BLOOMINGTON, Ind. — The Indiana Supreme Court will not review a lower-court ruling that says the state must provide Medicaid benefits to people with disabilities that can be improved with medical treatment.

        The decision by the court caps an eight-year legal battle that began when a Greene County woman sued the state for denying Medicaid coverage for knee- replacement surgery. It was the sixth time a court ruled against the state in the case.

        State officials, in explaining why they persisted in fighting the lawsuit, said it could cost at least $60 million a year to comply with court rulings ordering expanded Medicaid coverage.

        State Medicaid Director Kathy Gifford said Friday the annual cost could be as high as $90 million.

        Jacquelyn Bowie Suess, the attorney who has handled the class-action lawsuit for the Indiana Civil Liberties Union, told the Herald-Times of Bloomington the court's action was great news.

        “It's going to help a lot of people,” Ms. Suess said.

        The Supreme Court, in a brief order issued Wednesday, declined to consider the state's appeal of a ruling by the Indiana Court of Appeals issued last September.

        The lawsuit was filed in 1993 with Petricia Day, a health-care aide who then lived in Greene County, as the lead plaintiff. She later left the suit after qualifying for coverage on other grounds.

        The lawsuit challenged Indiana's policy of denying Medicaid coverage to disabled people who, with medical treatment, could overcome their disabilities and return to work.

        Critics said the policy prevented people from receiving medical help until their conditions worsened to the point that they couldn't be effectively treated. Some of those people died as a result of being denied Medicaid benefits, they said.

        Indiana's Medicaid disability requirements have been stringent in another way.

        Until this year, they required a person to have a disabling condition that was likely to last a lifetime to qualify for Medicaid. Last year, the General Assembly changed the law to require a disabling condition that's likely to prevent a person from working for four years.

        Forty-eight states provide Medicaid for people who meet the federal Social Security standard for disability — a condition that's likely to prevent work for a year or longer. New Hampshire requires a five-year disability.

        But the legislation didn't change the policy that denies coverage to people who would get better with medical treatment, the issue in the lawsuit.

        A Marion County judge first ruled in the case in 1995, saying the state was unjustly denying benefits. Then the state appeals court ruled the same way, but on different grounds.

        It said the state had made its rules more restrictive in violation of federal law. The Indiana Supreme Court agreed with the legal thinking but sent the case back to the trial-court level for arguments on the evidence.

        A different Marion County judge ruled against the state in December 1999. And last September, an appeals court panel ruled that “those who suffer from a disabling condition that could be treated, but do not receive treatment because of an inability to pay for the treatment, are disabled for purposes of Medicaid eligibility.”

        That was the decision the Supreme Court let stand last week.

        Ms. Gifford said as many as 20,000 people in Indiana could meet the Social Security standard for disability.

        The state might be forced to provide Medicaid coverage retroactively to some people who were denied coverage over the past eight years.

        Ms. Gifford said it would take time for staff officials and attorneys to review the court rulings and implement them.

        In the long run, administrative law judges will play a role in that by making rulings in individual cases.

        Ms. Gifford said the standards that were challenged can be traced back about 30 years, when the Medicaid program was started.

        “Over the years it evolved into a standard that nobody is happy with,” she said. “Over the eight years of this lawsuit, I think the barriers (to changing it) have been fiscal.”

Priest admits sex with boys
Pick a color for Suspension Bridge
Robber's warning unheeded
As mold grows, so do health worries
Mastering mold: how to get control
Answers about mold
Health in jeopardy at creek, state says
7-year-old's car wash helps neighbors
Got a goetta itch? Goettafest helps
Porkopolis party-goers queue up for BBQ
Secret degree shocks family
Theme parks expect many visitors
BRONSON: Fill in the stupid blank
CROWLEY: Unity event excuse for potshots
'Deadbeat' list yields 24 arrests in the first week
Graham's Gospel bridges generations
Many schools, one problem
Stroke treatment shows promise
XU panel: Trade vs. human rights
High school minorities get college credit
Local Digest
New era for career center
Tristate's priciest homes
Congrats
Dumpster divers digging in
Kids cautioned about railroad tracks
Ohio city deploys fish in war on mosquitoes
Court topples topless ban
Group seeks list of donors
Ind. day-care licenses pulled
Indiana must give aid to disabled
Jockeys' Guild fires staff amid insurance woes