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Hi All, For those of you with state Medicaid AAC coverage, could
you
please send me the link for your “Medicaid Rule” or policy
stating
the coverage, non-coverage criteria and the required documentation?
How
long is the typical wait to receive approval for Medicaid funding of AAC?
How many of your State Medicaid programs allow the use
of
the Medicare SGD report format? If you have a consumer with Medicare and Medicaid do you
have to write 2 different evaluation report
formats? And finally, do any of your state Medicaid AAC programs
require online submission of documentation? I am
researching this on the AAC Funding Help website and I see the statement
(below) but this is old data…. In Myers v. State of Mississippi,
3:94 CV 185 LN (S.D.Miss.
1995),
the District Court expressly referred to these data when it
rejected Mississippi Medicaid’s refusal to cover SGDs – based
on
its claim that SGDs were not ‘medically
necessary.’ Though this fact is certainly not
controlling, the court does find it instructive that forty other Medicaid
programs do pay for AAC devices, i.e., finds them medically necessary
[reference
omitted]... Moreover, over 200 health insurance providers pay for AAC
devices.
[reference omitted]. I see the database indicating health plan and SGD
approval,
but there does not appear to be a link to the actual policy.
Oh, and the last question, have any of your states
restricted or cut funding for AAC devices? Thanks for your assistance! Lisa M. Bruening, M.S., CCC-SLP Patient Services Coordinator The ALS Association phone: 216-592-2572 toll free: 888-592-2572 fax: 216-592-2575 Check out our webpage:
www.alsaohio.org Become an ALSA Advocate! It's easy!
Go to our website and follow the tab for Public Policy. Click on
Advocacy Action
Center and
sign up today! Where Patients
Matter
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