Since 2006, Legal Aid and Whitman-Walker Health have been helping thousands of Medicare beneficiaries navigate the complex prescription drug program known as Medicare Part D. The 2016 Medicare Part D open enrollment season is now underway. This means that Legal Aid and Whitman-Walker Health are again offering Medicare Part D clinics, as we have done for the past ten years, at our NW and SE offices, as well as at each of the Bread for the City locations in NW and SE. Read more →
ArchivesWritten by Jennifer Mezey
According to a recent New York Times article, in a survey of 32 states, the inspector general of the Department of Health and Human Services (HHS) found that half of the providers surveyed (who were listed as participating with one of the state’s Medicaid managed care plans) could not offer appointments to enrollees. Of these providers, one-third were no longer at the listed location; another 8 percent did not participate with the listed health plan; and another 8 percent were not accepting new Medicaid patients. Read more →
Updated June 17, 2014: This case is discussed in today’s Washington Post.
Updated June 18, 2014: It has also been covered by an article posted today on ThinkProgress.
In a case of first impression, the D.C. Court of Appeals issued a landmark decision on June 6, 2014, awarding full unemployment benefits to our client who was fired after repeated incidents of domestic violence that interfered with her workplace.
The case, E.C. v. RCM of Washington, Inc., clarifies when a job loss is “due to domestic violence,” under the 2004 domestic violence provision of the D.C. Unemployment Compensation Act (amended in 2010). The court held that the provision should be interpreted broadly to protect victims when domestic violence was a “substantial factor” in their job loss. In reaching this conclusion, the court recognized that victims of domestic violence often exhibit behaviors that, while intended to placate their abusers, may simultaneously undermine certain employer codes of conduct. Read more →
Yesterday, the Legal Aid Society of the District of Columbia and the DC Fiscal Policy Institute (DCFPI) issued a new, comprehensive report on the barriers in D.C. to the accessibility of major safety net benefits. Entitled, “Closing the Gap Between Policy and Reality: Preventing Wrongful Denials and Terminations of Public Benefits in the District of Columbia,” the report tells the stories of low-income individuals and families who were unable to apply for or lost critical benefits due to the problems they encountered at Economic Security Administration (ESA) Service Centers. This report builds on longstanding advocacy by Legal Aid and our partner organizations to ensure that the District’s longstanding commitment to progressive public benefits eligibility policies are not thwarted by access barriers. Read more →
A small group of individuals with disabilities in Queens, New York fought back against judicial bias in the Social Security disability appeals process – and won. A recent article, published by the Shriver National Center on Poverty Law, tells their story and highlights the important systemic reforms they achieved. Read more →
On Tuesday, April 29, in addition to recognizing our Servant of Justice Honorees who we featured on our blog on Wednesday and Thursday, Legal Aid will be presenting the Klepper Prize for Volunteer Excellence to Stefanie Doebler of Covington and Burling LLP. Created through the generosity of Martin and Arlene Klepper, the Klepper Prize recognizes attorneys early in their careers who have made significant volunteer contributions to Legal Aid.
Read more →
Regular readers of this blog have seen a great deal about implementation of the Affordable Care Act (ACA) in the District of Columbia. The District’s “Exchange” – that is, its online portal through which you can apply for Medicaid, shop for a private health insurance plan and determine if you are eligible for financial assistance with a private plan – is called DC Health Link. From all accounts we have received, the website appears to be going strong.
But with all of the buzz about how to purchase private plans on www.DCHealthLink.com, some in the DC community are concerned that people with public health insurance through Medicaid, Medicare and the DC Alliance might be confused about the impact of the ACA on them. Read more →
Through Collaboration Between Mental Health and Legal Professionals, Clients Receive Better, More Effective Support and Services
Legal Aid routinely collaborates with caseworkers and others in the community who work with our clients. Without the support of dedicated caseworkers, some clients might never get to Legal Aid to request our assistance. And when caseworkers, lawyers and clients work together effectively, all of the parties can learn from each other and complement each other’s efforts to the ultimate benefit the client.
Such was the case with Ms. F. After a long history of abuse, Ms. F was receiving treatment through Community Connections, an agency that provides comprehensive mental health treatment and supportive services. Ms. F and her community support worker, Lauren, came to Legal Aid, where they met Jennifer, a Legal Aid attorney. Together, Lauren and Jennifer were able to guide Ms. F through the stressful process of appealing a denial of Social Security benefits. Thanks to Lauren’s efforts, Jennifer was able to get medical records from Ms. F’s psychiatrist that provided detailed support for her claims of impairment. It was also critically important to have Lauren, who Ms. F already knew and trusted, assisting Ms. F and supporting her through what can be a lengthy and stressful process. Read more →
Legal Aid and Whitman-Walker Health Train About 70 Volunteer Attorneys to Help Low-Income Medicare Beneficiaries During the 2012 Medicare Part D Open Season
Jennifer Mezey, Supervising AttorneyFor the past six years, the Legal Aid Society of the District of Columbia and Whitman-Walker Health have collaborated to work with pro bono attorneys to counsel hundreds of Medicare beneficiaries about their options during the Medicare Part D (Prescription Drug Plan) Open Season which runs from October 15 through December 7. Last year the two organizations helped over 500 Medicare beneficiaries navigate both the Medicare drug program and the associated benefits that help low-income beneficiaries afford to participate in Part D. These beneficiaries are elderly and/or struggle with physical and mental disabilities, which makes it challenging for them to choose a drug plan and enroll in low-income benefits without assistance.
