Okla. doctors sue state over Medicaid pay, access woes

The state's pediatricians see court as a last resort to try to improve the state Medicaid program. They join Michigan and Pennsylvania in challenging the plans.

By Tanya Albert, AMNews staff. Sept. 24, 2001.

Frustrated that children on Medicaid don't have good access to doctors, a group of Oklahoma pediatricians is trying a tactic that few others have used to get their state's attention: They're taking the Medicaid program to court.

Members of the Oklahoma chapter of the American Academy of Pediatrics say they repeatedly have tried to work with the state Legislature to raise reimbursement rates to a level that would encourage physicians to participate in the program.

But the attempts haven't been successful, and pediatricians are dropping out of the state Medicaid program because they can't afford to stay. Some physicians are even leaving the state. As a result, physicians say, children have little access to doctors and sometimes have to go to other states to find specialists.

"We've been lied to, stolen from and cheated," said Norman, Okla., otolaryngologist Joseph E. Leonard, MD, who stopped accepting Medicaid patients because he lost so much money treating them. State reimbursement rates "should not drive us into bankruptcy."

So the OKAAP earlier this year turned to the courts, becoming the third group of pediatricians nationwide to file suit against their state Medicaid programs. AAP's Pennsylvania chapter filed suit there in 1991, and the group's Michigan chapter filed a lawsuit in 1999.

"It's been very difficult to address things legislatively," said Iowa pediatrician Richard Nelson, MD, who chairs the national AAP's panel on child health financing.

Pediatricians don't say the lawsuits are a trend. Instead, they say, it is an option that can be explored if nothing else is working. [...]