A Phoenix mother is seeking explanations after a weeklong delay in getting emergency medical equipment for her young son. Elizabeth Richards says her son, Stetson, who is 7, has faced serious health problems since birth and requires constant monitoring.
"My son has seizures daily and his oxygen drops sometimes when he has seizures," Richards said. "It's pretty scary." The family depends on a pulse oximeter and other monitoring gear to track his vital signs.
When the pulse oximeter stopped working, Richards reached out to Preferred Homecare, the company that provides Stetson’s durable medical equipment, expecting a swift replacement. Instead she was told a prior authorization was required before an emergency delivery could be made.
A pulse oximeter and monitoring unit hang beside a child’s bed and toys — the device Phoenix mother Elizabeth Richards says stopped working while she awaits answers about a delayed emergency replacement.
Richards said the company stood by that policy and advised her to admit Stetson to the hospital for seven to 14 days while waiting for approval. "It is a very helpless feeling. I had no idea what to do over the weekend," she said.
After several days and involvement from Stetson’s medical team, Richards said Preferred Homecare contacted her to say a prior authorization was not needed and a delivery would be scheduled. "I about lost my mind because they’ve been telling me I needed a prior authorization for the past week," she said. "Everyone tells me it’s out of their hands, there’s nothing we can do. I’m like, my child is on a ventilator and I’m calling for life-saving equipment. I’m just asking you to do your job."
State Medicaid officials with AHCCCS said there have been no recent state or federal policy changes that would cut coverage for medical equipment or emergency replacements. "AHCCCS contracts with managed care health plans, which are responsible for authorizing covered services and ensuring members have access to medically necessary equipment through contracted DME providers," a spokesperson wrote. A representative for Preferred Homecare declined to discuss the specific case because of patient privacy but said patient health and safety are a top priority and that the company works with physicians, insurers and others to obtain timely information.
Stetson ultimately received the replacement equipment, but Richards said she remains worried the problem could recur. "I’m terrified," she said. AHCCCS said it is reviewing the situation and reiterated its commitment to ensuring members receive medically necessary, life-sustaining services. Families experiencing delays were advised to contact their health plan or AHCCCS member services, and if the issue is not resolved to call AHCCCS’ Clinical Resolution Unit at 602-364-4558 or 800-867-5808.