Public Benefits Task Force

CMS Releases Final Rule on Medicaid, CHIP and Health Insurance Marketplaces

HHS Intergovernmental and External Affairs Notification

 July 5, 2013


From: Paul Dioguardi

            Director, Office of Intergovernmental and External Affairs

            U.S. Department of Health and Human Services

RE:   CMS Releases Final Rule on Medicaid, CHIP and Health Insurance Marketplaces

 Today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing provisions of the Affordable Care Act related to eligibility, enrollment, and benefits in Medicaid, the Children’s Health Insurance Program (CHIP) and the Health Insurance Marketplace.

 This final rule addresses aspects of the Medicaid, CHIP and Marketplace eligibility notices and appeals processes; provides additional flexibility regarding benefits and cost sharing for state Medicaid programs; codifies several eligibility and enrollment provisions included in the Affordable Care Act and the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and provides operational guidance to help states implement their Health Insurance Marketplaces.

 This final rule does not address all of the proposed regulatory changes included in the notice of proposed rulemaking (NPRM) released on January 22, 2013.  In order to best assist states in preparation for the availability of new coverage beginning January 1, 2014, this rule focuses on those provisions that are most critical for implementation.  CMS intends to address the remaining provisions of the January NPRM in future rulemaking.

 The final rule is available on display at the Federal Register here:

http://www.ofr.gov/(X(1)S(1vpecb3pcilomwwvusd4jf2b))/OFRUpload/OFRData/2013-16271_PI.pdf

The accompanying fact sheet about the final rule:

 http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2013-Fact-Sheets-Items/2013-07-05.html

  

 

Questions or Concerns? Contact HHSIEA@hhs.gov

 

Healthcare.gov - Open for Business

From the National Health Law Program

Today HHS relaunched https://www.healthcare.gov/ with an emphasis on providing information related to eligibility and open enrollment (98 days away!).  A press release announcing the relaunch is here.

Healthcare.gov will help individuals get ready for October 1 and link them to available coverage now.  For individuals in states with state-based marketplaces (SBMs), the site provides a link to the SBM’s website. For states using the federally facilitated marketplace (FFM), healthcare.gov will be the on-line portal.

 By October, healthcare.gov will allow consumers to create accounts, complete an online application, and shop for qualified health plans.  Between now and the start of open enrollment, the Marketplace call center will provide educational information and, beginning Oct. 1, 2013, will assist consumers with application completion and plan selection. 

For Spanish speaking consumers, CuidadoDeSalud.gov will be updated to match healthcare.gov’s consumer focus.  “Resources in Other Languages” at the bottom of healthcare.gov links to 12 “taglines” that provides the phone number for the federal call center so limited English proficient consumers can receive information directly in their non-English languages. More languages should be added soon and the call center can provide interpreting services in over 150 languages.

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A Connector Program to Address Cultural Competency and Promote Health Literacy: Webinar

Date: 
Mon, 06/24/2013 - 10:00am - 11:30am

From the Maryland Women's Coalition on Health Care Reform

Don't Miss this Webinar! 

A Connector Program to Address Cultural Competency

 and Promote Health Literacy

 Monday, June 24 - 10:00 - 11:30 a.m. 

 Register Now!

 Getting access to health coverage and care is not as simple as saying - "Health Care. Get It."  Both health literacy and cultural competency are key elements to doing this successfully. 

 On Monday, June 24 from 10:00 to 11:30 a.m. we will explore the importance of these strategies in the design and implementation of Maryland's Connector Program. 

 Our dynamic speakers will discuss the topic from different perspectives.  They include: 

  • Mara Youdelman, Managing Director of the DC office of the National Health Law Program (NHelp) will put Maryland's initiatives within the context of the ACA and national initiatives for language access and other key components.
  • Danielle Davis, Director of Communications, Outreach and Training at the Maryland Health Benefit Exchange, will discuss the role of the new Connector Program in supporting the principles of cultural competency and health literacy, as well as training elements for cultural competency and health literacy.
  • Sheila Mackertich, Vice President of Health Reform Initiatives at HealthCare Access Maryland, will provide an "on the ground" perspective as the Connector Entity for  the Central Region, will provide information on the "on the ground" application of cultural competency and health literacy training and its impact on the communities HCAM will serve.   

