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.”
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