Friday, March 30, 2007
Contact: Jessica Robinson, 573-751-0290
Blunt Directs DSS to Develop State of the Art Access to Medicaid Durable Medical Equipment Program
JEFFERSON CITY–Gov. Matt Blunt announced today that he has directed the Department of Social Services to utilize state of the art health care technology to develop a new durable medical equipment (DME) program consistent with the MO HealthNet approach.
"I want every participant that has a medical need for durable medical equipment to have access to that equipment," said Blunt. "Under the old program, we did not have good tools to ensure patients were getting what they needed in the most effective way. We now have the capacity to provide real-time prior authorization for those items of equipment that would be best administered through such a process."
Currently, a full range of durable medical equipment is available to any child in the Medicaid program while some equipment items are available to adults only through an exceptions process.
In a recent court decision the judge ruled that the exception process did not provide reasonable access, and indicated that providing services, like DME, that are not required for federal participation must be an "all or nothing" decision. Under the judge's ruling, the state is prohibited from providing access to some eligible equipment but not others. The governor, however, has ordered the department to make the full range of equipment available on the basis of medical necessity using electronic, real time prior authorization as indicated.
The court gave DSS thirty days to report back regarding how the state would proceed to implement the court's ruling. Blunt directed the agency to develop an ambitious plan to roll out the program and asked DSS to request a sixty day extension for development of the plan.