Hudson Valley parents, early intervention providers say new state billing system preventing children from receiving crucial care

Hudson Valley parents and early intervention providers are voicing their frustrations with what they say is a “major glitch” in the state’s new billing system, preventing children from getting crucial services.

The New York State Health Department switched to the EI Hub in October due to what they say were long-term security and stability concerns with the previous system, NYEIS.

Providers and parents, however, say the new system has made it difficult to enroll or get pre-authorization for children’s services since – leaving many young patients with developmental and physical needs without care and providers unpaid.

“It’s just devastating and frustrating as a mom that I can’t do anything,” says Alicia Olowu, from Pine Island.

Olowu’s 2-year-old daughter was born prematurely at 25 weeks and has been receiving occupational, speech, physical and special services from the state since she was 6 months old, according to the mother. Olowu says her daughter has only received half of those services since the implementation of the new system.

“I definitely notice a difference in terms of progression,” Olowu says. “She needs the services to learn to do basic things that just come naturally to kids {like} balance and walking upstairs.”

The DOH oversees early intervention services for roughly 70,000 children, up until the age of 3, who need care. A state representative acknowledges that the new system has created “some” difficulties, but says they’ve been fixed, and that providers are being reimbursed while improvements are made.

“New York state's first priority is to ensure that the 70,000 children served by the early intervention program continue to receive the health care and resources they need,” says NYS DOH spokesperson Erin Clary. “At this time, the Department has worked to address technical problems with the EI-Hub that have, in certain and limited circumstances, prevented providers from being paid on time. Providers are now being reimbursed in a timely manner, and we continue to make improvements to the EI Hub to ensure it operates smoothly for providers and therapists statewide."

Providers, however, say they were unpaid for months and that there are still disruptions to services as a result.

“After 12 weeks of being on the phone for countless hours, I was finally able to get my account fixed, however, due to the system's failing I have not been able to get reimbursed for all my sessions,” says early intervention provider Isabella Saffioti. “This has not only created gaps in care for children during this crucial time in their development but also many children are now waiting months for services due to the system's failures.”

Both providers and families we spoke to say they’re still having problems and claim they can’t get any answers from the state.

“It’s always kicked back to it being something else,” says Caroline Banks, of Ellenville, whose 19-month-old son needs services she says he isn’t receiving for a birth defect that causes developmental delays and neurological issues. “They have to do better. We shouldn’t have to fight to get these services.”

Clary says the EI Hub transition does not prevent children from receiving care and that providers should continue to deliver services, noting that the 90-day timely filing limit for providers has been extended. She says the DOH is seeing consistent increases in the number of claims processed.