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BSF Seeks Medicaid Improvements for Florida Children in Nation’s Largest Pro Bono Case

Pro Bono Highlights

Winter 2010

Stuart Singer

In the wake of several favorable decisions on summary judgment and class certification, the Firm's major pro bono case on behalf of Florida's 1.2 million plus children on Medicaid is now in trial.  The State's efforts to seek review in the 11th Circuit were denied, and the non-jury trial began on December 7, 2009 before US District Judge Adalberto Jordan in Miami.

The case's long road to trial began in 2005 when the Firm filed suit on behalf of a number of children and two organizations to obtain declaratory and injunctive relief requiring Florida officials to bring the state's Medicaid program into compliance with federal law.  The Medicaid Act requires that children receive preventative health care and treatment services known as EPSDT (Early Periodic Screening Diagnosis and Treatment) which includes regular examinations, immunizations, lead blood screens, dental care and treatment as needed.  The Act requires that access to these services be provided with "reasonable promptness," that Medicaid children have "equal access" to care that similarly situated children on private insurance receive, and that outreach be conducted to inform eligible individuals about their rights.

Unfortunately, in Florida, as well as in some other states, the Medicaid program has not come close to meeting these federal requirements.  The state's own statistics show several hundred thousand children receive no preventative health care visits at all, that only around 20% of the required lead blood  screens are conducted, and that there is an acute shortage of specialists willing to treat Medicaid patients.  With respect to dental care, the situation is, if anything, worse, with recent studies ranking Florida last or next to last in the entire country.  The Florida legislature has for years rejected proposals from state agencies to increase reimbursement rates for healthy kid checkups, for specialists, and for dentists, so the situation is deteriorating further.

State officials who are defendants in the action have, through the attorney general's office as well as outside counsel, opposed the case at every juncture.  The District Court on September 30, 2009 rejected the State's summary judgment motion and granted plaintiffs' motion for class certification. BSF partner Stuart Singer argued both motions.   The court certified a class of approximately 1.2 million children eligible for Medicaid.  The State petitioned the 11th Circuit to accept an interlocutory appeal of the class certification order.  In November, Judge Jordan denied the state's motion for a stay, and the State sought to review that decision as well.  On December 1, the 11th Circuit denied the State's petition for interlocutory appeal, resolving both issues. 

BSF has committed thousands of hours of time to this effort, representing what is believed to be the largest active pro bono case in the country.  The Florida Pediatric Society, Florida Academy of Pediatric Dentistry, and other state and national medical groups have provided financial support to defray expert and other costs of the litigation. The trial will occur in a series of one or two week settings over a number of months.  The case went back into trial on Feb. 9th.

The trial team for this case is being led by Singer and BSF partner Carl Goldfarb, who both examined the initial witnesses, and includes partner  Sashi Boruchow, counsel Gera Peoples, and associates Lauren Fleisher LouisSusan Klock, Ashanti Decker, and Tom McCawley.

Related Lawyers: Stuart H. Singer, Sashi C. Bach, , Lauren Louis, ,

Related Practice: Pro Bono