Alarming court decision for Alabama, Georgia, and Florida. Insurance gets last say, not doctor

[madfloridian]

in the Medicaid plans in those states according to an appeals court. This is just shocking to me.

Hat tip to FLA Politics blog for this article.

"State-run insurance plans for the poor and disabled can't be forced to pay for a treatment if they disagree with a doctor over whether it's necessary, a federal appeals court ruled Friday."

Sicko

The decision from the 11th U.S. Circuit Court of Appeals said state Medicaid officials can't be excluded from determining the care of a 14-year-old Georgia girl who suffers from near-daily seizures. Her mother filed a lawsuit after the state cut the number of hours the girl was seen by a home nurse.

The ruling applies to Alabama, Florida and Georgia, where health-care advocates fear it could allow state health agencies to overrule doctors' reccomendations. They also worry it would allow for-profit Medicaid contractors to decide on treatments based cost instead of health needs.

More from the article from Tampa Bay Online

Court says insurance plan has final say in treatment disputes

MIAMI - State-run insurance plans for the poor and disabled can't be forced to pay for a treatment if they disagree with a doctor over whether it's necessary, a federal appeals court ruled Friday. The decision from the 11th U.S. Circuit Court of Appeals said state Medicaid officials can't be excluded from determining the care of a 14-year-old Georgia girl who suffers from near-daily seizures. Her mother filed a lawsuit after the state cut the number of hours the girl was seen by a home nurse.

The ruling applies to Alabama, Florida and Georgia, where health-care advocates fear it could allow state health agencies to overrule doctors' reccomendations. They also worry it would allow for-profit Medicaid contractors to decide on treatments based cost instead of health needs

Anna Moore's mother, Pamela Moore, sued Georgia Medicaid in 2007 after she was told they were cutting the number of home nursing hours from 94 to 84 a week. The teen, who suffered a stroke in utero, attends school occasionally, but often requires medical intervention because of the strokes and frequent breathing problems, Atlanta Legal Aid Society attorney David Webster said.

Florida and Alabama joined Georgia in fighting the lawsuit, citing a federal regulation which allows them to limit service based on "medical necessity."