Despite Florida's claims that privatizing Medicaid will resolve problems, a federal judge has refused to dismiss a lawsuit that alleges the state does not provide adequate care to children in the Medicaid program.
State officials claim that an overhaul to privatize Medicaid will raise reimbursement rates, improve doctor participation, and address allegations that children can't get appointments with dentists or physicians, according to an NBCMiami.com story. State attorneys said the lawsuit, filed nine years ago, has become moot because of the Medicaid privatization. Enrollment for most children began in May and ends in August.
The changes are promising, said Judge Adalberto Jordan for the U.S. Court of Appeals for the Eleventh Circuit, but he refused to dismiss the case, saying it's uncertain whether the program will actually improve access to medical care.
Under privatization, the state pays insurance companies set fees for care. However, the judge said it will take time to see if insurers follow through.
Florida has spent millions defending a class-action lawsuit that claims the state is violating federal Medicaid requirements by not providing adequate medical and dental care for children on Medicaid. The complaint alleges 390,000 children did not get a medical checkup in 2007 and more than 750,000 received no dental care. Many doctors and dentists won't accept Medicaid; Florida's reimbursement rates are among the nation's lowest. The lawsuit claims children on Medicaid often must wait two to three months to see specialists, especially in rural areas.
Almost 3 million Florida residents -- more than half of them children -- are shifting to privatized Medicaid in 2014. Insurance companies are required to spend 85% on patient care and expand their network of doctors and hospitals, increase reimbursement rates, and meet many new standards.
About 5,000 children will not be transferred into the privatization program, and the state will still pay for their medical services, officials said.
Florida lawmakers voted not to expand Medicaid to roughly 1 million additional people under the Patient Protection and Affordable Care Act.