Register Now! Need more information? Contact us.

 

Sponsor: 
Maryland Women's Coalition for Health Care Reform

HUD Issues New Guidance to Encourage Integrated Housing

From the Administration on Community Living: The U.S. Department of Housing and Urban Development (HUD) last week issued new guidance to HUD-assisted housing providers on how they can support state and local Olmstead efforts to increase the integrated housing opportunities for individuals with disabilities who are transitioning from, or at serious risk of entering, institutions and other restrictive, segregated settings.

 Read more.

 

More on this from the Bazelon Center for Mental Health Law:

New HUD Olmstead Guidance Step in Right Direction

Washington -- June 5, 2013 -- The U.S. Department of Housing and Urban Development (HUD) has issued new guidance on how the U.S. Supreme Court's ruling in the

Olmstead case applies to HUD's programs and activities. The guidance makes clear that HUD and entities that receive financial assistance from HUD must provide housing for people with disabilities in the most integrated setting appropriate to their needs. Integrated settings, according to the guidance, are "those that provide individuals with disabilities opportunities to live, work, and receive services in the greater community, like individuals without disabilities."

 Examples of integrated settings include scattered-site apartments providing supportive housing, rental subsidies that enable individuals with disabilities to obtain housing on the open market, and apartments for individuals with disabilities scattered throughout housing developments. "By contrast," the guidance states, "segregated settings are occupied exclusively or primarily by individuals with disabilities."

 The guidance is intended to better educate state and local housing agencies, housing developers, and housing providers on their obligations under the "integration mandate" of the Americans with Disabilities Act (ADA).  To make real the promise of the ADA, the guidance instructs, "additional integrated housing options scattered throughout the community" are needed.       

 In issuing the guidance, HUD Secretary Shaun Donovan recognized that the "Olmstead decision-and subsequent voluntary Olmstead planning and implementation, litigation by groups representing individuals with disabilities, and Department of Health and Human Services and Department of Justice enforcement efforts-is creating a dramatic shift in the way services are delivered to individuals with disabilities." He affirmed that "HUD is committed to offering housing options that enable individuals with disabilities to live in the most integrated settings possible and to fully participate in community life."  

 "We are encouraged by the issuance of this guidance and its important recognition that HUD-subsidized housing must afford people with disabilities the chance to live in the most integrated setting," said Jennifer Mathis, director of programs for the Judge David L. Bazelon Center for Mental Health Law. "The vast majority of people with disabilities want to live in ordinary housing. We hope this guidance will spark development across the country of mainstream housing for people with disabilities."  

 The HUD guidance can be found at  

http://portal.hud.gov/hudportal/documents/huddoc?id=OlmsteadGuidnc060413.pdf

Finding Lost Pension Plans: Webinar

Date: 
Tue, 06/18/2013 - 12:30pm

For those who wished you could come to our pension rights training in March, or who are yearning for more, here's your chance!  See information below about a new webinar on finding lost pensions! - help your clients get the money they are owed.

The webinar Finding Lost Pension Plans is hosted by the Pension Rights Center, a grantee of the U.S. Administration for Community Living/Administration on Aging.  Participants in this webinar will learn about the problem of lost pension plans and the resources available to find these plans.

 Speaker:  Emily Spreiser, Staff Attorney, Pension Rights Center

 Date: June 18, 2013

Time: 12:30 p.m. EDT

 Register.

 

Sponsor: 
Pension Rights Center

How to Promote Good Legal Advice for Immigrants and Protect Your Community against Fraud: Webinar

Date: 
Mon, 06/10/2013 - 2:00pm

The Immigration Advocates Network invites you to join a free webinar, “How to Promote Good Legal Advice for Immigrants and Protect Your Community against Fraud,” on Monday, June 10th at 2:00 pm Eastern / 1:00 pm Central / 12:00 pm Mountain / 11:00 am Pacific. This webinar will discuss immigration fraud; the unauthorized practice of law; and, how to work with a lawyer. The panelists are Liz Sweet, Associate Director of the ABA Commission on Immigration; Susan Timmons, Associate Director of Practice & Professionalism at the American Immigration Lawyers Association (AILA); and Mary Carmen Madrid-Crost, Chair of AILA’s National Consumer Protection & UPL Action Committee. 

