Description:
Several recent high-profile court decisions, including Douglas v. Independent Living Centers of Southern California, Inc. by the U.S. Supreme Court and Finch v. Commonwealth Health Insurance Connector Authority by the Massachusetts Supreme Judicial Court, have altered the landscape for Medicaid and Connector Care providers and beneficiaries. Additionally, the Commonwealth is seeking federal approval for a Demonstration Project that will impact the way care is delivered to Medicare/Medicaid Dual Eligibles. This initiative will complement several other health plan options available to dual eligible beneficiaries in Massachusetts.
Attend this program to stay updated on the current Medicaid issues. An expert panel will address a broad range of topics including significant obstacles facing providers and beneficiaries, Medicare/Medicaid Duel Eligibles and Implications arising from the Finch decision.
Specific Topics:
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Significant obstacles faced by providers and beneficiaries who seek standing to sue a state Medicaid director for enforcement of the Medicaid Act. Douglas raises the question of whether the federal court provides any viable means of relief to an aggrieved provider or beneficiary.
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Medicare/Medicaid Dual Eligibles (¡¡±MDEs¡¨). The 9.2 million MDEs nationwide account for 40% of total Medicare/Medicaid cost. With 80% of their funding coming from the federal government, it is no wonder that they are the subject of several initiatives to better coordinate their health care and, in turn, potentially achieve health care savings. This seminar will discuss an innovative Demonstration Project submitted for approval by the Commonwealth, under which the MDE funding would be combined and MassHealth would contract with entities to provide a broader menu of services under an Integrated Care model. This initiative will complement other health plans in Massachusetts for dual eligible beneficiaries. In addition, the federal Centers for Medicare & Medicaid Services has recently issued a proposed rule that is designed to better preserve home and community based options for all Medicaid beneficiaries, including MDEs.
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Implications arising from the Finch decision, which held that legal immigrants could not be excluded from Commonwealth Connector programs based solely upon their alienage. Specific focus will be given to the intersection between the Finch decision and certain policy issues, such as tax credits and the operation of Exchanges, embodied in the federal Affordable Care Act, and the impact that the U.S. Supreme Court decision may have on these issues.
Sponsoring Section/Committee(s):
Health Law Section
Speakers:
Thomas Barker
Partner
Foley Hoag LLP
Lorianne M. Sainsbury-Wong
Litigation Director
Health Law Advocates, Inc.
Joel K. Goloskie
Deputy General Counsel/ Director of Compliance, Privacy & Ethics
CharterCARE Health Partners
William E. O'Gara
Pannone Lopes Devereaux & West LLC
Ara Beth Gershengorn
Foley Hoag LLP
Lauren Guth Barnes
Hagens Berman Sobol Shapiro LLP
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