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Health News Florida

Judge: FL Medicaid for Kids Violates Law

A federal judge has ruled that Florida’s health care system for impoverished and disabled children violates several U.S. laws.

In a ruling Wednesday, U.S. Circuit Judge Adalberto Jordan of Miami said lawmakers had for years set the state’s Medicaid budget at an artificially low level, causing pediatricians and other specialists for children to opt out of the insurance program for the needy.

CDC_Pediatric_shots_2006.jpg
Credit Centers for Disease Control and Prevention

Jordan said that amounted to rationing of care and exacerbated a shortage of pediatricians, particularly in rural areas.

“This is a great day for the children in this state,” said Dr. Louis B. St. Petery, a Tallahassee pediatrician who is executive vice president of the Florida Pediatric Society and helped spearhead a 2005 lawsuit against Florida’s Department of Health, Department of Children and Families and the Agency for Health Care Administration.

“This action was taken because we found that children weren’t being treated properly if they were on Medicaid. Our position as pediatricians is that children do not choose their parents. They don’t have a choice to be born into a rich family or a poor family,” St. Petery told the Miami Herald.

On behalf of the state agencies named in the lawsuit, the Agency for Health Care Administration issued a statement Wednesday responding to Jordan’s ruling: “The Judge’s outdated observations pertain to a Medicaid program that no longer exists. Florida’s new Statewide Medicaid Managed Care program is cost-effective and a working success.”

Enrollment in the Medicaid program increased from 1.2 million in 2005 to 1.7 million in 2011, but the number of pediatricians did not rise at all, Jordan said.

The judge found that almost 80 percent of children enrolled in the Medicaid program “are getting no dental services at all.”

He also said Florida health regulators were leaving a third of the state’s children on Medicaid with no preventative medical care despite federal legal requirements, and they sometimes switched children from one Medicaid provider to another “without their parents’ knowledge or consent.”

The number of needy Florida children able to get a potentially life-saving blood screening for lead is “extremely low, notwithstanding the fact that part of Florida has an aging housing stock, which means children are more likely exposed to lead-based paint,” Jordan ruled.

Jordan said he would set a hearing later this month to determine how to proceed with the state toward a resolution.

The lawyer who litigated the lawsuit on behalf of a group of pediatricians, dentists and nine children said their victory depends on whether the Legislature and Gov. Rick Scott set aside enough money to improve medical and dental care for needy children. Because the federal government will match each dollar the state spends, Florida would need to appropriate about $200 million to fix the Medicaid program, he said.

In an unrelated case, another judge blasted the state's handling of the care of two South Florida foster children needing in-patient mental health treatment, the Miami Herald reports. 

Miami-Dade Circuit Judge Michael Hanzman ordered DCF to find treatment beds for the children, ages 10 and 11, but it has not yet done so. The judge said the agency is ignoring a court order and thus denying critical care to children with severe mental health needs, the Heraldreports.

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