JEFFERSON CITY, Mo.--Last week the Missouri state senate introduced sweeping Medicaid legislation that scraps funding for most adult durable medical equipment.

"Nobody wants to do this," Sen. Chuck Purgason told the St. Louis Post-Dispatch. "The fact is, the state is broke. If we do not do what's in this bill, we're looking at a $600 million to $700 million shortfall."

The bill's language strikes coverage for most equipment, including "orthopedic devices or other prosthetics ... and wheelchairs," but keeps coverage for children and the blind. It also supports the Medicaid cuts in Gov. Matt Blunt's proposed budget, released earlier this year. The cuts, if approved, would take effect after the state starts its new fiscal year in July.

"This is the bill that would eliminate DME funding, which is congruent with the governor's budget proposal," said Brady Vestal, director of home medical equipment at Citizen Memorial Health Care in Bolivar, Mo.

Vestal is state chairman for the Midwest Association for Medical Equipment Services (MAMES), which is coordinating a grassroots effort to stop the proposed cuts. In early February, Vestal testified before state lawmakers against cuts to home oxygen, and plans to organize further testimony in the coming weeks, providing concrete numbers that prove the cost-effectiveness of DME and comparing DME Medicaid spending in Missouri with that of other states.

At a February rally, consumer groups protesting the measure created a sculpture titled "The Governor's Waste"--a trash bin filled with crutches, wheelchair parts and prosthetic limbs--in the rotunda of the Missouri capitol.

Also last week, the Missouri senate introduced legislation that would create a state Medicaid Reform Commission charged with recommending ways to overhaul the state's public health program. During the process, the commission will seek out expertise from health care providers and study other state Medicaid programs, sources said, including Utah's current program and Medicaid privatization proposals recently announced by Florida Gov. Jeb Bush.

The Missouri state Medicaid bill is posted on the state's Web site, available by clicking here. To view the bill on the Missouri Medicaid Reform Commission, click here.

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