Medicaid on 'right track'
MONETT, Mo. - The Midwest Association of Medical Equipment Suppliers (MAMES), which has worked hard to ensure coverage for HME under Missouri's maligned Medicaid program, got some good news in March.
A federal judge has ordered the state to restore coverage for all HME for 30 days and submit a new plan for what will be covered. In 2005, steep cuts to Medicaid left thousands without coverage for items like canes, hospital beds and nebulizer compressors. Last June, a federal judge ruled that Missouri had been unreasonable in denying Medicaid coverage for certain medical equipment.
MAMES has been working to include coverage for HME in S.B. 577, a bill that would revamp the Medicaid program and rename it to MO HealthNet.
"We think we've got them convinced to put it in (the bill)," said Roni Burns, Missouri chair. "We're optimistic that we are on the right track and (the state) will do what's right."
Also on the association's plate: the Smart PA system, an online system for Medicaid providers that streamlines the process for filling prescriptions and getting paid. The system would work this way: A doctor inputs the prescription, and the beneficiary goes to any Medicaid provider to get it filled. The provider accesses the system to verify the prescription and that it has been approved by Medicaid. Billing is also done through the system.
"I think the Smart PA system is going to be phenomenal," said Burns.
The system is not up and running yet for DME but has been used for pharmacy.