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DPW Report Indicates Number of Denials in HealthChoices is Low - Is this Accurate?
We Need Your Help
December 12, 2001

At a recent Southeast Region Meeting the issue of denials in HealthChoices was discussed. The Office of Mental Health and Substance Abuse Services (OMHSAS) reported that the number of denials was low. PCPA members present reported a very different experience. Members cited various ways in which services were being denied or limited without ever ending up reported as a denial to the state. Some examples included limited criteria, programs requirements that cannot be met, and a fail first mentality.

PCPA will be developing a summary of ways in which access to services is denied or limited but not being reported to the state.

Please send any specific examples you may have to Lynn Cooper at the Association no later than January 7, 2002. Be certain to include any documentation such as program descriptions, criteria, etc. Also, be sure to remove any specific agency or client information on the documents that you send.

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