Thursday, May 13, 2010

Statement by Hawaii Medicaid Employee regarding Martin Boegel and Ohana

The following statement was released this morning by a current Med-Quest employee who is familiar with the circumstances of Martin Boegel's Medicare and Medicaid coverage.  The statement was written after I reported yesterday that Ohana had told a local reporter that Martin's medications were a Medicare responsibility, not theirs.

 I want to clarify the following because this is the reason many more innocent lives will be affected because of the lack of care by insurances like Ohana (Wellcare).  When the QExA Healthplans went "live" February 1, 2009 they were not ready to go.  This is an example of how Ohana does not even understand the basic coverage of Medicare.  Mr. Boegel did not have prescription drug coverage (Part D) under Medicare, he only had limited hospital, he did not have Medicare Part B, C, D and limited coverage under A.  That is why he had coverage under the State Prescription Assistance Program (SPAP - see below).  There has been numerous Aged, Blind, and Disabled harmed, when I left there were thousands of complaints some have since passed because Ohana and United did not want to pay for the most vunerable populations care and no one was there to advocate for them.

Ohana is ultimately responsible as they were to coordinate all care for Mr. Boegel Ohana does not even know the basic coverage of the primary insurance Medicare, and concerning as over 35,000 Medicaid clients are dual eligible (Medicare Primary/Medicaid Secondary).  Now look at how many lives were affected, the shooter, the by-standers, and his family (mom).  I hope this email makes a difference as there has been and will be more incidents in the future.

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About Me

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.