MO Medicaid Re-Instates Payment for Orthotic Devices

The Missouri State Legislature has just re-instated payment for orthotic devices, which it stripped from coverage in 2005 in a rash of cuts to the program. A judge ruled last year that Missouri violated federal law in its arbitrary decisions to cover some devices and not others. Just this week, P & O Care received the new fee schedule from Medicaid, outlining how much they will pay for custom braces, boots and shoes, and other orthotic devices.

In 2005, the Missouri State Legislature was also ready to cut prosthetics from Medicaid coverage, but citizens from across the state called their legislators and P & O Care’s Clinical Director Jon Wilson, CPO, our CEO, Jim Weber, and one of our patients testified before a legislative committee. At the time, the trade journal O&P Almanac reported that it was their testimony that saved prosthetic coverage for Medicaid recipients, but unfortunately orthotic coverage was still stripped.

This decision led to the bizarre situation in which Missouri would pay thousands of dollars for a prosthesis but would not pay a few hundred dollars for a custom boot that could have prevented the amputation. Now two years later, we’re thankful that they’ve finally decided to pay for both.