Investigation Finds New York State Fails to Get DME to Disabled

NEW YORK–New York State has improperly prevented disabled
people from obtaining wheelchairs and other DME, a recent
investigation by the State Assembly found.

A report on the investigation issued earlier this month said the
state Department of Health has violated state and federal rules by
rejecting and postponing Medicaid requests for DME.

“Whether this has been caused by callous pursuit of short-term
savings, negligence or incompetence, the results are cruelty and
long-term increased costs,” the report said.

The investigation found that department reviewers “often deny
medically necessary items ordered by physicians, and regularly
change requested items to less expensive, inappropriate items that
are ill-suited for the patient.”

After the department closed its Medicaid office in New York
City–which handled about two-thirds of the state’s claims–claims
processing “slowed to a crawl statewide,” preventing people with
disabilities from getting equipment they needed, the report
said.

The department closed the office in 2004 and transferred its
operations to Albany. Since then, clinicians said their opinions
were disregarded, orders were changed and requests came back with
what they considered to be “irrelevant, redundant and otherwise
unreasonable” requirements.

The lawmakers said department reviewers “often deny medically
necessary items ordered by physicians, and regularly change
requested items to less expensive, inappropriate items that are
ill-suited for the patient.”

The report ultimately recommended that the department “comply
with its own regulations.” To access the report, click here.