Medicaid rule change may have negative consequences

My friends in Salt Lake City are among the people who spoke out against this new rule.

Medicaid Rule Change Means Outdoor-designed Wheelchairs May Not Be
Covered

By Kirsten Stewart

The Salt Lake Tribune

Wheelchairs designed for use outside the home will no longer be covered by Medicaid under a rule change that disabled-rights advocates say is misguided, and one occupational therapist likened to placing hundreds of Utahans on house arrest.

Utah health officials say the rule simply codifies existing practice. For more than a decade, Medicaid has paid only for manual and motorized wheelchairs deemed medically necessary and designed for use in the home, said Medicaid budget supervisor Don Hawley.

“Just because the design is for the home doesn’t mean it won’t be suitable for outside,” said Hawley. “But we’re not going to pay for someone to have knobby sports tires.”
 
Advocates fear, however, the rule will be taken too literally by front-line claims workers and used to deny benefits. “In the home” is a Medicare term that has been misinterpreted and expanded over the years, said Matt Knotts, director of the Disability Law Center. “A disability doesn’t stop at the door.” Jerry Costley, with the Disability Rights Action Committee, finds the rule offensive, saying “the message it sends is very much one of segregation.”

Matt Lowell, a physical therapist at Shriner’s Hospital, said he has worked with patients who might be able to get around in the home with a walker, but need a wheelchair to go to work, grocery shopping or church.

“This is like placing disabled people on house arrest,” said Lowell. Lowell was among a dozen people to protest the “in the home” provision at a hearing Wednesday. The rule also seeks to stop Medicaid payment for prosthetic limbs with special shoes and post-chemotherapy wigs and hair replacements.

Fewer than 1,000 beneficiaries would be affected, said Hawley. By comparison, the temporary loss of dental and vision care in previous years touched tens of thousands of people.

Hawley said the goal isn’t to save money, but to guard against overspending and fraud. About $13 million of Medicaid’s $7 billion budget was spent on medical devices in 2006.

What is affected

* Wheelchairs specifically designed for use outside the home

* Prosthetic limbs with special shoes

* Post-chemotherapy wigs and hair replacements

 

One Response to “Medicaid rule change may have negative consequences”

  1. Okapidread says:

    As uyou can imagine, I am fuming (once again) at the sheer audacity these organizations have with respect to the needs of people living with disabilities! Decisions have been made that literally will keep people from leaving their homes and becoming shut-in’s once again, as was the case decades ago here in the US and is still the case in third world nations right now!
    This type of thinking on the parts of the ‘powers that be’ make living with a mobility impairment requiring the use of a mobility aide an automatic prison sentence inone’s own home and what’s worse is the fact that they don’t care.
    If they REALLY wanted to cut back on fraud-they should go after the complanies like ‘The Scooter Store’ that are giving them away and actually bragging on their commercials that if you can’t get funding from medicareor madicaid then they’ll give it to you at no cost!

    It is obviously their intention th

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