Missouri lawmakers try to restore spending on health

Sunday, March 13, 2005

March 14, 2005

JEFFERSON CITY, Mo. -- Lawmakers here, many of whom have been staunchly defending Republic Gov. Matt Blunt's proposal to cut DME from the state's Medicaid budget, did an about face last week. The House panel that handles spending on health and social services approved a plan that would restore $242 million to the budget for services for the mentally ill, the disabled, the poor and people with drug and alcohol problems.
The plan restores $82.7 million in funding to cover some of the most contentious cuts Blunt proposed for rehabilitation and specialty services. The House plan would again pay for oxygen and respiratory-care equipment, wheelchairs, artificial limbs, diabetic supplies and hospice care for dying patients.
Blunt's budget proposal had called for the elimination of all adult DME services under the Medicaid budget. DME providers here said this would have been devastating to business.
"I think it's a safe estimate that providers would see a 10 to 25% loss in revenue," said Brady Vestal, director of Citizens Memorial Home Medical Equipment and chair of the Midwest Association of Medical Equipment Services (MAMES). "That's probably a conservative estimate. Providers in more rural parts of Missouri could be facing as much as a 50% loss in revenue."
The new House plan would still cut $10.2 million by eliminating coverage for hearing aids, eyeglasses, crutches and other medical equipment.
The House panel also proposes eliminating the sales-tax exemption for in-home medical services. In exchange, it restores nearly $38 million for in-home and community services provided through the Department of Health and Senior Services.
To partly cover the extra spending, the new plan makes several changes to the Medicaid program. The plan would require a greater effort to verify each year that patients' income is low enough to remain eligible for Medicaid. It also would require disabled patients to have more severe problems before they become eligible for in-home care or nursing home benefits, and it would impose new insurance premiums on about 30,000 families involved in the Children's Health Insurance Program.