In NJ, disabled patients say Medicaid insurers often delay, deny care

AI-assisted summary

New Jersey's Medicaid managed-care system allows private insurers to decide on essential services for residents with disabilities.

Families and advocates argue that insurers often deny or reduce care, like in-home nursing, to control costs.

Patients face a difficult appeals process that they say is stacked against them, even when doctors deem care medically necessary.

Josh Gargano knew what would happen when his therapy was cut.

His body would seize up. Without regular physical and occupational therapy, his spastic quadriplegia — a severe form of cerebral palsy — would lead to increased stiffness, reduced mobility and, eventually, chronic pain.

“You take these services away, I regress,” said Gargano, 35, who uses a wheelchair. “You put me back on them, I improve.