https://www3.gotomeeting.com/register/671674982

Sponsor: 
Immigration Advocates Network

Maryland Health Progress Act Ensures Access to Quality, Affordable Care

From the SHIP Health Action Newsletter

Effective June 1st, 2013, the Maryland Health Progress Act completes a three year process to ensure that hundreds of thousands of Marylanders that formally had little to no access to quality, affordable health care now have options that have never existed before.  The bill promotes transparency, non-discrimination, and fiscal responsibility that will help create a robust marketplace and provide feasible options for many Marylanders left out in the cold.  This legislation also makes sure that we continue the progress of 2007 that expanded Medicaid thousands of residents.

 Signed into law in May of 2013, the Maryland Health Progress Act expands Medicaid to 133% of federal poverty, establishes a dedicated funding stream for the Maryland Health Benefit Exchange, provides for the migration of Maryland Health Insurance Plan (MHIP) members in order to ease their transition and moderate the potential impact on rates, allows for the development of a state reinsurance program to counteract potential short term pressures on rates, establishes policies to promote continuity of care when individuals move in and out of Medicaid and commercial insurance, and makes other changes necessary for the Maryland Health Benefit Exchange to achieve final certification as a state-based exchange.

 Click here for an advocate's guide to the Maryland Health Progress Act of 2013.

 View the SHIP measures and tools for increasing the proportion of people with health insurance.

Maryland Center for Health Equity

From the Maryland SHIP Newsletter:
According to various measures, Maryland is one of the highest performing states in the nation. However, despite the gains across the state, significant health disparities in healthcare and health outcomes continue to exist. Eleven of the top fifteen causes of death show a disparity in the mortality rate between African Americans and whites, with African Americans nearly three times more likely to die in infancy than whites. In order to address these disparities, the Maryland Center for Health Equity (M-CHE) was launched in 2010. Since its establishment, M-CHE has made enormous impacts including the creation of a framework for eliminating racial and ethnic health disparities that incorporates community engagement, research, training, and the development of public policy that can be replicated on a state and national level. Using an interdisciplinary approach to health equity, the center places particular emphasis on working with students and the next generation of medical and public health professionals.

 Click here to read the full story.

 Click here for more information about health disparities in Maryland.

Connect for Coverage: Maryland Health Connection Community Outreach Summit

Date: 
Wed, 06/05/2013 - 8:30am - 12:00pm

Maryland Health Connection invites community-based organizations, advocates, health care providers, state and local agencies, and others reaching uninsured Marylanders and eligible Medicaid recipients to join us for this informative event. We will discuss health reform in Maryland, the state-based insurance marketplace, health disparities, consumer assistance and innovative approaches to outreach.

Date/Time: June 5, 2013, at 8:30am-noon
Location: UMBC University Center Ballroom
Address: 1000 Hilltop Circle, Baltimore, MD 21250

Agenda

Join us to:

  • Learn more about Maryland Health Connection.
  • Meet the six Connector Entities that will serve the six regions in Maryland. They will discuss their approach to outreach, education, eligibility, and enrollment.

In addition, please join us to hear the latest from these leading experts:

Lynn Quincy, Senior Policy Analyst with the Consumer Union, specializes in affordable health care coverage, better health insurance choices and tax credits. Lynn will explain tax credits and how these credits will help consumers pay for health insurance.

Patrick Holland, Director, Wakely Consulting in Massachusetts, is an expert in providing guidance to public and private entities navigating through the Affordable Care Act. Patrick will discuss his experience with other state exchanges and what Maryland can expect.

Melinda Dutton, a partner within the healthcare division of Manatt, Phelps and Phillips, LLP, specializes in the legal, regulatory and political challenges of Medicaid and other public programs. Melinda will discuss what role Maryland Health Connection navigators and assisters will play before and during the enrollment process.

A panel of authorities with a wealth of information relating to health reform and Maryland Health Connection will also speak, including: Becca Pearce, executive director of Maryland Health Connection; Dr. Carlessia Hussein, R.N. Ph.D., director of Minority Health and Health Disparities (MHHD) in the office of the Maryland Secretary of Health; and Carolyn Quattrocki, executive director with the Governor’s Office of Health Care Reform, who provides oversight and coordination of Maryland's implementation of health care reform.

