Georgia Judge Rules That State Cannot Reduce Prescribed Health Services For Children

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Litigation / Medical Malpractice
Article Date: 19 Jun 2008 - 12:00 PST

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U.S. District Court Judge Thomas Thrash last week ruled that Georgia does not have the authority to deny or reduce health care services prescribed by a physician for child Medicaid beneficiaries, the Atlanta Journal-Constitution reports. Pat Nobbie, deputy director of the Governor's Council on Developmental Disabilities, said the state in recent years has reduced services for hundreds or thousands of children. She said she hopes the recent the court decision forces the agency to reconsider its practices.

The lawsuit involved a 13-year-old developmentally disabled girl whose physician prescribed 94 hours of private duty nursing care per week for her. The state Department of Community Health had approved 84 hours of nursing care. DCH Commissioner Rhonda Medows said in a court filing that the state has discretion to limit the amount of treatment paid for by Medicaid. According to Thrash's ruling, the state did not have such discretion (Schneider, Atlanta Journal-Constitution, 6/16).

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