Federal court protects access to incontinence supplies

Thursday, May 15, 2014

PHOENIX – The 9th U.S. Circuit Court of Appeals has voided a cost-saving bid by Arizona’s Medicaid program to deny incontinence briefs to adults who need them.

The Arizona Health Care Cost Containment System (AHCCCS) contended that briefs are only medically necessary when prescribed to treat skin breakdown or infections due to incontinence and that doctors were preemptively prescribing them before any medical problems arose, the Arizona Daily Star reported.

The ruling by the three-judge panel leaned on AHCCCS’s own rules, which state that products are medically necessary when a doctor prescribes them “to prevent disease, disability, or other adverse health conditions or their progression,” the newspaper reported.

The judges also pointed out that CMS approved AHCCCS’s definition of medical necessity, but not an amendment carving out incontinence briefs, the Daily Star reported.