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Court throws out 'John B.' agreement, affecting care for 750,000 children under TennCare

6:48 PM, Mar 14, 2013   |    comments
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By Bobby Allyn / The Tennessean

A 15-year-old legal agreement that mandated regular medical and dental care for the state's poor children was thrown out Thursday by a federal appeals court.

The court found that the state is now meeting federal requirements, effectively terminating a longstanding agreement mandating compliance. Under that agreement, TennCare was providing checkups and treatment for 750,000 children, or more than a third of all children in the state.

The U.S. Court of Appeals for the 6th Circuit published an opinion on Thursday that voids an agreement that arose from a 1998 lawsuit alleging that children were not getting access to regular medical and dental checkups on TennCare, the state's Medicaid program.

Fifteen years ago, a federal court found that Tennessee was not providing adequate care to children on TennCare.

The appeals court on Thursday upheld a decision by federal judge Thomas Wiseman Jr. declaring that is no longer the case.

The agreement made 80 percent of children on TennCare receive regular checkups and medical, dental care.

For children in state custody, the agreement went even further, requiring the state to give all of those kids regular checkups and medical care.

State lawyers in 2006 sought to dismiss the case by arguing that TennCare already met federal standards.

Lawyers for children affected, however, said the state wasn't in compliance.

Since then, disputes over state data, questions of judicial impartiality and other squabbles have stalled the case's progress.

But Thursday's opinion resolves the issue for the moment, at least in a legal sense, of whether children on TennCare receive adequate health care.

Still, attorneys from Tennessee Justice Center say that are serious concerns over whether children services to which they are entitled. The group has characterized TennCare as being "dysfunctional."

The opinion stems from a case known as John B. after one of the original plaintiffs, among a group for whom attorneys for the Tennessee Justice Center filed a suit. It alleged that TennCare was falling short of providing necessary medical care to 750,000 children.

"TennCare had vastly improved its delivery of services to enrollees, and indeed become a national leader in its compliance with the Medicaid statute," according to the opinion.

In a release about the closure of the case, Michele Johnson, attorney with the Tennessee Justice Center, said: "Our daily contact with families and professionals who care for TennCare children makes us painfully aware that TennCare continues to shortchange some children, many of whom have great needs. The ruling therefore comes as a great disappointment."

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