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As of 1Sept05, MO Medicaid will no longer pay for feeding tubes, nutritional formula, breathing machines, canes, crutches, walkers, wheelchair batteries and other medical equipment necessary for people with disabilities.

The medical equipment and services are now considered “optional” requiring almost 340,000 adult patients to apply for “exceptions” to their medical care and get letters from their doctors.

Patients needing feeding tubes are being told to apply for appeals. Of the 1048 people who have filed appeals, 427 appeals hearings have been heard and only 31 patients have won.

[; HLA Action News, Fall 2005]


Missouri Cutbacks Target Feeding Tubes

Citing a huge deficit in the state’s Medicaid program covering about 1 million low-income patients, Missouri lawmakers have cut 90,000 people from the program, required others to pay some of their medical costs, and dropped payment for most of the “durable medical equipment” for 340,000 poor adults remaining in the program.

Included in that category of equipment are feeding tubes and the nutritional formula that flows through them.

[St. Louis Post-Dispatch, 8/30/05]



A scathing editorial critical of the equipment cuts appeared in the St. Louis Post-Dispatch.

Pointing out that feeding tubes and nutritional formula are not “optional” for the thousands of brain damaged and disabled Missourians who can’t swallow and will die without tube-supplied food and fluids, the editorial went on to describe some of the obstacles facing these patients and their caregivers.

While patients who need feeding tubes can apply for “exceptions,” most were never informed about that option. Furthermore, the patient cannot file for the exception; a letter from his or her doctor is required.

There is also an appeals process. According to the editorial, “Patients who are losing feeding tubes and other equipment have been told they can file appeals.

The results to date are less than encouraging.

As of last Wednesday [8/24/05], 1,048 people had filed appeals. Of the 427 appeals hearings held, the patient lost in 396 of them.” [“Missouri’s Medicaid Shame: Feeding tubes optional,” St. Louis Post-Dispatch, 8/31/05]

K. Gary Sherman, director of the MO Dept. of Social Services, defended the equipment cuts: “It simply is not possible to significantly reduce Medicaid spending without affecting the coverage for the elderly and disabled; spending for these categories accounts for nearly 70 percent of the Medicaid budget.” [St. Louis Post-Dispatch, 9/6/05; International Task Force on Euthanasia and Assisted Suicide Update, 2005, Volume 19, Number 3, 1Oct05]