A U.S. district court holds that the state is required to provide Medicaid coverage for incontinence briefs to recipients of Medicaid-covered home health services because the state provides coverage of the briefs to institutionalized adults. Hiltibran v. Levy (U.S. Dist. Ct., W.D. Mo., No. 104185CVCNKL, June 24, 2011).
A group of non-institutionalized Missouri residents who are incontinent due to their disabilities sued the state, arguing the state should provide Medicaid coverage of their incontinence supplies. Missouri provides coverage of incontinence briefs to Medicaid participants between the ages of four and 20, and the per diem provided to individuals in nursing homes can be used to cover incontinence briefs.
The plaintiffs asked for an injunction, arguing the state was violating federal Medicaid and disability discrimination laws. Under state law, the state must provide Medicaid coverage to durable medical equipment (DME). The state argued that incontinence briefs are personal hygiene objects that do not have to be covered.
The U.S. District Court for the Western District of Missouri grants the plaintiffs permanent injunctive relief. The court holds that incontinence supplies are DME, medically-necessary, and non-experimental and that the state is "required to provide Medicaid coverage of incontinence briefs to non-institutionalized adults if they provide such coverage to institutionalized adults."
For the full text of this decision in PDF, go to: https://ecf.mowd.uscourts.gov/cgi-bin/show_public_doc?2010cv4185-42
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