperson told Channel 9: "No Medicaid recipients will go without services. If any recipient is having difficulty accessing services, please call the Florida Medicaid helpline at 1-877-254-1055."

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