Please RSVP on the Maryland Health Connection website.

New Analysis Shows Maryland's Share of Seniors Living in Poverty is at Least Double the Official Rate

Maryland's Supplemental Poverty Rate is 17%, compared to the official rate of 8%.  See news release below from the Kaiser Family Foundation.

New Analysis Finds Share of Seniors Living in Poverty at Least Double the Official Rate in 12 States Under Census Bureau's Supplemental Poverty Measure

The Census Bureau's official poverty measure estimates that 9 percent of seniors nationally live in poverty. However, some have criticized that measure for not taking into account health care costs, the impact of taxes, and in-kind government assistance (such as assistance with energy costs) and for not varying poverty standards regionally based on the cost of living. To address those concerns, the Census Bureau in 2011 released an alternative "supplemental" poverty measure that shows 15 percent of seniors nationally living in poverty. The increase in the poverty rate is largely due to the consideration of health care costs in the supplemental measure.

A new Kaiser Family Foundation analysis presents state-by-state poverty rates among seniors, based on the supplemental measure. Under this measure, the share of seniors living in poverty is higher in every state than under the official measure, and is at least double the official rate in 12 states: California, Colorado, Connecticut, Hawaii, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, Nevada, Wisconsin, and Wyoming. The District of Columbia has the highest rate under the supplemental measure, with about one in four (26%) seniors living in poverty.

The study includes examples that show how a senior who is not classified as living in poverty under the official measure is considered to be living in poverty under the supplemental measure, because of high out-of-pocket medical costs or because of high housing costs where they live, for example.

The analysis provides context for assessing the implications of proposals under consideration in the deficit-reduction debate that would affect seniors with modest incomes, including proposals that would raise costs for people on Medicare or scale back Social Security benefits. Proposals to raise Medicare cost-sharing requirements or premiums, if enacted, would likely contribute to higher poverty rates for seniors under the supplemental poverty measure. The work is part of the Foundation's Project on Medicare's Future.

When Medicare launched, nobody had any clue whether it would work

Interesting column for those who wonder - will health care reform work?  This is a historic opportunity ....

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/17/when-medicare-launched-nobody-had-any-clue-whether-it-would-work/

TANF Participation of Eligible Families is Falling – but from Obstacles to Access, not Less Need

From Legal Momentum:

 Legal Momentum has a new brief report, TANF Receipt Falls to Less than One Third of Eligible Families, showing a troublesome decline in participation in the federal block grant program Temporary Assistance for Needy Families (TANF). The report is based upon new figures from the U.S. Department of Health and Human Services.

Legal Momentum has previously examined how and why TANF enrollment has fallen since ‘’welfare reform’’ began in the 1990s.  As discussed in our detailed 2011 report “Welfare Reform at 15,” the decline appears to be due to restrictive policies and unreasonable hurdles in accessing the program, rather than due to actual decreased need.  In addition to application process barriers, these obstacles include time limits, family caps, and five-year eligibility bans for legal immigrants.  One of the important facts to take away from the report is that the Supplemental Nutrition Assistance Program (SNAP) (formerly the Food Stamp program) continues to enroll most eligible families, even as TANF enrolls a smaller and smaller minority of eligible families.  

HHS Releases Enhanced Culturally and Linguistically Appropriate Services standards

From the National Health Law Program:

Today, HHS released the Enhanced Culturally and Linguistically Appropriate Services (CLAS) Standards. The Enhanced CLAS Standards update and expand the original CLAS Standards from 2000. The guiding principle for the 15 standards is to Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.

The Standards and other infomration on providing culturally and linguistically appropriate services are available on the Office of Minority Healths website Think Cultural Health. A Blueprint accompanies the new standards, offering additional information and resources.

HHS press release is available here.

Webinar: What You Need to Know About SSI

Date: 
Wed, 05/15/2013 - 2:00pm - 3:30pm

Webinar: What You Need to Know About SSI

 2:00 PM - 3:30 PM EDT

Wednesday, May 15, 2013

What is the Supplemental Security Income (SSI) program? Who qualifies for SSI benefits? What are the eligibility rules of the program? And how are SSI benefits the same as, and different from, other benefits from the Social Security Administration? We will answer these questions and explain what you need to know to be more informed and effective in assisting SSI recipients.

