[rehab] Medicaid Payments for O&M Services

[Marks, Jim]

Those who advocate that Medicaid should pay for orientation and mobility instruction and other blindness services carry the burden of proof for their point of view.  In other words, they have to show how involving Medicaid will be a good thing for blind people more than the status quo has to show it isn't.  A good starting place is to answer the question, "Who Benefits from involving Medicaid?"  The answer to who benefits almost always is answered by following the money.  If Medicaid pays for blindness services, then many professionals in and outside the medical world will profit.  The same really can't be said for blind people.  Dr. Bell did a wonderful job describing the negatives in using Medicaid to pay for blindness services.

At the same time, the world is changing, and Medicaid is going to play a larger role in most states as the Affordable Care Act is implemented.  A key feature of the Act is to expand Medicaid coverage.  Personally, I think the broader health insurance coverage is a tremendous thing.  However, when it comes to blindness, I'm not convinced that blindness has much to do with the health system.  Treatment of eye diseases is great, but turning the use of a long white cane into a medically prescribed and managed service makes little sense if one believes that blindness isn't that big of a deal.  Anyhow, challenging the separate nature of blindness services is good in that it helps the organized blind hone our point of view.  We definitely have to engage these sorts of questions or else we would be letting others decide for us what's best.  I think Medicaid should not be involved in blindness services for the sake of self-determination and more affordable and higher quality services.



Jim Marks jimmarks at mt.gov


-----Original Message-----
From: rehab-bounces at nfbnet.org [mailto:rehab-bounces at nfbnet.org] On Behalf Of gabe vega
Sent: Wednesday, January 19, 2011 4:20 AM
To: Rehabilitation Counselor Mailing List
Subject: Re: [rehab] Medicaid Payments for O&M Services

I am a little confused here. We always talk about spreading education  
and awareness to the public, government and other professions about  
blindness and all it brings, and you are telling me this medicade  
situation is a bad thing?

will it not put more of a spotlight on blindness based on the fact  
that more people will have to deal with and provide for people of who  
are blind?

I am not sure if I subscribe to this blind nitch rehab model anyways,  
how has it advanced this so called 70% emplyment rate for the past 20