|.||Robert "Buck" Wright, MD, FAAP
AAP Oklahoma Chapter
On assuming the presidency of Oklahoma Chapter of American Academy of Pediatrics (OKAAP) five years ago, I surveyed our membership and they identified difficulties with Medicaid as the biggest problem facing pediatricians in the state. With the help of the AAP, our chapter filed a lawsuit in March 2001 against the Oklahoma Health Care Authority (OHCA, the agency that runs Medicaid), suing on behalf of the poor children of Oklahoma who are deprived services promised by Title XIX law. We seek to have both reimbursement and operations of the Oklahoma Medicaid program improved.
Assembling the evidence has been a challenge over the past four years. We spent many hours talking to parents and doctors to name our plaintiffs and witnesses. I also stumped around the state as President of OKAAP to raise money for this effort. Many OKAAP members and the AAP staff provided research and information to help us. Our attorneys spent much time becoming familiar with the issues and assembling the facts for trial.
We've survived motions to change venue, to dismiss OKAAP for lack of standing, to dismiss the lawsuit in its entirety, and to dismiss our counsel. Last year our class was certified, which we estimate to be about 250,000 children. OKAAP now represents all children in Oklahoma who are not getting promised services.
It has all paid off. In the pretrial order, OHCA admitted its internal performance measure to comply with the equal access mandate is to raise provider reimbursement rates under Medicaid to "100% of the Medicare Fee Schedule." However, OHCA has never met this goal.
The trial took place from April 5 to May 12, 2004 in Tulsa. In addition to increasing reimbursement, many operational deficiencies of the OHCA program need addressing to achieve equal access, and a significant portion of the trial highlighted these deficiencies. We feel we presented our case well and we're optimistic that our efforts will result in positive changes.
I wish to thank the AAP and AMA for their support. AMA provided substantial financial support toward trial expenses, and the AAP provided and paid for expert witnesses and supplied research for our reports and testimony.
Closing arguments are June 30 and we expect a ruling in about three months.