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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