Metro Family Fights MCO For Adopted Daughter’s Psychiatric Treatment

PLEASANT Hill, Iowa--  The Henderson's from Pleasant Hill are waiting to see if their adopted daughter will continue to get the psychiatric treatment they believe she needs

The family says it’s been a long and tough road, but they are finally seeing progress.

“Taking whatever, she could and hitting me with it and physically punching me and kicking me trying to push me down the stairs," resident Melissa Henderson said.

Melissa Henderson is talking about her 15-year-old adopted daughter.

“There would be days that she destroyed our house," Melissa Henderson said.

The Henderson's say their daughter was born opioid dependent.

Records show she is diagnosed with bipolar and Reactive Attachment Disorder (RAD).

The state of Iowa gave her Medicaid for life and she has been in and out of mental health facilities almost her entire life.

“Well I am not leaving my child I want her to get the help she needs, and we couldn’t get it," Melissa Henderson said.

That’s when the family turned to Calo which is a treatment facility in Missouri that specializes in RAD.

“We feel like we are on the right track and we believe we are on the right track. We know this place is helping our daughter when she comes home we can be a family again," Dennis Henderson said.

The program cost $435 a day the family says without insurance they can't afford it, and now their MCO United Healthcare doesn't want to pay for it.

“United Healthcare is not denying that this child needs services, but United Healthcare believes that these services can be provided to this child out-patient,” attorney Jennifer De Kock said.

“Literally within a couple of months of AmeriHealth pulling out as an MCO and United Healthcare taking over they started questioning everything they were doing, and wanted her out of there," Melissa Henderson said.

Back in April, United Healthcare sent a letter to the family denying inpatient benefits at Calo.

The Henderson’s appealed that decision and a judge ruled in their favor.

“It was not only the family’s opinion but also of the medical providers that she continue to need inpatient psychiatric care," Attorney Jennifer De Kock said.

That wasn't good enough for United Healthcare, the MCO wants Director of Medicaid Jerry Foxhoven to conduct another review.

“We are asking that director Foxhoven to let this decision stand," Attorney Jennifer De Kock said.

DHS declined comment, and we reached out to United Healthcare and its attorney and have no heard back.

Foxhoven has agreed to review this case with no timeline about when a final decision will be made.

Attorney Jennifer De Kock says the worst case scenario is that the family will have to reimburse Medicaid more than $100,000.

The Hendersons' hope this case paves the way for other families.

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