JoAnne Morrow,an attorney with Legal Services of Eastern Missouri, has become achampion for local children denied orthodontic treatment by the state’sMedicaid system. In the past 9 years, she has won orthodontic treatmentfor 89 children in the region who had previously been rejected treatmentunder the state’s Medicaid standards, according to an article on

Missouri uses the Handicapping Labio-Lingual Deviation (HLD) IndexScore Sheet, with a 28-point cutoff, to evaluate orthodontic cases forchildren younger than 21 who qualify for Medicaid. Local dentists havecalled in Morrow on their Medicaid cases that were denied because theirpatients scored lower than the 28-point cutoff.

“The child should get treatment if they qualify, and in almost all ofthese cases, the orthodontist who examines the child has told me ‘Thiskid should qualify’,” said Morrow (pictured) in an interviewwith She added that the HLD evaluation, which is usedin clinical studies and research and never designed for Medicaideligibility, is flawed.

Morrow relies on the federal Early Periodic Screening, Diagnosis, andTreatment requirement, which says Medicaid treatment is warranted forpain relief or infection and tooth restoration.

“I always emphasize the maintenance of dental health,” she said. That’s what I hang my hat on.”