Lawsuit: State, managed care organizations not providing care to ‘most vulnerable’ children

Disability Rights New Mexico and three families filed a suit against the state and three managed care organizations for allegedly not providing necessary care to medically fragile children. The managed care organizations are New Mexico Blue Cross and Blue Shield, Presbyterian Health Plan and Western Sky Community Care. 

Medicaid is required to provide at-home care to severely disabled children whose ability to live at home is dependent upon trained nursing, the complaint states. Jesse Clifton, a lawyer with Disability Rights New Mexico, said the state has about 400 medically-fragile children, some of whom are not receiving any at-home nursing despite qualifying for it. He said he anticipates more families will join the lawsuit. The state is providing federal funds for that coverage, Clifton and Holly Mell, also a lawyer for Disability Rights New Mexico, told NM Political Report.