Division of Medical Services FY03 Budget Impact

The state budget that began July 1, 2002, included several cost-containment measures in the Medicaid program. These changes affect both Medicaid fee-for-service and MC+ managed care recipients. These changes include, but are not limited to the following:

Except for dentures, coverage for dental care for adults under the Missouri Medicaid was not funded for the coming fiscal year. This change will be effective July 1, 2002. Coverage will be limited to dentures and treatment for trauma to the mouth or teeth as a result of injury. Services to prepare the mouth for dentures, such as examinations, X-rays, or extractions will not be covered. Ancillary denture services such as relining, re-basing, and repairs will not be covered. Dental coverage through the Medicaid program will continue for children under the age of 21.

Update: Judge Timothy Wilson of St. Louis City entered a preliminary Injunction Order on August 21, 2002, prohibiting the Department from implementing the planned reductions of dental services for Medicaid eligible adults. As a result of the preliminary order, Medicaid covered benefits and limitations will be the same as those covered immediately prior to July 1, 2002.
Eyeglasses are no longer covered for adults, except one pair following cataract surgery. Eye examinations for adults remain covered.

Update: Judge Steven Ohmer of St. Louis City entered a preliminary Injunction Order on February 19, 2003 to restore coverage of prescription eyeglasses for Medicaid/MC+ eligible adults effective February 24, 2003. Beginning February 24, 2003, as a result of the preliminary order, Medicaid covered optical benefits and limitations will be the same as those covered immediately prior to July 1, 2002.
Children who are eligible for Medicaid or MC+ for Kids will still be covered for dental care and for eyeglasses.
Coverage for male circumcisions was eliminated except for medical necessity.
Eligibility for the following uninsured parent groups was eliminated: noncustodial parents (ME Code 77) and parent=s Fair Share (ME Code 78).
Eligibility for the uninsured parent group, Extended Transitional Medical Assistance, moved from two years of additional coverage to one year of additional coverage and eligibles must maintain income below 100% of the FpL versus 300% of the FpL.
The uninsured parent group, Women=s Health Services (ME Code 80), also moved from two years of coverage to one year of coverage for these services.
Eligibility for Adult Medicaid coverage under '1931 moved from 100% of the federal poverty level (FpL) to 77% of the FpL.

Update: A United States District Court judge entered a preliminary Injunction Order on October 3, 2002 regarding adults who lost coverage on July 1, 2002 when the Medical Assistance for Families income limit was reduced from 100% to 77% of the federal poverty level. The Order required the department to provide Transitional Medical Assistance to those families who had earned income and had received Medical Assistance for Families in three of the previous six months.
Effective October 1, 2002, Medicaid is only responsible for that portion of a person's spenddown amount that is the responsibility of the State.
Effective July 1, 2002, the only non-prescription (over-the-counter) drug that Missouri Medicaid pays for is insulin. Insulin syringes are still covered. Any other over-the-counter drugs are only covered through the Medicaid exceptions process.

07/13/05