Question: I have heard about the recent Medicaid case Rosie D. v. Romney. Are there any other cases on Medicaid?s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit that have come out recently?
Answer: There have been several significant EPSDT cases decided over the past two years. A number of these cases reach substantive issues, thus, they are particularly important. The cases and the trends they mark are summarized below.
The EPSDT Cases
A.G. v. Arnold, 2006 WL 334218 (M.D. Fla. Feb. 13, 2006).
C.F. v. Dep?t Children and Families, CASE NO. 3D04-1147, 2005 Fla. App. LEXIS 20245 (Dec. 28, 2005).
Clark v. Richman, No. 4:00-cv-1306, (M.D. Penn.), 339 F. Supp. 2d 631 (Oct. 7, 2004) (decision on motions for summary judgment), (Aug. 17, 2005) (judgment).
Hawkins v. NH Dep?t of Health & Human Servs., 2004 DNH 23 (D. N.H. 2004)
Health Care for All v. Romney, No. 00-10833-RWZ, 2005 U.S. Dist. LEXIS 14187 (July 14, 2005)
Jacobus v. Dep?t of PATH, 2004 Vt. 70 (2004)
Memisovski v. Maram, No. 92-C-1982, 2004 U.S. Dist. LEXIS 16772 (N.D. Ill. Aug. 23, 2004)
Okla. Chapter of Am. Academy of Pediatrics v. Fogarty, 366 F. Supp. 2d 1050 (N.D. Okla. 2005) (on appeal)
Pediatric Specialty Care v. Ark. Dep?t Human Services, No. 4:01CV00830 (E.D. Ark.)
Rosie D. v. Romney, NO. 01-30199-MAP, 2006 U.S. Dist. LEXIS 3026 (D. Mass. Jan. 26, 2006)
S.D. v. Hood, 391 F.3d 581 (5th Cir. 2004)
Semerzakis v. Wilson-Coker, 274 Conn. 1 (2005)
Westside Mothers v. Haveman, 368 F. Supp. 2d 740 (E.D.Mich 2005) (on appeal)
Discussion
Merits in Systemic Cases (Clark, Hawkins, Health Care for All, Memisovski, Oklahoma Academy, Rosie D.)
The past two years have yielded several excellent, far-reaching EPSDT verdicts in systemic cases. The years of hard work that advocates put into these cases, and the extensive evidence they presented, for the most part paid off. Though Hawkins settled, the fact that such a far-reaching settlement could be achieved in this era is impressive and welcome. The Oklahoma Academy case was not entirely successful, however, because the decision is on appeal, it is likely that there will be further litigation.
Merits in Individual Cases (C.F., Jacobus, S.D.)
Individual cases have met with success and the cases indicate the impact that evidence of individual harm can have on a trier of fact.
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