After more than a decade, Florida health officials have finally agreed to improve access to health care for poor children, ending a long-running class-action lawsuit that had accused the state of shortchanging doctors and leaving low-income families to trek long distances to visit specialists.
The state reimbursed doctors so little for Medicaid services that many doctors refused to treat the patients, lawyers argued in a 2005 suit filed by pediatric doctors on behalf of nine plaintiffs.
Hundreds of thousands of children who were on Medicaid never received checkups, and for years, 80 percent of the children never saw a dentist, the worst rate in the nation.
Doctors were being paid about half of what they received from the Medicare program, so parents whose children required specialists were forced to travel long distances or wait months to find a physician who would accept the insurance for low-income people.
One child was unable to be tested for lead poisoning because the laboratory was a three-hour round-trip bus ride away.
A Fort Myers boy who needed his ear drained was referred to a specialist in Sarasota, almost two hours away.
“They would tell you, ‘You have to wait another month,’ ” said Rita Gorenflo, a retired nurse in Palm Beach Gardens who adopted seven special-needs children who received Medicaid benefits. “My son would get a referral for a pulmonologist, but he couldn’t get seen for three or four months. I have seen so many children at the clinic going without what they need.”
As a plaintiff, Ms. Gorenflo testified for more than two hours at a 90-day trial that ended in 2012.
In December 2014, a Federal District Court judge ruled that Florida violated federal law.
The three health agencies named in the suit signed a settlement agreeing to take important steps that would improve care. Among the steps was an incentive plan that would eventually pay doctors who meet certain criteria at rates equivalent to the federal Medicare program.
The Florida Agency for Health Care Administration also agreed to meet national benchmarks for the percentage of children on Medicaid receiving preventive care by 2019 and the norms for dental care by 2021.
Florida had one of the worst records in the nation when it came to Medicaid fees paid to doctors and the number of eligible children who actually received health care.
http://www.nytimes.com/2016/04/06/us/florida-agrees-to-improve-poor-childrens-access-to-health-care-settling-suit.html
