Medical Assistance Amendment Gives People with Mobility Impairments Greater Access to their Communities
Pennsylvania’s Department of Human Services (DHS) has amended the state’s Medical Assistance plan to cover removable medical equipment for children and adults with mobility impairments. Removable medical equipment is necessary to the health and wellbeing of individuals with disabilities as it can support activities of daily living and help an individual enter or exit their home, facilitating greater engagement with their community.
The new coverage is part of a settlement in a class-action lawsuit filed by Disability Rights Pennsylvania on behalf of a class of children in the state’s Medical Assistance program. The plaintiff class alleged that DHS violated the Social Security Act by denying requests for removable medical equipment. Further, the suit alleged that DHS failed to inform the plaintiff class of the availability of such equipment under Medicaid and even led youth, hospitals, equipment vendors, families, advocates, and others to believe that such devices were not covered. As detailed in the resulting settlement, the state’s Medical Assistance plan has updated the definition of covered home health services to explicitly include wheelchair lifts, ceiling lifts, stair glides, metal accessibility ramps, and other such equipment that can be reused and removed without damage to the item.
The amendments, which are applicable to all Medical Assistance recipients regardless of age, have been approved by the Centers for Medicare and Medicaid Services (CMS) for coverage retroactive to April 1, 2020. Considering this, PHLP encourages individuals who have previously applied for and been denied removable medical equipment to reapply for approval with an updated letter of medical necessity from their physician. For those who denied after April 1, 2020 but have since paid out-of-pocket for removable medical equipment, this amendment may open the door for individuals to submit a claim for reimbursement from the state.
While this update increases access to necessary devices for individuals with mobility impairments, there are still gaps in coverage. Although the update includes coverage for certain elements of the installation process of these devices, the Pennsylvania Medical Assistance program does not cover home modifications outside of waiver services. This means that when a structural change to the home, like electrical updates or demolition of existing structures, is required for proper installation of removable medical equipment the beneficiary will have to pay for that service as separate from the installation.
For more information on the new Medical Assistance coverage and questions about how to apply for removable medical equipment, please call PHLP’s Helpline at 1-800-274-3258 or email us at firstname.lastname@example.org.
For more information about the lawsuit and settlement agreement, contact Disability Rights Pennsylvania by calling 1-800-692-7443, Option 6, or sending an email to email@example.com.
ACL Policy Update: What the Changes in the “Public Charge” Immigration Rule Mean for the Aging and Disability Networks
July 30, 2021
Summary: Earlier this year, the Department of Homeland Security (DHS) rescinded the “public charge” rule implemented in 2019. This means that receiving or applying for most Medicaid benefits, public housing, or nutrition assistance are no longer grounds for denying an individual seeking a visa to come to the United States or to become a lawful permanent resident. Services provided through ACL’s programs, and medical treatment or preventive services for COVID-19, including vaccinations, also will not count against people seeking legal entry to the country.
The “public charge” doctrine allows U.S. immigration officials to bar a person from getting a visa or becoming a lawful permanent resident if they are determined to be likely to become a “public charge,” meaning a person who is likely to primarily rely on the government for assistance. This long-standing policy was put into immigration law in the 1990s. In 1999, Interim Field Guidance clarified that this policy applies only to immigrants likely to become dependent on direct cash assistance, like Supplemental Security Income (SSI) or Temporary Assistance for Needy Families (TANF), or to individuals who rely on Medicaid-financed “long-term institutionalization,” such as a nursing or psychiatric facility.
The Trump administration issued a new public charge rule in 2019 to significantly expand the policy to include anyone who lawfully used virtually any public benefit for more than 12 cumulative months over any 36-month period. For example, enrollment in Medicaid for acute medical care or for home and community-based services (not just institutional care), or receiving housing or nutrition assistance, could all be used to designate a person as a “public charge” and deny them a visa or permanent legal residency.
One of the first executive orders issued by President Biden directly addressed immigrant access to public benefits and the public charge rule. Implementation of the order caused a series of actions by DHS and the Department of Justice that ultimately resulted in the 2019 rule being removed from the Code of Federal Regulations, and DHS announced in March that it would revert to 1999 Interim Field Guidance.
