Non-emergency medical transportation is a critical benefit ensuring that Medicaid beneficiaries have transportation to medical services. This webinar reviewed this increasingly important component of health care for low-income older adults and people with disabilities; explored challenges to accessing the benefit; shared examples of state strategies to overcome those challenges.
One important yet sometimes overlooked protection of the Affordable Care Act is its non-discrimination mandate Section 1557. This critical provision incorporates existing civil rights laws that protect against discrimination on the basis of race, ethnicity, sex, age, and disability, and applies them directly to the provision and delivery of health care. Earlier this year, the U.S. Department of Health and Human Services (HHS) released final regulatory guidance on Section 1557 with an effective date of July 18, 2016 for most covered entities.
Join Justice in Aging as we explored how the protections of Section 1557 affect the obligations of Medicare and Medicaid programs and providers serving older adults.
The Cal MediConnect (CMC) program, which created new health plans integrating Medicare and Medi-Cal benefits for dually eligible beneficiaries, has been in effect for over two years in seven California counties. Enrollment data released by DHCS and a recent series of evaluations, including surveys, focus groups, and polling, paint a picture of how the program is performing and how enrollees are faring so far. Read More
- Married same sex couples now have coverage for Medicare and Medicaid under the same rules as opposite-sex married couples.
- Transgender individuals have protection from discriminatory treatment in health care.
The New York Times: Doctors Are Improperly Billing Some on Medicare, U.S. Says (7/31/2016) Healthcare providers are illegally billing qualified Medicare beneficiaries, also enrolled in Medicaid, for deductibles, co-payments and other costs. The practice, known as “balance billing,” is illegal. Federal law requires doctors to accept the amount paid by Medicare and Medicaid as payment in full for qualified Medicare beneficiaries. Many beneficiaries do not know the practice is illegal and pay the fees. Part of the problem is due to low state Medicaid reimbursement rates. Justice in Aging’s Denny Chan is quoted saying in the piece, “Because of this gap in payment, many doctors and other health care providers try to bill the beneficiaries or refuse to provide services to them.”
Coming to a State Near You: Medicaid Managed Care Changes…You may have heard that the Centers for Medicare and Medicaid Services (CMS) recently finalized the regulations for Medicaid Managed Care. These new rules become effective in stages with the first round of changes taking effect on July 5. Over 70 regulations will become effective on that date, including the regulations governing important issues such as enrollment, disenrollment, requirements for long-term services and supports, enrollee rights, and grievance and appeal systems.
I shouldn’t have been surprised. After all, half of all people on Medicare live on $24,000 or less a year, with 25% living on less than $14,000 a year. Read More
This spring marks the 6th anniversary of the passage of the Affordable Care Act, which created the Medicare-Medicaid Coordination Office (MMCO). In the past few years, MMCO, states, and advocates committed incredible resources and time to improving care and services for dual eligible individuals. This webinar provided an update on dual eligible demonstrations and dual eligible initiatives and highlighted areas for future improvement. Read More
In January 2016, the Centers for Medicare and Medicaid Services (CMS) released the first ever evaluation of the Financial Alignment Initiative (FAI) known as the dual eligible demonstration.
Since the first dual eligible demonstrations rolled out in August 2013, Justice in Aging has followed the process both through the advocates on the ground who counsel clients directly, through the plans we’ve worked closely with, and through our work directly with the state agencies that administer the demonstrations. As national experts on the issues facing dual eligibles we’ve been both an information hub for advocates and feedback loop for policymakers. As such, we’ve been awaiting the release of the first formal evaluations of the demonstrations to see if they match the information we’ve been receiving. They have been released and we’ve analyzed them and published an issue brief on the findings.