Healthcare Access

March 7, 2022
DREDF, in collaboration with the Community Living Policy Center at the Lurie Institute for Disability Policy at Brandeis University submitted comments to the Centers for Medicare & Medicaid Services (CMS) on proposed changes to regulation of Dual-Eligible Special Needs Plans (D-SNPs) as part of a larger rulemaking on Medicare Part C & D. We support the direction of CMS’s proposals and appreciate the efforts to tighten and clarify requirements and the focus on enrollee experience and needs. Our comments primarily explore areas where we believe that CMS could include further specificity in the regulations such as advisory committees, network adequacy, durable medical equipment, and home health care. These regulations are important given the rapid growth of D-SNPs across the country. [...]

January 27, 2022
DREDF and our colleagues at the Bazelon Center for Mental Health Law commented on all these aspects of the proposed rule. Non-discriminatory benefit design in healthcare is especially important for people with disabilities, including those with mental health disabilities, who have experienced both obvious and subtle discrimination in insurance for decades such as visit limits, "special" co-pays, and outright failure to cover services and items that are medically necessary for mostly people with disabilities. In our comments, we recommend that plan spending on improving health equity for people with disabilities, such as by helping providers to get accessible examination equipment, could and should be considered a quality improvement that doesn't count toward an insurer's profits. We also pointed out how telehealth has been inaccessible for people who are Deaf or who have other communications disabilities. Finally, we pushed for better demographic data collection on disability in healthcare overall. [...}

October 8, 2021
California will be among 17 states in which the Centers for Medicare and Medicaid Services (CMS) plans to initiate a 5 year project to review all claims submitted for inpatient rehabilitation facility (IRF) services. IRFs provide intensive rehabilitation and care coordination that people may need to recover after a medical event such as a heart attack, a stroke, or a traumatic brain or spinal cord injury. Just as importantly, people with chronic conditions and disabilities may need IRF services to maintain their functional capacity and prevent or slow down functional deterioration experienced over time. A temporary IRF stay can mean a faster and more efficient return to the community. CMS has provided little evidence of the fraud that is cited as justification for the demonstration, and we already know that IRF services can be denied to people with disabilities even when they are of medical benefit, especially people with chronic progressive conditions who are already too often "written off" because they cannot be cured or "fixed." In our comment letter, DREDF opposed gatekeeping measures that stop people with disabilities from getting the care they need to live fully and independently in their communities. [...]

September 9, 2021
DREDF submitted comments to the U.S. Department of Health and Human Services (“HHS"), urging rescission of HHS’ approved Section 1115 waiver permitting the State of Tennessee to fundamentally alter its Medicaid program, to the detriment of low-income people with disabilities and chronic conditions. The comments explain how the approval was unlawful under the requirements of the Medicaid Act and how it will disproportionately harm disabled enrollees by reducing access to Long-Term Services and Supports (“LTSS”), needed prescription drugs, and retroactive healthcare coverage. [...]