Can a low-income child who was prescribed Ritalin, though Medicare, to calm down get his funding cut off?

Question

I am a Special Education teacher. One of my low-income students had shown behavioral improvement once he was prescribed Ritalin through Medicare; in other words, he was calming down and focusing on his schoolwork because of this prescribed drug.

Now his behavior has deteriorated again. His mother claims that Medicare cut off the funding to pay for her son's Ritalin, but won't tell me why.

Is this possible? What reason would Medicare do such a thing if the child in question still clearly needs the Ritalin?

Additional Details

My apologies, I meant Medicaid.

Answer 1

Best Answer - Chosen by Voters

I thought it was Medicaid?? My son is on medicaid and he's on focaline a similar drug... they have never threatened to cut him or lower his funding at all. If the doctor prescribes it they pay it.

Answer 2

It is possible. Medicade can do anything they see fit. If the mother had to provide documentation to the state, and she failed to follow through then it is a good chance the funds were terminated. Have you considered meeting with the behavioralist at the school you teach at and get some interventions in place for this child? If he is not on meds, get the physical therapist invovled and get him some sensory input, which can be very helpful for a child that is easily distracted. these things may be better for him than the medication. Medication is not always the answer!

Answer 3

I can't imagine Medicaid cutting off a kid from
a medication that he clearly needs. It sounds more
like a situation where if the mother tells the child's
doctor that he is doing better now, its possible that
the mother suggested that he may not need it anymore
or that that child's doctor feels that he doesn't need it
anymore. If the doctor doesn't feel he needs it, then
Medicaid isn't going to pay for something he doesn't need.

Answer 4

It sounds like the mother may have done something wrong to have the meds stopped. have another meeting with the mother.. Maybe you can see if she is telling the truth. If there is any doubt you could contact the authorities..