FDAnews Device Daily Bulletin

APPEALS COURT CALLS STATE DME MEDICAID POLICY 'UNREASONABLE'

July 11, 2006
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A panel of the Eighth U.S. Circuit Court of Appeals June 22 overturned a ruling in a case where a Missouri policy denied Medicaid device coverage to most of the state's adult program recipients.

U.S. District Judge Dean Whipple in September 2005 refused to block a policy denying Medicaid coverage for durable medical equipment (DME) such as wheelchair batteries and repairs, orthotic and orthopedic devices, intravenous nutritional services, hearing and speech aids, hospital beds, bed rails, lifts and prosthetics.

Missouri bill S.B. 539, which went into effect Aug. 28, 2005, names a wide range of DME as "optional" for Medicaid patients -- unless they belong to one of three sub-groups: "categorically needy" children, pregnant women and "persons who are blind," the judge noted in his ruling.

The plaintiffs, who are adult Medicaid recipients, "have disabilities ranging from paralysis to cardiopulmonary disease," the appeals panel noted in its decision. ()a href="http://www.fdanews.com/ddl/33_27/" target=_blank>