Doctors vs. Medicaid: Who decides treatment?

By: Kelli Kennedy / AP Writer
By: Kelli Kennedy / AP Writer

Who should ultimately decide what treatment is medically necessary -- a doctor or a state health agency?

Florida, Georgia and Alabama are arguing before a federal appeals court in Atlanta that Medicaid officials should have the final say in how to treat Anna Moore, a 14-year-old Georgia girl who suffers from near daily seizures. The state is trying to reduce the number of hours she can be treated by a home nurse, despite her doctor's recommendations.

Health advocates say the case could set a dangerous precedent if state health agencies and their for-profit contractors are allowed to decide which treatments should be administered, since they will consider cost before health needs.

But the states say doctors often prescribe experimental and unproven treatments that they shouldn't have to pay for.

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  • by well well well on Mar 31, 2009 at 12:37 PM
    The Dr. agrees to only get a portion of what they bill for. and not ALL Dr.s are seeking to abuse the system. And if the state determines her Dt is just money hungry or out for his own best interest- when and if this little girl suffers more damage or death and I'M SORRY from the stat WILL NOT BE enough. It is obvious i the child is on medicaid SHE qualifies for and is at the mercy of the state- but that does not mean she should be punished because of it. I can assure you she DID not ask for this condition and would get rid of it if she could... get a second opinion or a 3 maybe a 4 whatever you want BUT DO NOT CUT her benefits....
  • by Dream Location: Florida on Mar 31, 2009 at 12:34 PM
    medicaid officals are NOT Dr's stay out of this families business and worry about those who are failing the system!
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