Court Says Bureaucrats, Not Doctors, Decide What Is 'Medically Necessary'
Earlier this month, a panel of the 11th U.S. Circuit Court of Appeals ruled in favor of three states that filed suit to have final medical decision-making authority transferred from doctors to state bureaucrats.
In March, as reported here at Pajamas Media, Georgia, Florida, and Alabama appealed U.S. District Judge Thomas Thrash's ruling that physicians, not government bureaucrats, were qualified -- both legally and medically -- to decide what was "medically necessary" for their patients, regardless of bureaucrats' opinions.
The thrust of the states' argument in Moore was summed up in the amicus brief filed by the state of Florida, which said, "Treating physicians ... cannot be trusted with this sort of decision. When left to their own devices, they advocate for their patients, and deem all manner of unproven, dangerous, ineffective, cosmetic, unnecessary, bizarre, and controversial treatments as 'medically necessary.'"
The "final arbiter" of medical decisions is and should be "the state," said attorney Robert Highsmith in March 24 oral arguments -- and the panel of the 11th Circuit agreed.
As a result of this ruling, doctors within the 11th Circuit's jurisdiction will no longer be "left to their own devices" to treat Medicaid patients under their care. However, current events suggest the relegation of medical professionals' recommendations to the status of mere suggestions pending review by state bureaucrats isn't likely to be limited to Medicaid cases alone for long.
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