Kaiser Health News: Supreme Court Battle Brewing Over Medicaid Fees

Kaiser Health News: Supreme Court Battle Brewing Over Medicaid Fees

By Phil Galewitz

PALM BEACH GARDENS, Fla.—Rita Gorenflo’s 7-year-old son Nathaniel was in severe pain from a sinus infection.

But since the boy was covered by Medicaid, she couldn’t immediately find a specialist willing to see him. After days of calling, she was finally able to get Nathaniel an appointment nearly a week later near their South Florida home. That was in 2005.

Last month, ruling in a lawsuit brought by the state’s pediatricians and patient advocacy groups, a federal district judge in Miami determined Nathaniel’s wait was “unreasonable” and that Florida’s Medicaid program was failing him and nearly 2 million other children by not paying enough money to doctors and dentists to ensure the kids have adequate access to care.

“These lawsuits result in a massive expenditure of states’ limited resources,” he said. “There are more appropriate avenues for them to get their concerns across than dragging state Medicaid agencies to court.”

If Idaho wins its appeal to the Supreme Court, the decision could severely limit such suits, legal experts say.

“It would be beyond just a chilling effect,” said Sarah Somers, managing attorney for the National Health Law Program, a patient advocacy group.Read the full article here. »

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