Lankford v. Sherman

States participating in the Medicaid program must furnish medical assistance to the “categorically needy,” a group that includes blind, aged, and disabled individuals, pregnant women and children. Missouri participated in the Medicaid program and before 2005, had offered “durable medical equipment” (DME) as an optional benefit to all Medicaid recipients. DME included provision like wheelchairs, wheelchair batteries and repairs, orthotics, orthopedic devices, parenteral nutrition, augmentative communication devices, hospital beds, bed rails, lifts, and other prosthetics. Due to budget constraints, the state legislature eliminated the DME program in 2005, except for individuals who were blind, pregnant or children. Lankford (plaintiffs) and other disabled, adult Medicaid recipients brought an action against Sherman, Missouri’s Director of Social Services (defendant), seeking a preliminary injunction preventing Sherman from denying DME benefits to the majority of categorically-needy Medicaid recipients other than the blind. Lankford argued that Missouri’s actions violated federal requirements that the state treat Medicaid recipients equally and with reasonable, non-discriminatory standards and violated the supremacy clause. Sherman argued that its new regulation denying the DME benefits was valid because the state had applied to the Centers for Medicare and Medicaid Services (CMS) for a waiver of the federal requirements. Also, Sherman argued that Medicaid recipients still had the option to apply for an exception if DME was needed or apply for home health care, which would grant them DME privileges. The district court denied the injunction and Lankford appealed.