OKAAP v. Fogarty went to trial in April 2004, the first time that the full range of a state’s dental and medical care through Medicaid had been tried on its merits. The District Court issued detailed findings of fact and holding that the state had violated federal law by failing to make medical and dental care available.

The Court ordered Oklahoma to raise its rates to a level sufficient enough to attract providers to participate in Medicaid. State officials compiled and raised rates paid to providers to the same level as the rates paid for Medicare services (rates which were considerably higher).

The district court’s decision was overturned by the Court of Appeals for the Tenth Circuit, which interpreted the Medicaid law to mean only that if a child received a service, a state was obligated to pay for the service, although the law had long been interpreted to require the delivery of services, and not payment.