WellPower Is Sleeping With Colorado Medicaid

Dear Phil Weiser, Jared Polis and Colorado Access Board member Carl Clark MD and colleagues,

We would like to meet with you about how Colorado can devise a Corrective Action Plan to correct our failure to provide medically necessary services for children who are Medicaid members like we are.

Since August 2021 we have personally been researching the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) laws as we have been strenuously advocating for our own transition age children to receive a free appropriate public education, vocational rehabilitation, and access to medically necessary care in order to be able to survive and be able to attend school and work.

EPSDT is the child health component of Medicaid. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services. Unlike private insurance, EPSDT is designed to address problems early, ameliorate conditions, and intervene as early as possible.

We have discovered that Colorado Access does not have the processes in place to be able to comply with EPSDT and this must be rectified immediately. For Colorado children enrolled in Medicaid and entitled to EPSDT, the program is a vital source of coverage and a means to improve their health and well-being. Please be aware that where states have failed to implement EPSDT law, families have sometimes brought lawsuits in an effort to secure a remedy. We sincerely hope that we will not be forced to bring lawsuits for our own children due to Colorado’s non-compliance, but we are definitely being forced into that position right now by Colorado Access administrators’ actions and inactions.

Please be in touch at your earliest convenience. In the meantime, we will continue to pay out of pocket and use all of our family’s resources to ensure that our children’s medically necessary and education needs are met to the best of our ability. We are sincerely concerned about children and going broke protecting and advocating for our own. We have no choice. We have been unable to get your attention other than resorting to social media at this time. We hope you understand.

Respectfully and in service of our family, school, community, and 1m3s (Peace),
Lisa A. Weiss Rudofsky J.D. and Jason Rudofsky