Missouri Medicaid Budget Proposal Cuts Adult DME Coverage

JEFFERSON CITY–Missouri Gov. Mathew Blunt’s office has proposed
a budget that calls for the elimination of adult DME coverage under
the state’s Medicaid program.

A Department of Social Services (DSS) memo circulated in late
January said the state budget proposal calls for the elimination of
adult medical equipment and prosthetics coverage. According to the
memo, the cuts would not affect coverage to children, pregnant
women and the blind. The DSS administers the state’s Medicaid
program.

Within the proposed budget, DME covered by the state’s Medicaid
program falls under the “rehab and specialty services” line item.
The proposal cuts funding from $148 million last year to $52
million for the 2006 fiscal year, which begins July 1, 2005.

“The fact that there is a two-thirds cut means significant
numbers of adults would lose their DME coverage,” said Brady
Vestal, director of home medical equipment at Citizen Memorial
Health Care in Bolivar, Mo.

Vestal, who also serves as state chairman for the Midwest
Association of Medical Equipment Suppliers (MAMES), gave testimony
at a hearing state lawmakers held on Feb. 7. The provider, who was
given only five minutes to testify, said he decided to focus on
oxygen because “oxygen was easy to explain and understand; it is
life-sustaining, and these cuts would have a dramatic effect not
only on patients but on the budget as well.”

Missouri Medicaid currently pays a $200 monthly rental
reimbursement for concentrators and $30 a month for portable
systems, Vestal said.

The budget proposal marks the beginning of Missouri’s
appropriations process. The state will hold future hearings on the
budget before the state House and Senate vote on the proposal. The
Missouri legislative session ends in May, and an approved budget
will take effect on July 1.

To fight the cuts, MAMES is coordinating a grassroots effort
among providers and contacting national media about the issue. And
in future hearings at the state capitol, Vestal said he hopes to
provide concrete numbers proving the cost-effectiveness of DME.
“What is the cost to the Medicaid system for a broken hip, and how
does providing a hospital bed or wheelchair benefit the state to
prevent that broken hip from happening in the first place?” Vestal
asked. “Money spent on DME is not only compassionate but fiscally
responsible.”