JK Prosthetics & Orthotics is in danger of closing its doors.
The Mount Vernon company has crafted prosthetics and braces for many children with disabilities living in the Hudson Valley for the past 42 years but is now barely breaking even.
Owner Michael Caputo said it’s because of the billing process with Medicaid.
"I'm having a hard time ordering supplies, paying rent, utilities. Inflation is effecting us," said Caputo.
Caputo said his business is being shortchanged when it is reimbursed by Medicaid, sometimes by 30% to 40% of the cost.
It's impacting low-income families with children living with conditions such as spinabifida and cerebral palsy.
"They depend on what we give them sometimes for their very lives because they are in such a situation for a brace to stretch out muscles so they don’t become contracted and stiff," said Andrew Cinque, manager of JK Prosthetics & Orthotics. In some cases, claims are outright denied.
That's what happened to Jenny Pandolfo, whose 8-year-old daughter lives with cerebral palsy, a condition that makes braces essential to her growth and mobility.
"She was going through a growth spurt so needed new braces and the ones she had were pinching her at the calf to the point she was black and blue on her calf regularly," she said.
After getting fitted for a new pair of braces in 2022, the medical claim was denied twice by their Medicaid provider.
It was only approved after the family appealed the decision. Pandolfo's daughter had to wait 10 months to get her new braces.
"It just slows everything down with development. It's crucial at these ages and then also it takes a lot of time," she said. "I had to submit all kinds of paperwork call back and forth."
There is currently a bill in the state Assembly and Senate that would help remedy the problem. It would require Medicaid organizations to reimburse companies like JK at the full cost of prosthetics and orthotics.
"It would allow me to stay in business," said Caputo.
The hope is the help will come before it's too late.
For more on the Medicaid MCO Parity Bill, click
here.