We are facing several challenges this year that make our work even more important.
- During this period, most Part D plans change their coverage for the upcoming year so even if clients’ plans are currently working for them; that could change next year.
- Several plans that many low-income Medicare beneficiaries are enrolling in are changing their names (Medco to Express Scripts) or combining into another plan (Health Net Orange Option 1, CVS Caremark and Community CCRx Basic are combining into Silver Script Basic).
- We know that many low-income Medicare beneficiaries are having problems with their associated benefits of Medicaid, Qualified Medicare Beneficiary (QMB) (which helps with drug costs and Part B premiums) and the Low-Income Subsidy (LIS) (which helps with drug costs).
Without the work that we do, many beneficiaries would, at best, be confused by all of the above, and, at worst, face major health and economic crises because of unaffordable drug costs. Over the past six years, Legal Aid and Whitman-Walker, along with our pro bono volunteers, have saved countless clients from ending up in these crises.
This year has gotten off to a great start with two trainings hosted by Hogan Lovells and Arnold & Porter. In these two trainings, Legal Aid supervising attorney Jennifer Mezey and Whitman-Walker Health Senior Managing Attorney Erin Loubier trained about 70 volunteers from Arnold & Porter; Hogan Lovells; Steptoe & Johnson; Morgan, Lewis & Bockius; Wilmer Hale; Covington & Burling; Alston & Bird; Crowell & Moring; Ropes & Gray; Akin Gump; Foley & Lardner; Patton Boggs; and Davis Wright Tremaine. These attorneys will work with Legal Aid and Whitman-Walker staff at 12 walk-in clinics held in their NW and SE offices as well as the NW and SE offices of Bread for the City. (See flyers posted below for clinic dates and times).
Please feel free to distribute these flyers among your clients and any other organizations you work with that serve low-income Medicare beneficiaries. Hopefully, we can help even more beneficiaries this year ensure that they will be able to fill all their prescriptions at affordable prices, thus leading to better health outcomes.
Legal Aid-led Part D Clinics (English/Spanish)
English Flyer for Open Enrollment Clinics Legal Aid 2012
Spanish Flyer for Open Enrollment Clinics Legal Aid 2012
Whitman-Walker-led Part D Clinics (English)
English Flyer for Open Enrollment Clinics WWH 2012
All across the country, experts are going to be analyzing and commenting on today’s Supreme Court decision on the Affordable Care Act (ACA). For now, though, it seems clear that the vast majority of the law remains in place which is certainly something to celebrate for persons living in poverty in the District of Columbia. We are concerned about the Court’s limitation on the ACA’s Medicaid expansion and the implications of that part of the decision for many vulnerable families and individuals. However, we are pleased that coverage for Medicaid beneficiaries in the District does not appear to be jeopardized by today’s decision.
Let’s start with the good news. Lost in the discussion of mandates, taxes, and federal expenditures are the many great things contained in this law for our client community and all District residents, including:
- Protections against discrimination on the basis of pre-existing conditions for adults and children (which, in some states, could include being a survivor of domestic violence);
- Requirements that new insurance plans cover preventive health care services (including mammograms, HIV testing and contraceptive methods and counseling) at no cost to the consumer;
- Requirement that maternity care be covered under new individual, small business and Health Insurance Exchange plans;
- Closing of the Medicare Part D “doughnut hole;” and
- Requirement that insurance companies allow people under the age of 26 to stay on their parents’ insurance policies.
These are only a few of the improvements in the insurance market which will improve access to health insurance and health care for millions of families and individuals.
Now for the less than great news. Although we are awaiting the complete analysis by Medicaid experts, it appears that states may not have to expand their Medicaid programs (as required by the ACA) if they choose not to do so. There are, however, strong financial incentives for these states to provide coverage to these vulnerable populations, and we hope these incentives will be sufficient to ensure that these individuals are not left behind.
That said, our concerns about Medicaid should not extend to the District, which was one of the few jurisdictions who expanded its Medicaid program even before the requirement to do so kicked in. Again, much will be written on this in the upcoming days and weeks, but it would appear that the District can continue its expanded Medicaid program, which has contributed to the District having one of the lowest rates of uninsured individuals (6 percent) in the country. (The percentage of uninsured children is even lower at about 3.5 percent).
We applaud the District’s long term, sustained commitment to providing access to health insurance for so many low and moderate income families and individuals. Legal Aid and many other organizations have long worked with the District government to ensure that our Medicaid program delivers promised benefits to our client community. These efforts have continued through our collaboration with the many District agencies’ implementing the ACA. We look forward to continuing to work with the District government and our coalition partners to improve access to health insurance and quality health care services as we move towards full implementation of the ACA in Fiscal Year 2014.