Parents Sue Arizona’s Medicaid Program Over Denial of Respiratory Care Coverage for Son

An Arizona couple has filed a lawsuit against the state's Medicaid program to "force" it to pay for a mechanical breathing vest for their terminally ill adopted son, the Arizona Republic reports. Twelve-year-old Darren Bogden has bronchopulmonary dysplasia, an "end-stage lung disease" in which the airways become constricted with mucus. In January 2000, Bogden's doctor ordered the vest, which is on loan from its Minnesota-based manufacturer Advanced Respiratory. The vest, which "hooks to a machine" that vibrates and "shak[es] the mucus" in the chest, allowing the airways to clear, has given Bogden the "quality of life that at least resembles that of a regular kid," and has reduced his incidence of pneumonia. The boy, who is also developmentally disabled, qualifies for the Arizona Health Care Cost Containment System, but the Medicaid program has so far refused to pay for the vest, "saying the boy doesn't really need it," the Republic reports. According to James Passamano, the lawyer for Bogden's parents Bill and Elli, the vest costs $16,000 -- a figure similar to a typical hospital stay for Darren before he used the vest -- and is covered by several private health plans. The lawsuit says that AHCCCS has covered the vest for cystic fibrosis patients, while other states have covered the vest for people with lung ailments similar to Darren's. However, Logan Johnston, an attorney for AHCCCS, said that doctors "disagree" about "whether this vest is the most effective" treatment for Darren's condition. He added, "There's no movement afoot at AHCCCS to keep something that works from a child who needs it" (Bland, Arizona Republic, 11/8).