A U.S. District Court judge in Chicago has found that Illinois was violating federal Medicaid laws by not offering eligible children the same services available to children in private health plans and by not supplying the care required by law.
Judge Joan Lefkow scheduled a hearing in September to consider an injunction that could bring the state in compliance with the law. John Bouman, an attorney representing the plaintiffs and the director of advocacy of the Sargent Shriver National Center for Poverty Law, said that will be difficult unless reimbursements to pediatricians are increased.
He said that part of the reason the court said the state wasn't providing equal services to Medicaid children was because not enough doctors had been participating in the program.
According to the court opinion, the most commonly billed service in the state's Medicaid program yields a maximum return of $29.85, while Medicare reimbursements are $54.16 for the same service.