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07.24.20

Arkansas Medicaid Provides Medical Nutritional Supplements to Patients Needing Them Most

A wide range of illnesses, conditions, post-operative requirements can necessitate the need for medical supplemental nutritional products for both children and adults. These nutritional products can be administered intravenously, through a feeding tube that delivers them to the digestive system, or in some cases taken orally. Sometimes the supplements are only needed while a patient is in a hospital, recovering from a health condition or surgery; in other cases, as when a condition is chronic, the patient may live well at home for many years, thanks to nutritional supplements. Arkansas Medicaid does cover the cost of these products, in most cases, whether administered in a hospital setting, or at home. 

If you or your child are in need of specialized nutritional supplements due to medical conditions or procedures, you are likely wondering whether Medicaid will pay for them in your case. It is always best to check with the Arkansas Medicaid Website for updated rules and regulations regarding current coverage and requirements for applying. But the following is an overview of the latest guidelines, found on the official website. 

MEDICAL SUPPLEMENTAL NUTRITIONAL PRODUCTS

Hyperalimentation products for parenteral supplementation are, in most cases covered by Arkansas Medicaid.  So are nutritional supplement products for  enteral administration and for “sole source” oral use. Sole source refers to the condition when over 75% of an individual’s nutritional requirements are received through orally administered nutritional supplements, due to the individual’s inability to swallow traditional foods safely or to absorb any other form of oral nutrition. 

These products are literally lifesavers for many children as well as adults. The Arkansas Medicaid program offers coverage for them, but coverage does vary depending upon the specific condition. Certain guidelines must be met in order to receive benefit payments. Finnegan Health Services can assist you in determining if coverage is available for your situation.

WHAT IS HYPERALIMENTATION?

This term refers to administration of nutrition through intravenous means. Sometimes nutrition is administered entirely in this manner. In other cases, hyperalimentation supplements nutrition administered through the digestive tract, if insufficient nutrients are being absorbed that way.

WHAT ARE PARENTERAL NUTRITIONAL PRODUCTS?

Parenteral nutritional products are specialized food products, complete with all vitamins, minerals, nutrients, electrolytes necessary for life, prepared to be administered intravenously. Sometimes these products are used to supplement enteral nutrition, other times by themselves. 

WHAT ARE ENTERAL NUTRITIONAL PRODUCTS?

Used for what is commonly known as “tube feeding”, enteral nutritional products also include all the vitamins, minerals, nutrients, required for life. Enteral products are administered through the digestive tract via a tube inserted through the skin of the abdomen and into the stomach or intestine, or – if a specialized feeding method is not expected to be needed long-term, through a feeding tube passed through the nose, and into the stomach or small intestine. 

SOME CONDITIONS THAT MAY REQUIRE MEDICAL NUTRITIONAL SUPPLEMENTS

Following are some health concerns the Mayo Clinic says may require parenteral nutritional supplementation:

  • Cancer of parts of the digestive tract; sometimes chemotherapy.
  • Crohn’s disease when it causes severe inflammation and discomfort.
  • Short bowel syndrome – when there is not enough bowel to absorb enough nutrition from food.
  • Ischemic bowel disease – blood flow issues to the bowel.
  • Abnormal bowel function caused by a variety of other conditions.

Here are a few conditions the Mayo Clinic mentions as causes triggering the need for enteral supplementation:

  • Cancer: Head and neck cancers that make it difficult to swallow, cancers affecting segments of the digestive tract.
  • Neurological problems: Stroke and other problems affecting the ability to swallow.
  • Gastrointestinal disorders: delayed gastric emptying or obstruction issues.
  • Trauma: Digestive tract injury.

ARKANSAS MEDICAID REQUIREMENTS FOR MEDICAL NUTRITIONAL SUPPLEMENT BENEFITS ELIGIBILITY

Both parenteral and enteral supplements are covered under Arkansas Medicaid guidelines. Cost of fluids, equipment, and supplies necessary for home administration are paid for under the program as long as the patient

  • Was first under treatment in a hospital and:
  • The treatment is deemed medically necessary by a physician.
  • Supplemental hyperalimentation must also be the sole source of nutrition for the patient in order for Arkansas Medicaid to cover the cost. 

If you have questions about potential coverage for nutritionally related products that are medically necessary, please do not hesitate to contact us. Thickeners for those for whom swallowing liquids presents a danger, can be covered with a doctor’s prescription. 

MEDICAID COVERED SUPPLEMENTAL MEDICAL NUTRITION FOR BABIES AND CHILDREN

Pediatric nutritional supplement products are covered for babies and children following similar qualifications and application procedures as those required for adults.

Products designed for enteral use via tube administration can often be covered for oral consumption, with some restrictions, if a child must drink the formula instead of consuming traditional foods, because of a severe allergy, failure to process foods properly, inability to gain sufficient weight, or other reasons a specialized nutritional product becomes medically necessary.

There is no required dollar limit, but the prescription limit is 3,000 calories or 30 units of formula per day. The age limit is from 5 to 18 years of age. There must be a valid diagnosis and prescription from the child’s primary care provider. Well Child visits must be up to date, (EPSDTs).

LINKS TO MORE RESOURCES FOR YOUR CONVENIENCE:

Finnegan Health Services,the largest and oldest durable medical supply business in Arkansas has been in business over 30 years. We are experts in the field of health care supplies, and have always served them to the citizens of Little Rock and all of Arkansas, free of shipping charges. We care about helping people when they need it most. Have a question about Medicaid, Medicare, PASSE and more? Contact us. We will do our best to help determine if what you need is covered.

Our representatives reach out to the entire state of Arkansas. Want to set up an appointment for an informational in-service about medical nutritional supplements and Medicaid coverage? E-mail our friendly and helpful customer service reps at wecare@finneganhealth.com 

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