Chew On This

Here's another example of the idiocy of health insurance regulations.

An Arizona appeals court is ordering the Arizona Health Care Cost Containment System (AHCCCS) to pay for dentures after talking out of both sides of its mouth.

The Arizona Daily Star reports:

Those rules, which mirror state law, say the program will provide dentures when they are “medically necessary.”

But the agency also adopted a rule which says that the inability to chew food, by itself, does not make the artificial teeth medically necessary. Instead, AHCCCS took the position someone without teeth can survive with a totally liquid diet.

Attorneys for AHCCCS defended the rule, saying the statute requiring “medically necessary” dentures says nothing about eating or chewing.

So in the mind of an AHCCCS attorney, gummin' is good enough.

Right now, I am going rounds with my health insurance company over payment for an assistant surgeon who repaired my shattered right arm. Said company has, for no discernible reason, turned up its nose and said, "Your contract doesn't allow for that." If one of those bureaucrats or paper pushers had seen the state of my arm, he'd agree there was no way the job could have been done without some help in the ER.

Or maybe not. Maybe he would have said an intern could have handled it. I'd expect this pretzel logic from an HMO, not a PPO.

But in Arizona, where our legislature consistently cuts education funding, it's par for the course.