PHLP News
2012 News
April 2012 Senior Health News
- MATP Crisis Averted – For Now
- Special Series: What Happens When I Become a Dual Eligible, Part I
- Certain Medicaid Co-pays to Increase Soon
- Improved Medicare Summary Notice Available Online
- …and much more!
Medical Assistance Copays Still Planned for Families of Children with Disabilities
A notice sent out recently from the Department of Public Welfare regarding changes to copayments under Medical Assistance effective May 15th has caused some confusion among families who have children with disabilities on Medical Assistance. While this notice does not apply to children under 18, it does not mean that DPW has dropped plans to impose significant copays under Medical Assistance on families with children under 18 with disabilities.
DPW still plans to impose significant copays on families with incomes at or above two times the federal poverty level for services provided under Medical Assistance to children with disabilities under 18. Those copays may begin in September although operational issues may push the implementation date back. Nonetheless, we fully expect DPW to impose copays on many families of children with disabilities sometime this year or next. A separate notice will be sent by DPW before they implement those copays.
While DPW is still going forward with copays on services to children with disabilities, there are still important issues regarding how much families will have to pay. For more information, see PHLP’s Action Alert, now also available in Spanish [Alerta de Acción].
PHLP Co-Authors White Paper on Eligibility, Enrollment & Renewal in Pennsylvania’s Medicaid and CHIP
In March 2012, the Federal Department of Health and Human Services released final rules for health insurance exchanges and Medicaid that will take effect under the Affordable Care Act (ACA) on January 1, 2014. These rules establish requirements regarding eligibility and enrollment processes that will allow people to obtain health coverage that is most appropriate to their financial and health needs and maximizes reliance on electronic databases and other technology. PHLP and Community Legal Services co-authored a white paper on the revisions necessary to Pennsylvania’s administration of Medicaid and CHIP.
Fran Chervenak Receives 2012 PLAN Excellence Award
Fran Chervenak, PHLP’s Director of Client Services and Managing Attorney of the Pittsburgh office, was honored by the Pennsylvania Legal Aid Network (PLAN) at its annual awards banquet. To view Fran’s tribute video, click here.
Congratulations to Fran and to the other 2012 PLAN Excellence Award Winners!
March 2012 Health Law PA News
- Governor Proposes Severe Cuts to Human Services Funding in 2012-2013 Budget
- Spotlight on the 2012-2013 Budget, including highlights of the proposed OLTL and ODP budgets.
- MATP Crisis Averted – For Now
- Certain Medicaid Co-Pays To Increase
- Open Enrollment for HealthChoices Expansion Begins in May
- …and much more!
PHLP Comments on Proposed Exchange Legislation
In February 2012, the Pennsylvania Department of Insurance released conceptual draft legislation for a state-operated exchange. The proposed bill would establish multiple private exchanges, a model very different from other states. PHLP is concerned about the multiple exchange approach and with Community Legal Services co-authored comments critical of the proposed model. A summary of the Department’s proposal, our comments, and the Department’s conceptual draft can be found here.
Preview of U.S. Supreme Court Arguments on Federal Health Reform
At the end of March, the U.S. Supreme Court will examine the constitutionality of the Affordable Care Act (ACA), potentially producing a landmark decision. For most cases, the Supreme Court allocates one hour for oral argument — 30 minutes for each side. For the health care reform case, the Court has scheduled six hours for oral argument — the most time devoted to a case in more than 45 years. These arguments will take place March 26, 27, and 28, and the Court’s ruling will probably be announced in June. In this preview, PHLP has compiled materials explaining the issues raised by the cases, answering some of the key questions about the parties’ legal arguments, and considering potential effects of the Court’s decisions. To read more, click here.
February 2012 Senior Health News
- 2012-2013 Budget Proposal Announced
- MATP Co-Pays To Start May 1st
- DPW To Change Consumer-Directed Support Services
- 2012 Federal Poverty Levels Announced
- …and much more!
New Prescription Coverage Limit for Adults in Fee-for-Service Medical Assistance
Effective January 3, 2012, the state has reduced pharmacy coverage to 6 prescriptions a month for adults in fee-for-service Medical Assistance. To learn more about the new limit and about important exceptions and work-arounds, see our new fact sheet.
PHLP Urges Pennsylvania to Simplify Enrollment and Renewal Practices for Child Health Insurance
It has been widely reported that a significant number of Pennsylvanians, primarily children, are losing coverage at a time when they can least afford it. PHLP is working with others to immediately halt these unnecessary and harmful terminations, and has re-issued a briefing paper about simplifying enrollment and renewal practices. 
In December 2011 the Pittsburgh Post Gazette profiled a PHLP client, Alexander, a 5-year-old boy with leukemia whose mother carefully updated his Medical Assistance reenrollment forms, twice, but still lost his health insurance because the county assistance office declared that the paperwork was missing. PHLP was able to help Alexander’s family restore his health coverage, but his case is one of thousands. Nearly 32,000 Pennsylvanians were cut from Medical Assistance between August and September 2011. 18,000 of them were children.
PHLP believes that simplifying enrollment and renewal in Medical Assistance makes sense for families, as well as overwhelmed county assistance offices struggling to meet increased demands for assistance.
January 2012 Health Law PA News
- Pennsylvania Intends to Operate Health Insurance Exchange
- DPW Planning to Impose MATP Co-Pays on April 1st
- New Law Limits Transportation to Methadone Treatment
- HealthChoices Expansion Starts July 1st for Seven Counties
- And much more…
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