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  Alabama Medicaid

email: reimburse@cochlear.org




Alabama was one of the few State Medicaid agencies that initially refused to comply with the Federal mandate to cover cochlear implant services for children under age 21. In 1995-1996, the Supervisor of Reimbursement Services for Cochlear Corporation, Mark Hobratschk directly lobbied the agency to develop a cochlear implant policy that complied with this Federal mandate.

Alabama Medicaid refused to comply. However, when the agency made an "exception" and covered the cochlear implant surgery just for the relative of a State senator, Mr. Hobratschk brought the matter to the attention of the regional office for the U.S. Health Care Financing Administration (HCFA). This Federal agency required Alabama to implement a coverage policy for all children under age 21.

Alabama Medicaid now covers cochlear implantation only on an inpatient basis for children under age 21. However, reimbursement for the device is included under the hospital's flat rate per diem. Thus, hospitals are likely to incur significant losses in absorbing such an expensive device into their per diem. In addition, because physicians are reimbursed at an abysmal rate of $892.00 (by far the lowest reimbursement rate in the country), many have stopped performing cochlear implant for Medicaid children, or are strongly considering doing so.

Alabama continues to refuse to provide Medicaid benefits for adults. In 1995, this policy forced one family to relocate from Alabama to Iowa just to receive adequate reimbursement for cochlear implantation of an adult family member.

Effective January 1, 2003, Alabama Medicaid added coverage (for children) of replacement of external equipment due to loss or damage, as well as reimplantation after device failure.