The Problem:
A psychologist raised concerns about a new request from a Medicaid provider to release raw testing scores without interpretation. This practice could allow unqualified individuals to use complex assessment data, create ethical concerns, and risk breaches in test security. It could also create new barriers for children with disabilities by requiring duplicate evaluations, adding unnecessary costs and stress for families. If the practice continued, it could delay access to the services needed.
Action:
The Maine Developmental Disabilities Council (MDDC) worked quickly through its strong relationships with leadership at the Department of Health and Human Services (DHHS) and MaineCare. The Council raised the concern and helped bring attention to how the practice could affect service access and professional standards.
Results:
State leaders reviewed the issue and found that the problem was caused by a misinterpretation of MaineCare rules by a newly contracted prior authorization agency. DHHS leadership corrected the policy and stopped the practice. By resolving the issue early, the state avoided creating unnecessary barriers that could have affected more than 6,000 children seeking services.
Unique Role of the Council:
MDDC is a trusted systems partner that can quickly connect professionals, agencies, and decision-makers to address policy problems. Because of its relationships and reputation, the Council was able to elevate the issue and help resolve it before it created widespread barriers for families.