Wednesday, October 7, 2009

Disabled Arizonans sue over state's refusal to pay for adult diapers prescribed by doctor

From the Phoenix New Times:


A group of severely disabled Arizonans have filed a class-action lawsuit against the Arizona Health Care Cost Containment System for denying payment for adult-incontinence briefs prescribed by a doctor.

The lawsuit claims that AHCCCS denied payment for the briefs, which forces caretakers of disabled people to pay for the briefs out of pocket.

By not providing the briefs, according to the lawsuit, it is preventing some disabled people from integrating into society.

"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 lawsuit claims.

AHCCCS spokesperson Monica Coury tells New Times the organization does provide the briefs to disabled people as long as a doctor has prescribed them as "medically necessary."

"We do cover the briefs for adults; what they're doing is trying to change the definition," she says.

For the briefs to be considered medically necessary, Coury says, the patient must have a skin rash or infection that could be prevented or treated by using the briefs.

Apparently the embarrassment of involuntarily urinating in public isn't enough for the AHCCCS.

Typically, Coury says, for there to be a change in policy, people go to the Legislature, not the courts, and the cost of providing the briefs to people not under the current definition will be felt in the budgets of other agencies.

Given the status of the current state budget, adult diapers are probably not a top priority.

Calls to the Arizona Center for Disability Law, the organization that filed the suit, were not immediately returned, but in a press release, the ACDL says the current policy is unfair and places a tremendous financial burden on caretakers of the disabled.

"Arizona's policy has a negative impact on the disability community," Jennifer Nye, staff attorney with the ACDL says in a statement. "Without briefs, people who are incontinent would be confined to their homes and risk developing dangerous and debilitating infections. The failure of AHCCCS to cover these preventative medical supplies means that people with disabilities and their guardians must choose between buying briefs or paying for other necessary living expenses, like food, housing, clothing, and medical services not covered by AHCCCS, like dental care. At costs between $100 to $300 per month, incontinence briefs can account for up to half of the monthly income of a person with a disability."

The ACDL is asking for a permanent injunction barring AHCCCS from denying coverage of the briefs and asking the state reimburse plaintiffs for the cost of briefs since requests for coverage were denied.