Pediatricians back Medicaid patients' right to sue for basic health care

Appeals court ponders Michigan Medicaid case in which a lower court went against years of case law allowing such lawsuits on children's behalf.

By Tanya Albert, AMNews staff. Feb. 11, 2002.

Pediatricians and advocates of children's health hope a federal appeals court will overturn a lower court decision they fear could prevent Medicaid-eligible children from getting the most basic health care services.

The 6th U.S. Circuit Court of Appeals in January heard arguments in a case in which a Michigan federal judge said parents of Medicaid-enrolled children don't have the right to sue the state on children's behalf if they think the state isn't paying for services the federal government says should be covered.

Michigan parents sued the state officials in federal court because they said their children had been denied the most basic Medicaid Early and Periodic Screening, Diagnostic and Treatment services.

The decision by the U.S. District Court for the Eastern District of Michigan that the recipients did not have the right to sue went against 35 years of case law, according to legal experts. And physicians fear that without the courts as a remedy for disputes, states could stop adequately funding Medicaid services. That could shift more financial burden onto physicians treating Medicaid patients.

If that happens, children's health advocates said, more physicians would likely stop treating Medicaid patients because they couldn't afford to stay in the program. That would leave already vulnerable low-income children -- about one in four U.S. children -- without access to basic health care.

"A large percentage of physicians already can't be part of the program in a meaningful way because they will go broke because of low reimbursement rates," said Beatrice Murray, MD, a fellow at the American Academy of Pediatrics. [...]