ACDL Wins Incontinence Briefs Case Against AHCCCS; State Appeals

Arizona Center for Disability Law
DDNN Summer 2014

Sarah E. Kader, Staff AttorneyOn May 13, 2014, The United States Court of Appeals for the Ninth Circuit (Court) ruled that AHCCCS (Arizona’s Medicaid program) must pay for incontinence briefs for adults over the age of 21 when medically necessary.  The Court said that AHCCC’s policy to deny them went against Federal law.

“This policy was bad medicine and bad law,” said Sarah Kader, staff attorney at the Arizona Center for Disability Law, who is the lead attorney on the lawsuit and argued the case in the Ninth Circuit Court of Appeals (pictured right).  “It was unreasonable and it denied people medical supplies that their doctors say were medically necessary.”

The case, Alvarez v. Betlach, was filed in 2009 by the Arizona Center for Disability Law for 11 individuals with disabilities against AHCCCS.  All Plaintiffs in the Alvarez suit are AHCCCS members age 21 and over who are incontinent because of their disabilities.  Each Plaintiff’s doctor had prescribed incontinence briefs to prevent skin breakdown and to allow the person to participate in activities.  Even so, AHCCCS denied coverage.

“We are so gratified that the Court did what is right,” said Kader.  “Today, the Ninth Circuit Court of Appeals put an end to this unreasonable practice and we could not be happier.”

Alvarez v. Betlach is a continuation of ACDL’s work to ensure that people with disabilities have the health care services they need.  ACDL is a non-profit public interest law firm. ACDL advocates for the legal rights of persons with disabilities to be free from abuse, neglect, and discrimination and to gain access to services, maximizing independence and achieving equality.