TALLAHASSEE — In 2002, under the leadership of then President Dr. Rick Bucciarelli, the Florida Chapter of American Academy of Pediatrics, Inc. (FCAAP), decided to sue the State of Florida for failure to assure that children on Florida Medicaid have appropriate access to Early Periodic Screening Diagnosis and Treatment services. After being appointed to lead the effort on behalf of FCAAP, then Executive Vice President Dr. Louis St. Petery, worked with several organizations and legal experts to secure the pro bono representation of the Fort Lauderdale-based law firm of Boies, Schiller & Flexner (BSF).
The lawsuit was filed in Federal District Court in Miami in 2005 and the two- and half-year trial began in 2010, in which numerous FCAAP leaders and members participated as subject matter experts. In April 2016, under the leadership of then President Dr. Tommy Schechtman, the parties entered into a court-approved settlement agreement which included several measures intended to improve access to care for the children who depended upon the State’s Medicaid program for their health care. With that settlement came the launch of the Medicaid Physician Incentive Program (MPIP) through which pediatricians, pediatric subspecialists, dentists, and obstetricians/gynecologists were provided a way to earn Medicare-equivalent rates for their care of Floridians with Medicaid. Over the past five years, the MPIP has continued to evolve to expand the number of providers eligible for the increased rates.
With the expiration of the settlement approaching, the parties negotiated an amended settlement agreement to extend the State’s requirement to pay the increased rates to qualified providers through at least 2030. The amended agreement also secured the State’s commitment to maintaining recognition of membership in a certified patient centered medical home as one avenue by which physicians can qualify for the enhanced rate, in addition to the agreement to create a statewide alternative avenue based on HEDIS metrics. The amended settlement agreement was filed with the court in September 2022 and received the court’s approval in November 2022.
“The 2016 settlement has led to programmatic changes to deal with wrongful terminations, switching, and resulted in hundreds of millions of additional dollars being spent on reimbursement to increase access to care. Now that will continue until at least 2030 and benefit millions of Florida children who depend on Medicaid,” said BSF lead counsel Stuart Singer, Esq. “On behalf of our firm, let me say we feel privileged as well as proud of our involvement in the Florida Medicaid case over these many years.”
“The court’s approval of the amended settlement agreement is a huge success for Florida’s children and pediatric health care providers,” said FCAAP President Thresia Gambon, MD, MBA, MPH, FAAP. “FCAAP is grateful to the legal team at BSF, Judge Adalberto Jordan, the state leaders who worked with FCAAP to reach the settlement, and the numerous FCAAP members and leaders who played such a critical role in the pursuit of and ultimate success in this 20-year effort.”
Through its more than 2,500 members, the Florida Chapter of American Academy of Pediatrics, Inc., promotes the health and welfare of Florida’s children and supports pediatricians and pediatric specialists as the best qualified providers of their healthcare.
For more information:
Scott VanDeman, Communications Coordinator
Florida Chapter of the American Academy of Pediatrics
850-224-3939, ext. 1005