The Indiana Family and Social Services Administration (FSSA) cannot cap Medicaid coverage of medically necessary dental procedures, according to a ruling last week by the Seventh Circuit Court of Appeals.
In 2011, the FSSA established a $1,000 cap as a cost-cutting measure, according to a story by Indiana Public Media.
But Sandra Bontrager, a 66-year-old Medicaid patient who needed implants, sued the FSSA after being told the agency would only cover $1,000 of the cost of any necessary dental procedure for a Medicaid recipient in a given year -- despite the fact that Indiana's Medicaid program considered her procedure to be "medically necessary."
Last year, a federal district court issued an injunction against the limit, and on September 26 the Seventh Circuit Court upheld that ruling.
However, "the state cautions that it may end coverage of all dental services under its Medicaid plan if the $1,000 cap is no longer in place," the appellate court wrote.
