Big Win in FL Medicaid Case
A federal judge found that Florida’s Medicaid program is not providing children with federally guaranteed rights to medical and dental care.
On December 31, 2014, Judge Adalberto Jordan found that Florida’s 1.9 million children who depend on the Florida Medicaid program for their medical and dental care are not receiving the care required by federal law.
In his 153-page findings of fact and conclusions of law, Judge Jordan documented the extreme failures in that state’s Medicaid system, leading to life-threatening delays or failures to provide medical and dental care, insurmountable bureaucratic hurdles faced by low income children and an enrollment system that failed to capture a quarter of a million additional eligible children
Together with Boies, Schiller & Flexner, we brought this case back in 2005 on behalf of children who depend on the Medicaid program, and by the Florida Chapter of the American Academy of Pediatrics, and the Florida Academy of Pediatric Dentistry.
Following more than 90 days of trial, the Court found that hundreds of thousands of children did not receive even one of the check-ups they need in a year, even newborns; only 60,000 of the 250,000 1- and 2-year-olds who should have received lead screenings received one, even though Florida has the 8th largest number of children with elevated blood lead levels; the state faces a “crisis” in the availability of specialists to treat children enrolled in Medicaid; and only a small fraction of the children received any dental care at all.
The Court documented the bureaucratic hurdles contributing to this systematic failure: the state unlawfully terminated tens of thousands of newborns and young children from Medicaid; it switched children to different doctors without informing their parents, or their doctors, causing delays in needed treatments and tests; and it eliminated a budget for outreach and enrollment, replacing it with an incomprehensible, 50-screen online application process.
Finally, the Court documented the extremely low—and sometimes below cost– reimbursement rates established by Florida state officials without reference to whether those rates are sufficient to secure enough doctors or dentists to serve the children enrolled in Medicaid. Relying on state Medicaid officials’ own published statements as well as expert testimony and reports, the Court found that these low rates are a significant cause of the state’s systemic failure to provide for the required medical and dental services; and that when rates are increased, the number of children who receive services also increase.