TUCSON (CN) – A group of severely disabled Arizonans and their caretakers want a federal judge to force the state’s Medicaid program to pay for doctor-prescribed “incontinence briefs” that prevent skin breakdown and infection.
In a federal class action, adults with severe disabilities, such as cerebral palsy, spastic quadriplegia and seizure disorders, and their guardians sued officials at the Arizona Health Care Cost Containment System (AHCCCS).
Arizona’s Medicaid plan only covers incontinence briefs for patients under age 21.
The guardians and caretakers of the disabled adult plaintiffs say AHCCCS denies their charges the chance to integrate into the community by refusing to pay for the briefs.
Absent state funding, caretakers typically spend at least $100 on briefs — money that comes from disability checks that average only about $600 per month, according to the lawsuit.
“Without the incontinence briefs, plaintiffs with disabilities would be confined to their homes and unable to participate in community, social, educational, and therapeutic activities, including day treatment programs, which require attendees who are incontinent to wear incontinence briefs,” the class action states.
“Plaintiffs should not have to enter nursing homes or other institutions to receive medical supplies their doctors have determined to be medically necessary.”
Most of the plaintiffs have applied for and been denied briefs from AHCCCS because they didn’t have skin breakdown or other incontinence-related ailments at the time of their application, the lawsuit states.
Class members accuse AHCCCS of violating federal Medicaid laws and the Americans with Disabilities Act by refusing to supply the briefs.
They want a permanent injunction barring AHCCCS from denying coverage for incontinence briefs, and an order requiring the state to reimburse them for all the briefs purchased since their requests for coverage were denied.
They are represented by Jennifer Nye of the Arizona Center for Disability Law.