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Moore v. Medows (N.D.Ga., No 1:C7-CV-631-TWT, June 4, 2008)
A federal court rules that Georgia must provide all of the nursing care a physician prescribed for a child receiving Medicaid benefits and that the state may not cut back on that care. Moore v. Medows (N.D.Ga., No 1:C7-CV-631-TWT, June 4, 2008).
Anna C. Moore, a 12-year-old Medicaid beneficiary who suffers from multiple disabilities, requires 24-hour care. Under the Georgia Pediatric Program, Anna received 94 hours of in-home nursing care, which the Georgia Department of Community Health attempted to reduce to 84 hours. Anna initially appealed the care reduction, but then withdrew her appeal and filed a civil rights suit in federal court. Both parties moved for summary judgment.
In her motion, Anna alleged that the Department's reduction of care violated the Early and Periodic Screening, Diagnostic and Treatment Services(EPSDT) provisions of federal Medicaid law. Her primary argument was that the state was required to provide the amount of nursing care prescribed by her physician to "correct or ameliorate her condition." The Department agreed that it was required to provide treatment, but claimed that it could limit the amount of care to less than what was prescribed.
The court denies the Department's motion and partially grants Anna's. It finds that "the state must provide for the amount of skilled nursing care which the Plaintiff's treating physician deems necessary to correct or ameliorate her condition. The Defendant may not deny or reduce the hours of skilled nursing care that is medically necessary based upon cost or the lack of a secondary caregiver."
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<i>Moore v. Medows</i> (N.D.Ga., No 1:C7-CV-631-TWT, June 4, 2008)
A federal court rules that Georgia must provide all of the nursing care a physician prescribed for a child receiving Medicaid benefits and that the state may not cut back on that care. Moore v. Medows (N.D.Ga., No 1:C7-CV-631-TWT, June 4, 2008).
Anna C. Moore, a 12-year-old Medicaid beneficiary who suffers from multiple disabilities, requires 24-hour care. Under the Georgia Pediatric Program, Anna received 94 hours of in-home nursing care, which the Georgia Department of Community Health attempted to reduce to 84 hours. Anna initially appealed the care reduction, but then withdrew her appeal and filed a civil rights suit in federal court. Both parties moved for summary judgment.
In her motion, Anna alleged that the Department's reduction of care violated the Early and Periodic Screening, Diagnostic and Treatment Services(EPSDT) provisions of federal Medicaid law. Her primary argument was that the state was required to provide the amount of nursing care prescribed by her physician to "correct or ameliorate her condition." The Department agreed that it was required to provide treatment, but claimed that it could limit the amount of care to less than what was prescribed.
The court denies the Department's motion and partially grants Anna's. It finds that "the state must provide for the amount of skilled nursing care which the Plaintiff's treating physician deems necessary to correct or ameliorate her condition. The Defendant may not deny or reduce the hours of skilled nursing care that is medically necessary based upon cost or the lack of a secondary caregiver."
<i>Moore v. Medows</i> (N.D.Ga., No 1:C7-CV-631-TWT, June 4, 2008)
<p>A federal court rules that Georgia must provide all of the nursing care a physician prescribed for a child receiving Medicaid benefits and that the state may not cut back on that care. <i>Moore v. Medows</i> (N.D.Ga., No 1:C7-CV-631-TWT, June 4, 2008).
<p>Anna C. Moore, a 12-year-old Medicaid beneficiary who suffers from multiple disabilities, requires 24-hour care. Under the Georgia Pediatric Program, Anna received 94 hours of in-home nursing care, which the Georgia Department of Community Health attempted to reduce to 84 hours. Anna initially appealed the care reduction, but then withdrew her appeal and filed a civil rights suit in federal court. Both parties moved for summary judgment.
<p>In her motion, Anna alleged that the Department's reduction of care violated the Early and Periodic Screening, Diagnostic and Treatment Services(EPSDT) provisions of federal Medicaid law. Her primary argument was that the state was required to provide the amount of nursing care prescribed by her physician to "correct or ameliorate her condition." The Department agreed that it was required to provide treatment, but claimed that it could limit the amount of care to less than what was prescribed.
<p>The court denies the Department's motion and partially grants Anna's. It finds that "the state must provide for the amount of skilled nursing care which the Plaintiff's treating physician deems necessary to correct or ameliorate her condition. The Defendant may not deny or reduce the hours of skilled nursing care that is medically necessary based upon cost or the lack of a secondary caregiver."
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