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Pennsylvania Health Law Project: Helping People in Need Get the Health Care They Deserve
 
                    
Seven-Year-Old Sponsors Bake Sale and Lemonade Stand for PHLP

Last month, as students across Pennsylvania said goodbye to summer and hello to the new school term, PHLP opened a donation letter and learned how one student spent her summer. Attached to the donation was a small, hand-written note from seven-year-old Zivia’s mom. She explained that for the last few summers Zivia has raised money for various causes with a bake sale and lemonade stand. When Zivia learned about the problems many Americans face accessing health care, she decided to use the proceeds from this year’s sales to help people get health insurance. After a summer of squeezing lemons and baking treats, Zivia donated to PHLP to continue helping people in need get the health care they deserve.

PHLP relies on contributions like Zivia’s. Please consider donating today. Your support will help Pennsylvanians access health coverage for themselves and their families, giving them peace of mind and the opportunity to be independent, contributing citizens of our Commonwealth. 


PHLP Maintains Health Coverage for a Cancer Survivor

Four years ago, Pennsylvania resident Margie was diagnosed with lymphoma. As Margie processed how her cancer diagnosis would change her life, she confronted another reality: she did not have health insurance.

Looking for guidance, Margie turned to PHLP. With the help of PHLP staff, Margie successfully enrolled in Medical Assistance and received life-saving cancer treatments.

This month we heard from Margie again. Now 59-years-old and living in Westmoreland County, Margie called PHLP terrified about losing the Medical Assistance benefits she fought so hard to gain. She worried about how she would manage her many health problems, including severe diabetes and a stroke in March, without the support of Medical Assistance.

What led to this change? Margie was recently approved for Social Security Disability Insurance, which increased her income. As a result, the Department of Public Welfare held she was no longer income eligible for Medical Assistance and would soon terminate her coverage.

PHLP advised Margie about her choices and highlighted the Medical Assistance for Workers with Disabilities program (MAWD). Unlike other categories of Medical Assistance, MAWD includes a work requirement and asks enrollees to pay a monthly premium.

Margie found a job that matched her abilities, provided verification of employment, and enrolled in MAWD to manage her chronic conditions at an affordable cost.

PHLP Staff Travels to Rural Pennsylvania Educating Stakeholders On Changes To Medical Assistance

Over the past several months, PHLP sponsored 15 presentations to approximately 900 people across 12 counties about the Department of Public Welfare's expansion of the Medical Assistance (MA) managed care program, HealthChoices, to all 67 Pennsylvania counties.
 
Originally only in the 25 most populated counties, HealthChoices has since expanded to include all of Southern Pennsylvania and by March 2013 will include the entire state.  Before this change, most people on MA in those less-populated counties used the ACCESS Plus program to obtain medical services; those residents will now be enrolled in Medicaid managed care plans.

Furthermore, medical providers must enroll in one or more of the Medicaid managed care plans if they intend to continue serving MA recipients.

Each PHLP session was consumer-centered and focused on:
  • who is and who is not impacted by these changes;
  • how to choose the best plan to meet your needs;
  • the role of your primary care physician;
  • the significance of network providers;
  • consumers’ rights to file complaints and grievances; and
  • the rules regarding continuity of care.
Consumers and providers also received fact sheets, such as "Tips for Choosing a Medicaid Managed Care Plan" and "Denied a Service by Your Managed Care Plan? Appeal!" These materials complement the information presented in the trainings and can be shared with family, friends, and coworkers.

In subsequent evaluations attendees gave the sessions high marks.  The comment of one Potter County resident was typical: “I don’t know what I would have done without this information.”
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PHLP in The News

Erie, Crawford Medicaid recipients must choose HMO by Thursday, Erie-Times News, September 6, 2012

Medical Assistance Redetermination Process Frustrates Workers and Recipients; Produces Churn, WESA Pittsburgh's NPR News Station, September 25, 2012

What We're Reading

The Affordable Care Act: Implications for Public Safety and Corrections Populations, The Sentencing Project, September 2012

Medicaid Coverage and Care for the Homeless Population: Key Lessons to Consider for the 2014 Medicaid Expansion, The Henry J. Kaiser Family Foundation, September 2012

Health Reform: Seven Things You Need to Know Now, Consumer Reports, September 2012

Income, Poverty, and Health Insurance Coverage in the United States: 2011, United States Census Bureau, September 2012

The State of Children’s Health Care in Pennsylvania, Pennsylvania Partnership for Children, September 2012

Medicaid Health Homes for Beneficiaries with Chronic Conditions, The Henry J. Kaiser Family Foundation, August 2012

Spotlight on Advocacy

PHLP and Partner Organizations Work to Ensure Children's Access to Quality Health Care

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The Pennsylvania Health Law Project is a nationally recognized expert and consultant on access to health care for low-income consumers, the elderly, and persons with disabilities. PHLP engages in direct advocacy on behalf of individual consumers while working on the kinds of health policy changes that promise the most to the Pennsylvanians in greatest need.
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Copyright © 2012 Pennsylvania Health Law Project, All rights reserved.
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