Mark Hobratschk came to Cochlear Corporation from Wyoming Medicaid in July 1994.  At the time, at least 22 state Medicaid programs were refusing to cover cochlear implants for both children and adults. 
 
Mr. Hobratschk immediately recognized that federal regulations governing the Early Periodic Screening Diagnosis and Treatment (EPSDT) program required Medicaid coverage for any medical necessary treatment in children under age 21--even if that treatment is not covered under the state's Medicaid program.  Since cochlear implants were the only alternative to a profoundly hearing impaired child remaining deaf, Mr. Hobratschk lobbied several U.S. Senate offices to seek enforcement of these regulations.

With the backing of these offices, Mr. Hobratschk petitioned the central office for the Health Care Financing Administration (since renamed the Centers for Medicare and Medicaid Services) for a directive requiring all states to comply with EPSDT by covering cochlear implants in all eligible children nationwide.
 
Below is HCFA's November 1994 response, agreeing that since cochlear implants were the only available treatment for a child's hearing impairment, every state is not only required to provide benefits for the device, but all treatment necessary to effectively use the device.

HCFA regional offices sent out this directive to each state.  While no state has successfully fought this directive, several states including Arizona, Louisiana, and Utah, refused to comply until a beneficiary successfully appealed a denial of benefits.  Mr. Hobratschk personally represented several of these patients who were receiving devices from either Advanced Bionics Corporation or Cochlear Corporation.  He used this HCFA directive to obtain a favorable administrative hearing decision, then worked with state Medicaid officials on drafting an appropriate coverage policy. 
 
This HCFA directive literally brought the invaluable benefits of hearing to thousands of children nationwide, a fact not lost on Cochlear Corporation's Vice President of Finance Michael Wallace.

HCFA November 1994 Response
HCFA Regional Office directive