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Litigation to Improve Access to Health Care for Children

Lessons from Memisovski v. Maram

By John Bouman, Frederick H. Cohen, David J. Chizewer, Stephanie Altman & Thomas Yates

Memisovski v. Maram, a federal class action lawsuit on behalf of some 600,000 Cook County, Illinois, children receiving Medicaid, has led to improved ways of delivering health care services. In a bench trial plaintiffs used the state’s own data to show the low level of care that the class received, showed through expert analysis of reimbursement rates how the state discouraged doctors from serving Medicaid children, and gave testimony from the children’s parents about their difficult experience with health care. The court rejected the state’s argument that plaintiffs had no enforceable rights and ruled that the state was out of compliance with the Medicaid Act. The parties then negotiated a consent decree of multiple approaches, including higher reimbursement rates, to ensure that children have access to and receive mandated health care services.

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