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State, Advocacy Organizations Settle Medicaid Lawsuit

August 22, 2007

LANSING - The Michigan Department of Community Health (MDCH) and children's advocacy organizations today announced an agreement to settle an eight-year old lawsuit brought under federal Medicaid law.

"We welcome this settlement as an opportunity to improve the delivery of medical and dental care to the more than 1 million children in the state enrolled in Medicaid," said Janet Olszewski, MDCH Director. "Our top priority continues to be ensuring that low-income children in Michigan have access to the very best medical care Michigan has to offer." Jennifer R. Clarke, lead counsel for the advocacy groups which brought suit against Michigan in federal court, hailed the agreement as "an opportunity for advocates and MDCH to work collaboratively, using the data to obtain more resources for better care."

State officials also agreed to collect and give advocates detailed information regarding access to medical and dental care as well as the care that children are actually receiving. They also agreed to ongoing consultation with advocates to improve children's access to health care and dental services. Under the settlement agreement, MDCH also will expand the Michigan Care Improvement Registry (MCIR) to include the mandated checkups and screenings actually received by children.

Originally filed in 1999, the case was brought in federal court against state officials by the Michigan Chapter of the American Academy of Pediatrics, the Michigan Chapter of the American Association of Pediatric Dentists, Westside Mothers - an organization of mothers in the Detroit area, Families on the Move - an advocacy organization for foster care families - and several individual children and their families.

These groups had claimed that Michigan's Medicaid program did not meet the federal requirements for state Medicaid programs for children. State officials denied the allegations of the complaint, but agreed to settle the case to avoid the cost and distraction of litigation, and to further the shared goal of improving children's access to medical services under Medicaid.

In 2006, while the suit was pending, Michigan raised its rates for certain children's medical and dental services by 47 percent. Dr. Sheila Gahagan, president of the Michigan Chapter of the American Academy of Pediatricians, stated that the settlement, which protects the 2006 increases in reimbursement rates, is "an important step in ensuring that enough doctors are available to meet all of the need."

To implement the agreement, the state and advocates have appointed designees who will monitor the settlement agreement and be the principal contact for issues associated with the lawsuit. Michigan also agreed to pay $25,000 per year over the next three years to help compensate the advocates' chosen designee.

Advocates have designated Dr. Charles Barone, M.D., Chair, Department of Pediatrics, Henry Ford Health Services to serve in that capacity, while the state has designated Neil Oppenheimer, Assistant to the Director of the Medical Services Administration of MDCH.