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Utah Medicaid officials abused their discretion by denying electronic speech-aid devices to disabled recipients based on their age, the Utah Court of Appeals ruled Thursday.
The devices speak for people who are unable to produce intelligible words. The Utah Department of Health's Division of Medicaid and Health Financing covers them for Medicaid recipients who are pregnant women and for beneficiaries who are younger than age 21, but not for anyone else.
That is arbitrary and unreasonable, according to the ruling.
"We also determine that the Division's policy of denying such coverage ... violates the Medicaid Act," the appeals court judges wrote, quoting from a similar Texas ruling that stated: "This court cannot divine a rational basis to make available the blessings of speech to one who is 20 years, 364 days old and deny the same blessing to one who is two days older."
One of the plaintiffs in Thursday's case was Nicholas Conley, who suffers from a cerebral palsy. He was 22 when the division denied a request to replace his old, malfunctioning device in 2010. His case was joined with one filed by 38-year-old Patty Olguin, who has multiple sclerosis and lost the ability to speak following a stroke she suffered during surgery.
An administrative law judge upheld the denials, but Conley and Olguin appealed. The ruling remands the requests back for further proceedings.
The state health department is "reviewing the ruling, and its potential impact on the Medicaid program, prior to determining how to proceed," spokesman Tom Hudachko said in a statement. He could not immediately say how many devices are requested and their average cost.