Federal court says Georgia’s Medicaid rules shortchanged medically fragile 3-year-old

The policies that Georgia uses to approve or deny services for children enrolled in Medicaid fail to satisfy federal requirements for adequate care, according to a new federal court ruling.

A three-judge panel of the U.S. Court of Appeals for the Eleventh Circuit upheld a federal district judge’s order requiring the Georgia Department of Community Health (DCH) to provide nearly five times more in-home nursing care to a child at risk of dying than the state had approved through a contractor.

The 3-year-old boy, referred to by the court as L.W., has a rare metabolic disease that interrupts his body’s ability to store and use glycogen, a kind of fuel.