In an April letter to interagency partners, the U.S. Citizenship and Immigration Services also stated that “medical treatment or preventive services for COVID-19, including vaccinations, will not be considered for public charge purposes. This policy will help ensure that noncitizens are able to access important government services for which they may be eligible.”
Recently, the Centers for Medicare and Medicaid Services issued an informational bulletin reminding state Medicaid agencies that they may not share information with immigration officials about an person’s Medicaid coverage (or application) for the purposes of a public charge determination.
The 2019 Public Charge Rule had a chilling effect on immigrants accessing benefits to which they are legally entitled – research has shown that immigrant families have avoided both programs specified in the 2019 rule and those outside the rule for fear of immigration-related consequences. It created particularly devastating consequences for older adults and people with disabilities, who often rely on Medicaid to stay healthy and to live in their communities. That’s why sharing information about the changes is so critical.
As trusted messengers in your communities, the aging and disability networks have a particularly important role to play in dispelling fear and confusion. Please help spread the word that using public benefits to which people are entitled (with the longstanding exception of cash assistance and Medicaid-funded institutional care) will not adversely affect the immigration status of older adults and people with disabilities.
We will continue to keep you updated about policy changes like this one as they arise.
Grant Opportunity for Agencies Working with Children
Kiwanis Club of Lebanon, PA is currently accepting applications for their Community Grant program. Awards are granted to those that help kids in our community.
Applications are due August 8, 2021
Effective July 1, 2021, APPRISE is now Pennsylvania Medicare Education and Decision Insight, PA MEDI – Same Program, Same Services for Pennsylvania’s Medicare Beneficiaries, now with a New Name.
Pennsylvania Medicare Education and Decision Insight (PA MEDI) offers free Medicare counseling to older Pennsylvanians. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance.
PA MEDI Counselors do not sell Medicare products but rather offer current, non-biased Medicare education to help you make the most informed choice about the Medicare options available to you.
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“Steven Heller, 70, has lived with Parkinson’s for more than 10 years. Véronique Vienne, 79, only recently learned that she had the disease. Both have had long careers as art directors, and the two have been friends for more than three decades. Back in March, the pair exchanged a flurry of emails over a 10-day period, where they explored the “before” and “after” of a Parkinson’s diagnosis. Here is an edited version of their conversation.”
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Click here to download this report – The focus of this report is on sharing the concerns and recommendations of people who have direct personal experience with suicide, particularly those who have attempted suicide and those who have lost a loved one to suicide.
“By studying centenarians, researchers hope to develop strategies to ward off Alzheimer’s disease and slow brain aging for all of us.”
by Jane E. Brody
“One of my greatest pleasures during the Covid-19 shutdowns was having the time to indulge in hourlong phone conversations with friends and family whom I could not see in person. Especially uplifting were my biweekly talks with Margaret Shryer, a twice-widowed 94-year-old Minneapolitan.
“I met Margaret in Minneapolis in 1963, six months after her first husband was killed by a drunken driver. With four small children to support, this young widow wasted no time getting qualified to teach German to high school students. Margaret and I are kindred spirits who bonded instantly, and despite living half a country apart since 1965, we’ve remained devoted friends now for 58 years.
“My conversations with Margaret are substantive and illuminating, covering topics that include politics, poetry, plays and philosophy as well as family pleasures and problems. I relish her wisdom and sage advice. I especially delight in the fact that she seems not to have lost an iota of her youthful brain power. She’s as sharp now as she was when we first met decades ago.
“Recent findings about the trajectories of human cognition suggest that if no physical insult, like a stroke, intervenes in the next six years, Margaret is destined to be a cognitively sharp centenarian.”
Click here to continue reading this article at The New York Times.
The mistreatment of older adults can be by family members, strangers, health care providers, caregivers, or friends. Abuse can happen to any older adult, but often affects those who depend on others for help with activities of everyday life. Learn how to recognize some of the signs of elder abuse so you can step in and help. For example, you may notice that the older adult:
- Seems depressed, confused, or withdrawn
- Appears dirty, underfed, or dehydrated
- Has unexplained bruises, burns, cuts, or scars
- Has unpaid bills or recent changes in banking or spending patterns
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