MIAMI — Florida health officials did not adequately market its Medicaid program and remind parents of the importance of keeping children's medical appointments because it worried an influx of appointments would strap a system already low on doctors, attorneys said this week during testimony in a class-action lawsuit.
In 2001, federal health officials asked Florida to send letters to the parents of children on Medicaid who had not had a dental appointment for several months. Ten years later — in July and September 2011 — the state complied and sent letters, according to documents shown in Miami federal court.
The state is fighting a class-action lawsuit that claims 390,000 Medicaid children did not get a medical checkup in 2007 and more than 750,000 received no dental care. Attorneys representing 1.7 million children on Medicaid say Florida's reimbursement rates, among the lowest in the country, mean few doctors participate in the program, making it difficult for patients to get care.
The state is required to market its Medicaid dental program under federal law, but plaintiff's attorneys warned the state purposely delayed doing so because it couldn't meet the potential demand.
"If you sent the letters and there weren't enough providers it would create a negative consequence because Medicaid patients wouldn't be able to find a dentist," plaintiff's attorney Stuart Singer said.
The Centers for Medicare and Medicaid Services, which oversees the federal program, asked the state to send a letter in 2001 to stress the importance of seeing a dentist by three years of age and every six months afterward. The letters were also to include details on how to access services.
But the state didn't send the letters, according to testimony.
Beth Kidder, a top state Medicaid official, said the state worried about "oversaturating" patients with too much information.
Federal health officials again urged the state to send the letters in 2008. The state said they were hiring a new private contractor and would send the letters as soon as they made the transition, according to documents presented at trial.
Three years later, the letters were sent. When asked about the delay, Kidder testified the agency was working on a new website at the time where the information would be posted.
"Those things were not moving as quickly as we would have liked given other priorities," Kidder said.
State officials testified about other outreach efforts, including websites, to help patients access services. Attorneys for the plaintiffs say applying for and accessing Medicaid services is difficult and many recipients don't have computer skills or access to a computer.
The Medicaid program has added roughly 500,000 children over the last two years as the economy plummeted. Attorneys for the plaintiffs say the increase has further strained the system.
Kidder said Monday the Medicaid program is not perfect, but children receive care when they need — contradicting dozens of documents from her agency.
The state has spent about $4.6 million defending the case, which is being tried in chunks. It's unclear whether the trial will finish this year.