Nursing home residents win battle against ruthless insurer, will finally receive payment for specialized wheelchairs

The courts have ruled a huge private insurer must pay for nursing home residents’ customized wheelchairs after all in a trio of cases taking place in Iowa.

UnitedHealthcare lost three simultaneous legal battles against disabled Iowans who cannot walk independently. The insurer, covering patients through Medicaid managed care, reportedly rejected both physician and state orders to pay for specialized equipment, according to the Des Moines Register.

After the directors of the Iowa Department of Human Services sided with disabled individuals, UnitedHealthcare filed litigation, challenging the state’s authority as the final arbitrator, the newspaper reports.

Now, after months of legal wrangling, the cases have concluded, with the court ordering UnitedHealthcare to pay up. Two of the three cases are tied specifically to nursing home residents. In one: Ann Carrigan, a 70-year-old nursing home resident in Spencer, IA, has cerebral palsy and brain injury from a vehicle accident. She was denied coverage of a customized wheelchair to help her sit without choking or falling.

In the second,  Mildred Baker, a 70-year-old resident of a nursing home in Oakland, IA, has multiple health issues that leave her unable to walk independently. UnitedHealthcare denied coverage of a customized wheelchair with added functions that’s designed to be lighter in weight.

The insurer told the Register through a spokesman that it does not plan to challenge the court rulings. Meanwhile, state Sen. Pam Jochum (D-Dubuque) is urging sanctions or cancellation of the payer’s Medicaid contract. “’Ruthless’ is the one word I hear every (healthcare) provider say about UnitedHealthcare. It just blows me away,” Jochum said in the report.

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