Revision to DS and Medicaid... any suggestions??

I was wondering if anyone had any information or advise on my situation. I had RNY in April of 2008. Lost 50lbs. Since then I have been diagnosed with diabeties and hypertension. I have missouri medicaid and I want to do a revision to a DS. My first problem is if medicaid will even pay for a 2nd surgery and the second problem is that there are no DS drs in MO so I would have to travel to another state. I am wondering if medicaid would pay for a dr who is out of state. I don't even know where to begin, Any help would be greatly appreciated