Arkansas Officials Ask Judge to Modify Decision Requiring State to Provide Services to Developmentally Delayed Children

Lawyers representing the state of Arkansas have sent a letter to U.S. District Judge Bill Wilson asking him to modify his order requiring the state to cover day treatment and therapy services for developmentally delayed children enrolled in Medicaid, the Arkansas Democrat-Gazette reports (Satter, Arkansas Democrat-Gazette, 7/19). Last year, the state announced it would cut Medicaid funding for the two programs in an effort to save $4.9 million to $5.7 million. But five companies that provide the services sued the state, claiming the cuts could cause them to go bankrupt. In December, Wilson sided with the providers, a decision that officials said "essentially directed" the state to expand the services to all 75 counties, which would cost an estimated $100 million or more per year. The state appealed the decision, and in a June 10 ruling, the 8th U.S. Circuit Court of Appeals in St. Louis agreed with Wilson that Medicaid-eligible children have a right to early childhood services. But it disagreed that those services must be provided through the state's Medicaid program. The appeals court did, however, rule that Medicaid "must pay part or all of the cost of treatment for conditions discovered by doctors who first diagnose and evaluate the children" (Kaiser Daily Health Policy Report, 6/12).

No Specifics
The state wrote to Wilson asking him to modify his ruling to comply with the nuances of the appeals court's decision. Without such action, the state cannot "redefine Child Health Management Services," the Medicaid-funded programs in question, the Democrat-Gazette reports. The state has not said how it wants to modify the programs, and lawyers for the providers said the state is trying to "hide" the fact that it must cover such services in hopes that doctors will be "less likely to prescribe" them. A letter sent by the providers' lawyers to Wilson asked the judge not to "destroy this mandatory and vital program," citing a sentence in the appeals court's ruling that states, "The state may not shirk its responsibilities to Medicaid [beneficiaries] by burying information about available services in a complex bureaucratic scheme." Wilson is not expected to address the state's request to modify his order until next week, the Democrat-Gazette reports (Arkansas Democrat-Gazette, 7/19).