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Investigation Finds New York State Fails to Get DME to Disabled

NEW YORK--New York State has improperly prevented disabled people from obtaining wheelchairs and other DME, a recent investigation by the State Assembly found.

A report on the investigation issued earlier this month said the state Department of Health has violated state and federal rules by rejecting and postponing Medicaid requests for DME.

"Whether this has been caused by callous pursuit of short-term savings, negligence or incompetence, the results are cruelty and long-term increased costs," the report said.

The investigation found that department reviewers "often deny medically necessary items ordered by physicians, and regularly change requested items to less expensive, inappropriate items that are ill-suited for the patient."

After the department closed its Medicaid office in New York City--which handled about two-thirds of the state's claims--claims processing "slowed to a crawl statewide," preventing people with disabilities from getting equipment they needed, the report said.

The department closed the office in 2004 and transferred its operations to Albany. Since then, clinicians said their opinions were disregarded, orders were changed and requests came back with what they considered to be "irrelevant, redundant and otherwise unreasonable" requirements.

The lawmakers said department reviewers "often deny medically necessary items ordered by physicians, and regularly change requested items to less expensive, inappropriate items that are ill-suited for the patient."

The report ultimately recommended that the department "comply with its own regulations." To access the report, click here.

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