Court Settlement Increases Medicaid Reimbursements For Treatment Of Children

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Litigation / Medical Malpractice;  Dentistry;  Pediatrics / Children's Health
Article Date: 28 Aug 2007 - 10:00 PDT

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U.S. District Court Judge Robert Cleland last week approved a settlement in a federal lawsuit between child advocacy groups and the Michigan Department of Community Health that will increase Medicaid reimbursement rates for physicians and dentists who treat children and expand access to the program, the Detroit Free Press reports (Kresnak, Detroit Free Press, 8/23).

The suit, filed in 1999, claimed that low Medicaid reimbursement rates for beneficiaries younger than age 21 had resulted in many physicians refusing to accept beneficiaries. When the suit was filed, 88% of physicians in the Michigan State Medical Society accepted Medicaid, but by 2005, the number had dropped to 65%.

The settlement locks in for three years and increases by 47% the Medicaid reimbursement rate for physicians who treat child beneficiaries. The settlement also locks in higher reimbursement rates for the Healthy Kids Dental program, which provides dental care for children in families with incomes at or below 150% of the federal poverty level. The dental program is available in 59 mostly rural counties throughout the state. In addition, the settlement requires the state to provide more outreach and detailed reporting on Medicaid services for children (Kozlowski, Detroit News, 8/23).

According to Jennifer Clarke -- executive director of the Public Interest Law Center of Philadelphia, which filed the lawsuit along with parents and medical groups -- the settlement will guarantee that Healthy Kids Dental continues (Detroit Free Press, 8/23).

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