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Hell Hath No Fury Like A Mama Grizzly Denied

It is no secret that Medicare, Medicaid and Social Security are in major need of overhauling. In fact, these three entitlements are some of the most heavily debated issues for both political parties.

What no one on either side of the political aisle will stop and think about is how the abuses of these systems that were created to help are now hurting the very ones that need it the most.

My husband and I have adopted 5 children from the foster care system. One of the benefits we receive from the state for them is healthcare in the form of Medicaid until they are 18 years of age.

We received our youngest child when he was only 7 weeks old. He was born addicted to cocaine, and when he came to us, he was still experiencing withdrawal tremors from the drug he was born addicted to. This is one of the most excruciatingly painful things I have ever experienced in my life! I felt so helpless, just wanting to make the pain go away for him!

Thankfully, he stopped having the withdrawal tremors. He is now a healthy, vibrant 3 1/2 year old who is into absolutely everything!

However, about 6 months ago, we began to notice a spot on his spine. It actually began as a bruise, which we originally thought was caused by his tumbling around with his two older brothers.  He may be the youngest, but he thinks he is as big as they are!

Unfortunately, the bruise did not go away. I took him to the doctor, and she told me that bruises of this kind take a very long time to heal. She explained that they are deep, so the healing process and time is much more extensive than a “normal” bruise. Feeling slightly better about things, we went about life, watching and waiting.

However, while the bruise eventually went away, a bump began to appear on his back, in the very same spot. I took him to the doctor yet again. She examined him, and determined that due to the fact that she could move the bump around, there was nothing to be alarmed about. This time, I wasn’t so sure. She told me to keep a watch on it, and if it didn’t go away, bring him back.

Rather than going away, the bump grew bigger. I took him back to the doctor yet again, and finally received a referral to a dermatologist.

Three weeks later, I was finally able to see the dermatologist. Upon examination, he determined that he needed to refer us to a neurologist. I questioned him extensively, and he explained that it could be a number of things, including the possibility of fluid leaking from his spine. This set off alarm bells for me! I tried desperately not to panic, but the thought that this is a real possibility is alarming!

The dermatologist also scheduled an MRI, so the neurologist would have this information at that appointment.

That evening, while discussing everything with my husband, we began to question the length of time it was going to take to get the MRI.  I told him that I would call the doctor’s office back the next day, to see if there was any way we could get the appointment moved up.

Before I had a chance to call, they were calling me to give me the neurologist’s number. I started telling the nurse about my concerns for the length of time we were still going to have to wait. She told me that when she first called to make the MRI appointment, the first available was in March! The doctor was not happy with this, so he personally called back to get an appointment sooner. The nurse assured me that if he had thought it was an absolute emergency, he would have gotten him in immediately! She advised me that if my son complained of his back hurting we simply needed to take him to the emergency room.

We’ve made the necessary arrangements for both appointments- the MRI and the neurology- and were simply waiting.

Then I received a call from the dermatologist office telling me that Medicaid has denied the MRI request! Remember: the children are on Medicaid due to the fact that they were adopted through the state Foster Care System. This is not simply a case of irresponsible parenting on our part.

When the nurse told me that Medicaid had denied the request, I got angry! She said the reason they gave for the denial was because there “was not enough documentation” to warrant an MRI!

Now, if you are not familiar with what an MRI is, WebMD will help explain it:

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. In many cases MRI gives different information about structures in the body than can be seen with an X-ray, ultrasound, or computed tomography (CT) scan. MRI also may show problems that cannot be seen with other imaging methods.
As you can see, an MRI is a TEST! The bureaucrats who make the decisions on who is approved and who is not approved can’t take into account that he has been by his pediatrician on 3 separate occasions, as well as a dermatologist. Four doctor appointments is not enough documentation to have a test performed to see if it is something that will require surgery.
However, a local dentist chain has “earned millions by targeting children on Medicaid.” This has gone on for years! My children were actually targeted by this very dentist chain, and had NUMEROUS “cavities” according to the dentists. It sure is strange- we’ve not had a SINGLE cavity since that visit, and the 3 previous visits were cavity free as well! Interestingly enough, the cavity free appointments were not at that clinic!
Unfortunately, they were still in foster care at the time, and not adopted, so I did not have the options I have now that they are adopted!
It took MONTHS, if not YEARS, for this dentist chain to be investigated, and in fact, I was interviewed in the process of the investigation. All this time, approvals went out from Medicaid with no questions asked. Yet, a test for a potentially harmful, or even deadly problem is denied?
This is just one specific situation I know of personally! There are thousands upon thousands of stories of medicaid fraud that go on daily in this country, with nothing at all being done! Yes, there are investigations, but much more needs to be done! Stop the fraud- by doctor’s and recipients, and you will save BILLIONS of dollars (possibly even TRILLIONS of dollars at this point, since the previously linked article is from 2005)!
We have reached a breaking point in our society. We talk about helping those in need- such as orphans- yet we have allowed fraud to run rampant on both sides of the process. We are receiving nothing but lip service from both political parties who claim they are seeking real solutions to the problems we are facing as a nation. Those who are truly in need cannot receive the necessary help because so many before them have abused the system. However, those who know how to “work” the system are allowed to continue “working” it, while those who truly need it are forced to do without.
As a Mama Grizzly, I am watching my little boy like a hawk! At the slightest inkling of increased pain, we have been advised to take our son to the emergency room. Medicaid has denied my son the necessary test to determine what must be done, but rest assured I will not sit idly by! I have made it my life’s goal to fight for these children who start out in life with so much against them! I will not allow these innocent children to pay the price for the actions of those before them!
It is a crying shame that we have allowed our innocent children to carry the burdens of this nation on their backs. They are paying the price for an out-of-control society that refuses to face reality! This is their future we are squandering away!
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  1. Kayla says:

    I have the same problem, I am 19, I went to the doctor, I have been complaining about back problems for several years and they scheduled me an MRI. I was denied the MRI by medicaid, it’s not fair to me because I hardly ever go to the doctor, and I have to be in pain every day not knowing what’s going on with my back because they won’t pay for it.