An Ada County woman is entitled to have Medicaid pay for treatment for being overweight because it was directly related to a medical condition, the Idaho Supreme Court says.
The court on Friday unanimously overturned previous decisions denying benefits to Nancy Morgan.The woman was diagnosed as having pseudotumor cerebri, a condition that causes severe headaches and may cause blindness.
The attending physician noted that Morgan was about 35 pounds overweight, a complicating factor, and recommended a medically supervised treatment program to help her lose weight.
A Department of Health and Welfare hearing examiner said Medicaid has a provision barring payment for treatment of obesity and refused payment.
But the Supreme Court says the doctor approved a weight-loss treatment to help a medical condition, and there was no specific ruling that the woman was obese.
"The clear evidence in the record establishes that the treatment prescribed is not a procedure to treat obesity as contemplated in the regulations," the court said. "Rather, the weight-loss program . . . is for the treatment of Morgan's condition of pseudotumor cerebri."