National Health Law Program

Founded in 1969, the National Health Law Program (NHeLP) protects and advances the health rights of low-income and underserved individuals and families. The oldest nonprofit of its kind, NHeLP advocates, educates and litigates at the federal and state levels. NHeLP’s lawyers and policy analysts stand up for the rights of the millions of people who struggle to access affordable, quality health care.

Medicaid/CHIP

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  • NHeLP Comments on House Passage of CHIP Reauthorization

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    NHeLP: The National Health Law Program (NHeLP) issued a press release after the House of Representatives passed HR 2, which would reauthorize CHIP for two years. The release lauds the passage of the bill but cites concerns that the bill includes the Hyde Amendment that would severely limit federal funding for abortions. Elizabeth G. Taylor, executive director for NHeLP, stated, “[w]e hope that this bipartisan two-year extension is the start of a longer conversation about protecting CHIP and moving forward to fully fund the program for four more years.”

  • NHeLP Issues Statement on Medicaid Reimbursment Rate Supreme Court Decision

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    NHeLP: The National Health Law Program (NHeLP) issued a press release strongly disagreeing with the Supreme Court’s decision in the case of Armstrong v. Exceptional Child. In Armstrong, Medicaid providers sued Idaho after the State failed to raise reimbursement rates to levels suggested by federal Medicaid statute. The Court ultimately ruled that private parties cannot sue to enforce Medicaid rate setting, citing the Constitution’s Supremacy Clause. Jane Perkins, legal director for NHeLP, stated, “[t]oday's decision ignores hundreds of Supreme Court cases, dating from the early 1800s, which have recognized the ability of private parties to bring Supremacy Clause suits in federal court to stop state officials from implementing state laws that violate a federal law or the Constitution.”

  • NHeLP Published E-Newsletter on Hospital Presumptive Eligibility

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    NHeLP: The National Health Law Program (NHeLP) published the latest issue of Lessons from California, focusing on the ACA’s requirement to implement Hospital Presumptive Eligibility (HPE). As of January 2014, HPE allows uninsured individuals who may be eligible for Medicaid to apply at qualified hospitals and receive benefits for up to two months. In California, individuals were incorrectly being HPE because they were previously eligible for coverage and tax credits through Covered California. As a result of NHeLP and other advocates’ actions, CMS has required the state to submit a mitigation plan by the end of the year and develop a manual work around by April to re-determine eligibility for all those who were incorrectly denied HPE in the past.

  • NHeLP Pens Guide to Medicaid Managed Care

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    NHeLP: The National Health Law Program published a guide on oversight, transparency, and accountability in Medicaid Managed Care, highlighting tools, tips, and ways to get information about states’ managed care programs. The guide provides a comprehensive primer on the program including: background on the history and structure of Medicaid managed care; contracting; plan design and performance; enrollment; waivers; and grievances and appeals.

  • NHeLP Examines Medicaid Health Expense Accounts

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    NHeLP: The National Health Law Program published key takeaways and a Q&A examining states’ plans to establish health expense accounts as part of their Medicaid expansion proposals. Indiana, Michigan, and Arkansas received federal 1115 Waivers to implement health expense accounts

  • NHeLP Publishes Newsletter on Advocates Success in Protecting Medicaid Benefits

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    NHeLP: The National Health Law Program (NHeLP) published a newsletter examining advocates’ successful efforts to restore Medi-Cal coverage for tens of thousands of Californians. These individuals lost their coverage during the annual renewal process when the State incorrectly applied the modified adjusted gross income (MAGI) methodology to determine their eligibility. The newsletter explains that individuals over age 65 or with disabilities are not subject to the MAGI methodology established by the ACA. NHeLP is currently working with the Department of Health Care Services (DHCS) to ensure that non-MAGI eligible Medi-Cal beneficiaries do not have their eligibility terminated and that the correct rules and forms are applied for future renewal determinations.

  • NHeLP Releases Statement on Republican CHIP Proposal

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    NHeLP: The National Health Law Program (NHeLP) issued a press release on the discussion draft bill released by Representative Upton, Representative Pitts, and Senator Hatch. The press release notes that the Republican proposal would eliminate the maintenance of effort (MOE) provisions, allow states to shift children from Medicaid to CHIP, allow states to impose waiting periods before coverage can begin, and eliminate federal funding to cover children with family incomes above 300 percent of the federal poverty line. Elizabeth G. Taylor, executive director for NHeLP, stated, “While we welcome continued bipartisan commitment to protect and extend CHIP, we are troubled by some major provisions in the draft plan.”
  • NHeLP Publishes Brief on Proposed Republican ACA-Replacement Plan

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    NHeLP: The National Health Law Program published a brief breaking down the proposed Burr-Hatch-Upton (BHU) plan introduced in Congress on February 4th. The brief notes that although the plan calls for complete repeal of the ACA, it reiterates and supports much of the ACA’s framework. However, the brief explains that the plan would lead to higher numbers of uninsured and result in significant cuts to the Medicaid program.

