Ensuring Access to Health Care Services for Students with Disabilities

Children spend a lot of their day at school, so it is important that they have access to needed Medicaid services during the school day.  In 1997, DRP and co-counsel from ELC filed Bates-Booker v Houstoun on behalf of Medicaid eligible children who were denied services by their MCO.  The MCO denied coverage for hearing aids and speech therapy on the basis that the children’s school district was responsible to provide those services.  We argued that while some services may be covered under the Individuals with Disabilities Education Act, medical treatment is excluded from coverage and children are entitled to medically necessary services under Medicaid regardless of other coverage.  Again in 1999, we filed a similar suit with ELC, Hurst v. Houstoun, to challenge denials of nursing services and therapies for Medicaid-eligible children in the fee-for-service system on the basis that schools should pay for those services.  Pennsylvania agreed to stop denying services on that basis and to remedy unlawful denials that had occurred.