Lauren Rainey will probably die soon

Lauren Rainey wins!

This 13-year-old middle-school student had been in danger of having her nursing care terminated. Now Medicaid has changed its policies for the better. Read details here.

Please read this update for current news on Lauren Rainey’s case.

This is Lauren Rainey.

She is 13 years old and very sick. She may die soon. And if she does, it’ll probably be because Alabama Medicaid terminated her nursing care. The horrific story comes via Eschaton and Bob Harris; the following text comes from WPMI (NBC 15):

Due to her medical condition, Lauren requires 24-hour a day supervision. Medicaid currently provides her a trained nurse for 10 hours a day. But a recent letter from Alabama Medicaid says a decision has been made to eliminate Lauren’s care.

As to why, Medicaid officials would only tell Lauren’s mother: “She doesn’t meet the criteria. I don’t know how they can do that.”

To find out, NBC15’s Bruce Mildwurf went to Montgomery to meet with Alabama Medicaid Medical Director Dr. Mary McIntyre. She is the doctor who made the final decision in Lauren’s case. “I have to make it (decisions on Medicaid clients) based on the medical information that is provided, the documentation that is submitted, and whether or not they actually meet the criteria,” said McIntyre.

The Medicaid official said the decision is based solely on the individual’s medical records and the nurses progress notes. She said Medicaid only provides nursing care for patients whose condition is clearly worsening.

Dr. Lawrence Sindel, Lauren’s doctor, responds to that by saying, “Clearly the people that made the decision don’t understand what’s going on with Lauren or they decided taking care of her is not worthwhile.”

Dr. Sindel has cared for Lauren for ten years. He said if they waited for her condition to worsen further, the price could be her life. “I think if she were to get the flu, it would be very difficult to help her through that. If she were to catch a pneumonia, it would be very difficult to help her through that. So the likelihood she could die is very high.” said Sindel.

“Words like could and may, those are all things that could happen to anyone in this room.” said McIntyre during our interview. The difference being everyone who was in the room when she made that comment was healthy. [...]

Minutes before our interview with Dr. McIntyre, Mildwurf was told we would only speak in general terms… that we were not to mention Lauren by name… “Because of regulations, that is not something as an individual or as an agency… that’s not something we can discuss.” We were told that even though Lauren’s mother filled out the necessary paperwork giving Medicaid permission to speak specifically about her case.

When Lauren’s name was mentioned by us, just to ask what information we had access to, the interview abruptly ended. “Turn the camera off. We’re done with the interview at this point,” we were told.

Before walking away, Dr. McIntyre did admit she makes her final decision to deny care without ever seeing the patients.

This is Dr. Mary McIntyre.

And this is her phone number:(334) 353-8473.

And this is her email address: mmcintyre@medicaid.state.al.us.

Help Dr. McIntyre make the right decision.