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On September 23, 2016, the United States Court of Appeals for the Seventh Circuit upheld a Federal District Court's Preliminary Injunction which Ordered the Illinois Department of Healthcare and Family Services (HFS) to "take immediate and affirmative steps" to provide in-home nursing care to children with severe medical needs.
HFS has approved more than 1,200 children for in-home nursing care based on medical necessity, but has failed to arrange the in-home nursing care.
As a result, many children are at risk of hospitalization, because the nursing agencies are unable to staff all the approved hours at the child's residence. Additionally, other children who could and should be cared for in their homes have remained in hospitals and other similar facilities, some for years.
HFS's refusal to arrange for in-home nursing care violates Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision, which requires the State to make medical assistance available for Medicaid eligible individuals.
According to Attorney Robert H. Farley, Jr., "As a result of this landmark decision, under Federal Law, the States have an affirmative obligation to make sure that children and persons entitled to medically necessary services are able to actually receive these services."
FOR MORE INFORMATION: Please email Attorney Robert H. Farley, Jr., at farleylaw@aol.com or call at 630-369-0103.