SUBJECTS COVERED
NHeLP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the recently released Medicaid and exchange eligibility and enrollment regulations. While most of the regulations were issued as final rules, CMS designated certain sections for public comment. NHeLP will continue to advocate for strong protections for applicants and enrollees and work to ensure that the new streamlined eligibility processes meet the needs of low-income and underserved populations. Read our most recent Medicaid comments here and exchange comments here. Read all of our previous ACA implementation comment letters here.
As co-chair of the Leadership Conference on Civil and Human Rights Health Care Task Force, NHeLP helped draft comments on regulations governing "meaningful use" in electronic health records to CMS and the Office of the National Coordinator for Health Information Technology. These comments focused on reinforcing federal civil rights and privacy laws; requiring robust demographic data collection and the use of that information; and building linkages with existing health disparity strategies. Read the comments here.
NHeLP continued to support advocates reviewing state proposals to integrate Medicaid and Medicare services for individuals dually eligible. NHeLP developed a topic-by-topic guide to help advocates reviewing state proposals issue-spot their proposals for problems and omissions. Read the guide here.
NHeLP also developed model standards to protect dually eligible individuals who are subject to passive enrollment in state integration programs. Read the model standards here. Specific to California, NHeLP submitted formal comments and concerns on the state's draft proposal to implement a dual eligible demonstration project and drafted a letter with a number of advocates outlining these concerns. Read the letter here.
NHeLP worked in collaboration with California advocates and legislative staff and prepared an analysis of California's Essential Health Benefits (EHB) bills, Senate Bill 951 (Hernandez) and Assembly Bill 1453 (Monning). The two bills were recently amended in March, 2012 to include the state's selection of an EHB benchmark plan. NHeLP also led a call with California advocates about the Medicaid benchmark selection process and the intersection with EHBs. Read NHeLP's analysis of the EHB bills here.
NHeLP contributed comments concerning Qualified Health Plan selection to the California Exchange Board on March 29, 2012. The comments were submitted on behalf of NHeLP and the Health Consumer Alliance, and emphasized the importance of ensuring that low-income consumers who purchase health care coverage through the Exchange have real access to the services they need and are able to find culturally competent providers. NHeLP's comments were praised by members of the Exchange Board for highlighting important consumer issues. Read the comments here.
NHeLP released two new publications explaining how the Affordable Care Act will increase access to contraceptives for women. Section 2713 of the ACA requires that new insurance plans cover a number of women's preventive health services, without cost-sharing, including all FDA-approved methods of contraception. In addition, the U.S. Department of Health and Human Services has clarified that these preventive services are also part of the Essential Health Benefits (EHB) package that must be included for individuals newly eligible for Medicaid, in the Basic Health Program, and in plans sold through the exchanges.Read NHeLP's issue brief on the preventive services standards and contraceptive coverage here. Read NHeLP's short summary chart on the preventive health requirements here. The contraceptive coverage requirement has attracted strong opposition from the Catholic Church, which is advocating for a very broad refusal clause that would deny hundreds of thousands of women access to contraceptives. NHeLP is actively engaged in preserving these critical services. Click here to read NHeLP's issue brief on health care refusals and contraception.
NHeLP continued to provide training for reproductive health, rights and justice advocates and family planning providers on the intersection of the ACA and Medicaid. NHeLP presented at the U.S. Department of Health and Human Services, Office of Population Affairs; the National Family Planning and Reproductive Health Association; University of Southern California Medical Students for Choice; and the Los Angeles Unified School District. NHeLP developed an extensive advocate's guide to reproductive health in the Medicaid program, including changes under the ACA. Read NHeLP's full advocate's guide here, and the ACA update.
As California health reform implementation moves forward, NHeLP leads the California Coalition for Reproductive Freedom's (CCRF) efforts to ensure that implementation in the state supports access to reproductive health services. NHeLP drafted comments on Qualified Health Plans to the California Health Benefit Exchange on behalf of CCRF members. Read the comments here.
NHeLP and co-counsel obtained a preliminary injunction in a pending case in North Carolina, L.S., et al. v. Delia, halting reductions to home- and community-based services and restoring lost services for plaintiffs who were denied care without due process. The Court noted that without an injunction, the plaintiffs - children and adults with disabilities - would experience deteriorating health, financial strains, and the threat of having to go into institutions to get care. In addition to the preliminary injunction, the Court granted class certification in the case. Read the press release here.