Presenters are Kate Lang, Staff Attorney and Gerald McIntyre, Directing Attorney of the National Senior Citizens Law Center.

Additional sponsorship for this Webinar is provided by a grant from the Administration on Aging/Administration for Community Living. This webinar is part of a series of National Elder Rights Training Project webinars for the National Legal Resource Center.

There is no charge for this webinar. If you have any questions about this webinar, e-mail training@nclc.org.

To register - 

https://www1.gotomeeting.com/register/192820336

 

US Hospitals Send Hundreds Of Immigrant Patients Back To Home Countries To Curb Cost Of Care

The Associated Press/Washington Post: US Hospitals Send Hundreds Of Immigrant Patients Back To Home Countries To Curb Cost Of Care
In interviews with immigrants, their families, attorneys and advocates, The Associated Press reviewed the obscure process known formally as "medical repatriation," which allows hospitals to put patients on chartered international flights, often while they are still unconscious. Hospitals typically pay for the flights (4/23).

http://www.washingtonpost.com/national/health-science/us-hospitals-send-hundreds-of-immigrant-patients-back-to-home-countries-to-curb-cost-of-care/2013/04/23/8cce5224-abe4-11e2-9493-2ff3bf26c4b4_story.html 

White House Briefing Series on the National HIV/AIDS Strategy and the Affordable Care Act

Date: 
Mon, 04/29/2013 - 9:00am - 12:00pm

The White House Office of National AIDS Policy (ONAP) will host the fourth in a series of regional meetings on the implementation of the National HIV/AIDS Strategy (NHAS) in Baltimore, Maryland.  This series of meetings is designed to promote awareness and understanding of local-and state-level efforts as they relate to the implementation of the NHAS and the Affordable Care Act (ACA).  The goal is to engage key stakeholders about ongoing challenges and successes of NHAS/ACA implementation.

 Meeting Details

Date: Monday, April 29, 2013

Time: 9:00 a.m. to 12:00 p.m. (EDT)

Site:  Vollmer Center Auditorium, Clyburn Arboretum, 4915 Greenspring

Avenue, Baltimore, Maryland 

 This meeting is free and open to the public, but if you wish to attend, you must RSVP.  Once you submit your RSVP, you will receive a detailed confirmation letter via e-mail.

 If you have questions about registration or other logistics, please contact Marjorie Burdetsky at mab@cmpinc.net.

Sponsor: 
White House Office of National AIDS Policy

Leveraging Health Care Reform: Cultural Competency & Health Literacy Strategies Webinar

Date: 
Mon, 04/22/2013 - 2:00pm - 3:00pm

On Monday, April 22nd from 2:00 to 3:00 pm the Coalition is hosting the first in its webinar series on Cultural Competency and Health Literacy.  These are two of the pillars to ensure that we create a Culture of Health in Maryland where everyone will receive health care services that meet their individual needs.  Consumers must understand not only what it means to have an insurance card, but also how to use it effectively. 

In this first webinar we will discuss the basics as an introduction to the future webinars.  Topics we discuss will include::

  • Definition of the terms - cultural competency and health literacy; and
  • The framework for integrating these into Maryland's health care reform initiatives.

Our two dynamic speakers are:

  • Laura Herrera MD, MPH serves as the Deputy Secretary of Public Health Services at the Department of Health and Mental Hygiene (DHMH).  In this capacity she oversees local public health, prevention and health promotion, and health systems and infrastructure.   Prior to this she served as the Chief Medical Officer (DHMH) and Acting Deputy Chief Patient Care Services Officer in the Veterans Administration.  She also served as an advisor for the Coalition's Issue Brief - Health Equity: The Promise of Health Care Reform.  
  • Maria Rosa Watson DDS, DrPH is currently the epidemiologist and Research Director for the Primary Care Coalition of Montgomery County.  She has a broad background in health disparities, public health, Latino health, health literacy, health promotion and disease prevention, barriers to access to care, and qualitative and quantitative data collection and analysis.

Register now!  Need more information? Contact us.

Sponsor: 
Maryland Women's Coalition for Health Care Reform
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