Opinion ID: 214263
Heading Depth: 2
Heading Rank: 3

Heading: DCH's First Appeal in 2009

Text: In April 2009, this Court reversed and remanded. Moore v. Medows, 324 Fed. Appx. 773 (11th Cir.2009) (per curiam) (unpublished) ( Moore I ). A prior panel of this Court agreed that DCH was required to provide Moore with any medically necessary treatment or services but disagreed with the district court's ruling that the treating physician was the sole arbiter of medical necessity. The panel's two-paragraph opinion concluded that (1) the state is not wholly excluded from the process of determining what treatment is necessary; (2) both the state and Moore's physician have roles in determining what medical measures are necessary to `correct or ameliorate' Moore's medical conditions; and (3) [a] private physician's word on medical necessity is not dispositive. [18] Id. at 774. Beyond declaring that the state was not excluded, the treating physician's opinion was not dispositive, and both actors play roles in determining medical necessity, the Moore I decision did not address what happens when there are conflicting opinions about medical necessity by the treating physician and the state's medical expert. Moore I did not at all elucidate the respective roles of a treating physician and the state, or how to reconcile a treating physician's role vis-à-vis the state's oversight function. However, Moore I did cite our precedent in Rush v. Parham, 625 F.2d 1150 (5th Cir.1980), [19] which we discuss later.