Assistive Technology, Disabled Texans, and Medicaid
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For the past 50 years, Medicaid has played a vital role in the lives of low-income people who have a critical need for health care. According to the Kaiser Commission on Medicaid and the Uninsured, "Medicaid is the nation's main public health insurance program for people with low income and the single largest source of public health coverage in the U.S." Nationally, nearly 70 million individuals are eligible for Medicaid and people with disabilities make up approximately, 16 percent of all Medicaid beneficiaries.
For individuals with disabilities, Medicaid is an essential source of funding for acute health care and long-term services and supports, including assistive technology (AT) devices and services. With appropriate AT devices and services, individuals with disabilities can maintain their health, increase their functional abilities, and enhance their independence at home and in the community.
The term "assistive technology" describes a broad range of medical equipment and devices that can enhance the functional abilities of individuals with disabilities.
The term "assistive technology device" means any item , piece of equipment, or product system, whether acquired commercially off the shelf, modified or customized , that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.
The term "assistive technology service" means any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.
As defined, the term “AT device” encompasses a wide array of equipment, including but not limited to:
- Power and manual wheelchairs
- Speech Generating Devices (SGDs, also referred to as Alternative/Augmentative Communication Devices)
- Hospital beds
- Prosthetic limbs
- Environmental control units
- Therapy vests for treating respiratory conditions
- Patient lifts, including hydraulic and electronic floor, wall and ceiling lifts
- Assistive listening devices, hearing aids, and personal FM units
- Personal Response Systems
- Stair glides
- Standing devices
- Arm and leg braces
- Closed caption television (CCTV) and other vision aids
Medicaid coverage of an AT device or service is established when the item or service fits within the definition of one or more benefit categories included in the state plan. This test for Medicaid coverage of medical equipment and supplies has been applied by federal and state courts across the country, spanning several decades, and addressing numerous items of equipment. Consequently, the definition of various categories of service in the state’s Medicaid plan is key to establishing whether an AT device is covered by the state's Medicaid program.