COLUMBIA - The General Assembly should have no say in the Medicaid changes Gov. Mark Sanford wants to make, his attorneys said in response to a lawsuit challenging the plan.

Rural health clinics and a nonprofit group sued earlier this year, saying the proposed changes to the $4.8 billion Medicaid program must be considered by lawmakers under the Administrative Procedures Act.

The lawsuit, designed to stop changes in the health care program for hundreds of thousands of poor, disabled, children and senior citizens, has been transferred to federal court.

Sanford's proposal would move from medical care covered by Medicaid to managed health care programs that private insurance companies run as money goes into personal health accounts and beneficiaries choose to use a managed-care organization, a medical home network or an alternative coverage option bought outside of Medicaid.

The Department of Health and Human Services is the "single state agency" that can set Medicaid policy, Sanford's attorney said.

The governor's lawyers say federal law prohibits review, clearances or other interference by a state agency into Medicaid, except for Health and Human Services.

The General Assembly approves the state funds necessary for South Carolina to qualify for federal Medicaid money.

Sanford's lawyers misinterpret the federal law, said Tony Megna, a Columbia attorney representing the plaintiffs.

The governor asked the federal government in June to approve changes to the state's Medicaid program, including cuts to children's services and the addition of significant co-payments by recipients.

Democrats and advocates for the poor, disabled and elderly have been complaining since.

Sanford has modified or dropped some of the proposal.

If the federal government approves the changes, they could not be implemented before July 1.

Health and Human Services Director Robbie Kerr said he wants Washington to approve the changes by the end of the year.

Attorneys for Sanford and Kerr asked that the case be moved to federal court and requested a nonjury trial.

Senior U.S. District Judge Matthew J. Perry has scheduled a conference between the two sides this week.

The suit was filed in September on behalf of Pee Dee Health Care, a group of mostly rural health clinics in Florence and Darlington counties, and the S.C. Coalition for Integrity in Medicaid Reform, a group of interested citizens.

Sanford spokesman Joel Sawyer said Health and Human Services officials acted within their authority in requesting the changes.

South Carolina is among a dozen states considering changes in Medicaid because of the rising costs of health care.

South Carolina got about $4 billion from the federal government to provide Medicaid services this year and contributed less than $1 billion as the state's share.

Sanford wants to slow the cost increases of the state's share of Medicaid, which last year rose at a 5.8 percent rate.

State Medicaid officials said the growth rate this year is around 9 percent. Medicaid's annual national average growth was 9.3 percent in 2003.

Republican lawmakers who support Sanford's changes say Medicaid growth must be slowed because it could consume up to 29 percent of the state's budget 10 years from now.