Court Says Injunction to Block Missouri DME Cuts Must Be Reconsidered

KANSAS CITY, Mo.–A federal appeals court has overruled a 2005
court decision that denied a preliminary injunction to stop
enforcement of a new law restricting Missouri Medicaid’s coverage
of certain DME.

A number of disabled state residents and advocacy groups had
filed a lawsuit after the state Medicaid program–citing budget
constraints–discontinued coverage last year of equipment such as
parenteral nutrition, catheters, wheelchair batteries, hospital
beds and lifts for all beneficiaries except children, pregnant
women and the blind.

In September, U.S. District Judge Dean Whipple ruled that the
state government’s move was legal since the federal government does
not require Medicaid to cover DME. But last month, the U.S. Court
of Appeals for the Eighth Circuit said Whipple must reconsider the
ruling.

The appeals court found that “while a state has discretion to
determine the optional services in its Medicaid plan, a state’s
failure to provide Medicaid coverage for non-experimental,
medically necessary services within a covered Medicaid category is
both per se unreasonable and inconsistent with the stated goals of
Medicaid.”