NHeLP and co-counsel obtained a victory for a client in a pending case in New York, Davis v. Shah, when the District Court for the Western District of New York ordered the state Medicaid agency to provide crucial medical equipment (prosthetic shoes and compression stockings) to plaintiffs. The lead plaintiff - 60 year old Mr. Davis - needed special prosthetic shoes because parts of his feet had been amputated. New York's Medicaid program, however, would not cover his shoes as he did not fit into the narrow exception for this coverage, putting him at risk of being forced out of his home as his home is not wheelchair accessible. The Court ordered that the shoes be covered, which should allow Mr. Davis to stay in his home and continue to ride his bike around town! The case is a class action, but the class has not been certified yet. Read the order here.
NHeLP and co-counsel reached a final court approved settlement in Van Meter v. Harvey, a class action involving individuals with cerebral palsy and similar developmental disabilities who were living in nursing homes. The named plaintiffs were young men in their 20s and 30s who wanted to live in the community or at least, receive specialized services in the nursing home that they were entitled to under Medicaid. Under the settlement, the state will apply for a home- and community-based waiver that will enable the plaintiffs to live within the community if they choose. In addition, the state will implement a system to ensure that individuals with developmental disabilities who are living in nursing homes receive the specialized services that they need.Read the settlement order here. Click here to learn more about the settlement.
NHeLP submitted an amicus brief to the Ninth Circuit in California Medical Association, et al. v. Douglas, one of a number of consolidated cases challenging across-the-board 10% provider rate reductions in California's Medicaid program, Medi-Cal. NHeLP worked on the brief with Hogan Lovells, which graciously provided pro bono support on this project. The brief described the significant impact on beneficiary access to care that would result from the proposed reduction in reimbursement levels - levels that are already shockingly low. In addition, the brief addressed the level of deference that should be given to CMS' approval of California's rate reductions. The rate reductions were implemented in violation of existing Ninth Circuit law requiring reasonable cost studies and were supported by scant evidence that beneficiary access would not be detrimentally affected.
Kim Lewis, NHeLP's LA managing attorney, and the litigation team involved in the recentKatie A. v. Douglas settlement received the California Mental Health Advocates for Children and Youth Advocate of the Year Award. Lewis and the Katie A. v. Douglaslitigation team were recognized for their work in reaching a landmark settlement with the state of California that protects the rights of children and youth to receive the services and supports to which they are entitled under Medicaid. The settlement will improve the lives of thousands of vulnerable children and youth and ensure that they receive the home-based mental health services and supports that they need to succeed in life. For more information about the Katie A v. Douglas settlement and the mental health services it guarantees for children and youth, read our issue brief.
The Philadelphia Inquirer quoted Corey Davis, Limiting 'Gross Charges' On Hospital Bills, June 10, 2012. Read the article here.
The Huffington Post featured two articles from Emily Spitzer on the ACA. Pay No Attention to That Patient Behind the Curtain, June 5, 2011. What Will America Look Like if Health Reform is Struck Down, April 23, 2012.
MedPage Today quoted Leo Cuello, Supreme Court: Decision Nears on 'Obamacare,' June 5, 2012. Read the article here.
The Washington Post quoted Mara Youdelman, Hospitals Struggle to Provide Interpreters for Patients Who Don't Speak English, May 21, 2012. Read the article here.
The Omaha World Herald quoted Jane Perkins, Lawsuit: Coverage Is Illegally Denied, May 19, 2012. Read the article here.
The New York Law Journal wrote a story on the recent victory obtained by NHeLP and co-counsel in the Davis v. Shah case, U.S. Judge Questions Denial of Medicaid for Footwear, Hosiery, May 8, 2012.
The Salt Lake Tribune quoted Corey Davis, Utah's Largest Hospital Chain Sticking With Embattled Debt Collector, May 2, 2012. Read the article here.
The Shriver Brief referenced a recent piece by Corey Davis and Community Catalyst in a posting entitled, The Debt Collector Will See You Now, April 30, 2012. Read the article here.
California Healthline quoted Jane Perkins, Advocates Hope ACA Will Knit Children's Patchwork, April 25, 2012. Read the article here.