Florida violated federal law by underfunding healthcare for needy children, judge rules

BMJ 2015; 350 doi: (Published 09 January 2015) Cite this as: BMJ 2015;350:h151
  1. Owen Dyer
  1. 1Montreal

Florida’s system of providing healthcare to needy children is so inadequate that it violates federal law, effectively leaving the most vulnerable children unable to get medical care, a federal judge has said in a ruling on a decade long case.

The state’s Medicaid budget, which provides health insurance to poor families, has been set artificially low for years, paying pediatricians and other specialists far less than they earned by treating the children of privately insured patients, found US Circuit Judge Adalberto Jordan. Many simply stopped seeing patients on Medicaid, whose reimbursement rates were also about 40% lower than those from Medicare, which caters to elderly people.

“In discharging its responsibility to set physician reimbursement rates, AHCA [the state Agency for Health Care Administration] does not consider whether the reimbursement rates are sufficient to ensure that children on Medicaid …

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