  • NHeLP Examines California’s Marketplace to Medicaid Transition

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    NHeLP: The National Health Law Program published an issue of Lessons from California examining how Covered California handled newly eligible enrollees transitioning from the Marketplace to Medi-Cal. The brief explains that nearly 30,000 individuals were found newly eligible for Medi-Cal due to decreased projected incomes for 2015. California attempted to make consumers’ transition to Medi-Cal seamless by automatically enrolling them in a Medi-Cal managed care plan as of January 1, 2015. Although this ensured there were no gaps in coverage, the brief is concerned that consumers did not receive sufficient notice of changes. 
  • NHeLP Outlines 2015 Priorities

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    NHeLP: The National Health Law Program (NHeLP) published an e-newsletter outlining the organization’s top priorities and goals for 2015. The newsletter explains NHeLP’s goals and expectations for many issue areas, including: ACA implementation; Medicaid expansion; CHIP; and reproductive health.

  • KidsWell Partners File Amicus Brief Supporting Private Enforcement of the Medicaid Act

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    First Focus, NHeLP: KidsWell partners, First Focus and The National Health Law Program, along with 16 other organizations, filed an amicus brief in the Armstrong v. Exceptional Child Center case arguing that private enforcement of the Medicaid Act is necessary when state violations harm program beneficiaries. The brief argues that a decision against private enforcement would remove one of the main ways low-income individuals can legally challenge states’ harmful decisions.

  • NHeLP Publishes Medicaid Fact Sheet

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    NHeLP: The National Health Law Program published a fact sheet on the top 5 reasons Medicaid is essential to low-income people. The fact sheet explains that Medicaid is essential for low-income individuals because: it is designed specifically for this population; it has  provider network rules guaranteeing access; it is truly affordable; it protects individuals’ rights; and because it provides people with access and continuity.

  • NHeLP Publishes Newsletter on California’s EPSDT Guidance

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    NHeLP: The National Health Law Program published an issue of Lessons from California on advocating for Medi-Cal managed care plans to provide a wide array of services to children.  The newsletter explains that federal Early and Periodic Screening, Diagnosis and Treatment (EPSDT) requirements to mandate that states provide services to children without delay or denial based on the possibility that other entities could provide said services.

  • NHeLP Publishes Summary of 2014 ACA Litigation

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    NHeLP: The National Health Law Program published an issue of Health Advocate that provides a summary of significant ACA-related cases in 2014. The e-newsletter examines cases that directly challenge: the ACA; coverage of reproductive health services; Medicaid maintenance of effort requirement; and preemption.

  • NHeLP Publishes Comparison of Medi-Cal and Covered California Benefits

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    NHeLP: The National Health Law Program published a fact sheet comparing Medi-Cal benefits to Covered California’s essential health benefits (EHBs). The fact sheet provides an overview of services covered by each program, a list of differences, and considerations to keep in mind when comparing benefits.

  • NHeLP Publishes Q& A on Relatives as Paid Providers

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    NHeLP: The National Health Law Program published a Q&A about a federal program that allows states to pay adults who are legally responsible for children or other relatives for providing Medicaid-funded home and community-based services. The Q&A also discusses different options available to states and existing case law.

  • NHeLP Publishes Issue Brief About Vision Services for Children on Medicaid

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    NHeLP: The National Health Law Program published an issue brief on vision services available to children with Medicaid coverage through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. The brief discusses: the severity and prevalence of common eye conditions among children; the developmental consequences of untreated vision loss; standards and recommendations for screenings; performance and monitoring of vision services rendered under the EPSDT benefit; and recommendations for CMS and state Medicaid agencies to improve children’s vision services.

  • NHeLP Publishes E-Newsletter on Open Enrollment

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    NHeLP: The National Health Law Program published an issue of Health Advocate focusing on challenges and concerns regarding the 2015 Open Enrollment Period. The newsletter acknowledges the enrollment process has advanced considerably since last year, but points to the shortened timeline and redetermination process as major concerns.

  • NHeLP Publishes Fact Sheet and Lessons Learned on CMS Guidance on Treatments for Children with ASD

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    NHeLP: The National Health Law Program (NHeLP) published a fact sheet on CMS’s guidance related to treatments for children with autism spectrum disorders (ASD). The fact sheet explains that states are now obligated to cover services for children under 21 when medically necessary, even if they are not covered for adults. NHeLP also published an issue brief, Lessons from California, highlighting how California is working to provide Behavioral Health Treatment to children with ASD who are enrolled in Medi-Cal.

  • NHeLP Publishes Issue Brief on Reducing Medicaid ED Use

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    NHeLP: The National Health Law Program published an issue brief on Medicaid cost sharing policies that target non-urgent use of  emergency departments. The brief reviews problems with emergency department co-payments and looks at alternatives that have proven successful in reducing utilization while improving care coordination and quality.

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