Prosthetics among benefits threatened by Blunt proposal

Monday, March 7, 2005 | 12:00 a.m. CST; updated 1:11 a.m. CDT, Friday, July 4, 2008

At first glance, Bob Kilgore would seem to have little stake in the heated debate over a proposal to drastically reduce Medicaid cuts in Missouri.

For the pharmacist-turned-business owner, the medical-supplies industry is a good one.

He has owned Kilgore Medical Pharmacy for about 11 years. Five years after starting the business, it was doing so well that he expanded to a second location on Chapel Hill Road. This year, he plans on moving his original pharmacy to a larger location on Providence Road.

But with an estimated 30 percent to 40 percent of the pharmacy’s customers depending on Medicaid for their prescription drugs and other medical needs, Kilgore is closely following the news about planned Medicaid cuts to see how they could affect his business.

“If there was a significant loss, I’d have to cut back on staffing and make some changes,” Kilgore said.

In addition to Gov. Matt Blunt’s plan to reduce the number of eligible recipients by an estimated 40,000, three Medicaid services are slated for elimination: adult dental care, podiatry care and rehabilitation and specialty services.

According to the Missouri Department of Social Services, 385,000 Missourians use those services through Medicaid.

Under Blunt’s proposal, which awaits debate in the state House of Representatives, Medicaid recipients would no longer be able to receive durable medical equipment such as wheelchairs, crutches and blood-sugar-testing equipment.

The average lifespan of a wheelchair is two to three years. Wheelchairs sold at the pharmacy cost between $350 and $1,000, Kilgore said, but such sales account for a small portion of his total business.

Also slated for elimination under the category of rehabilitation services are payments for artificial limbs.

At Hanger Prosthetics & Orthotics, which has two Columbia offices, manager Gary Lenzini said he is more concerned about his customers’ fates than the stores’ potential loss of income. Prosthetics generally must be replaced every three years.

“My greatest concern is for the patients’ quality of life, should this funding source be taken away, and the future health profile for them if they can’t get medical care on a regular basis,” he said.

If patients cannot afford to have their prosthetics replaced, Lenzini said his company would merely adjust the users’ older artificial limbs to make them more comfortable.

In Columbia, about 5 percent of prosthetic wearers use Medicaid. Elsewhere in Missouri, 10 percent to 15 percent of prosthetic users are on Medicaid, he said.

The most common prostheses supplied at Hanger’s Columbia locations is a trans-tibial artificial limb that attaches below the knee. On average, such prostheses cost between $5,000 and $6,000.

“If patients’ needs are not taken care of at this time, it will lead to an increase in social cost,” Lenzini said.

Failing to replace a prosthesis can lead to skin infection and, in extreme cases, a bone infection that if severe enough could result in another amputation and long-term hospitalization.

“I’m hoping that the legislators understand that these aren’t luxuries for these people,” Kilgore said. “They are necessities.”

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