OKAAP v. Fogarty (Okla.)


Long Term Effects of OKAAP v. Fogarty (Okla.)

The Law Center’s efforts on behalf of hundreds of thousands of Oklahoma’s Medicaid kids made long-run marked, statistically measurable changes in key health indicators.

At the time the lawsuit was instituted, Oklahoma was paying its doctors at only 72% of the rate which Medicare pays for comparable services. At the time, Oklahoma’s performance on three key statistical measures which the federal Medicaid agency requires states to report on was quite poor.

  1. Oklahoma’s “screening ratio,” i.e., the percentage of all the well child checkups which Oklahoma’s Medicaid kids should have received in a years was 56%, i.e., 44% of the checkups were not occurring.
  2. Oklahoma’s “participant ratio,” i.e., the percentage of children who should have received at least one checkup a year who got that check up was 40% , i.e., 60% of Oklahoma’s Medicaid kids who should have gotten at least one checkup a year did not get one.
  3. The percentage of Oklahoma’s Medicaid kids who received in the year at least one dental service (including cleanings and checkups) was only 16.8%, i.e., 83 % got no dental service.

Despite the Court of Appeals 2007 decision vacating the 2005 injunction, Oklahoma did not reduce Medicare rates until several years later when the rates were lowered only slightly to about 95% of Medicare rates.

Over the course of the nine years following the institution of the lawsuit, the key statistical measures of performance Oklahoma’s Medicaid program made marked improvements from 2001 until 2010 (the latest year for which numbers are available).

  1. The screening ratios increased from 56% to 77%.
  2. The participant ratio increased from 40% to 56%; and
  3. The percentage of Medicaid kids receiving at least one dental service during the year increased from 16.8% to 45.2%.

In addition to the statistical measures it is the judgment of Dr. Robert Wright the Stillwater, Oklahoma pediatrician who helped organize the Oklahoma pediatricians to support the lawsuit, that there has been since the lawsuit was brought marked improvement in the ability of Oklahoma pediatricians ability to refer their Medicaid patients for dental care and for most types of medical specialty care. In addition, Dr. Wright has said that since the lawsuit, the Oklahoma Medicaid agency has been far more responsive to the expressed concerns of Oklahoma pediatricians that it was prior to the lawsuit’s conclusion in 2005.

It seems, therefore, fair to conclude that the Oklahoma children’s Medicaid case received in the long perspective did achieve material and measurable benefits for Oklahoma’s several hundred thousand children enrolled in Medicaid and for the pediatricians who serve them.