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Health Law News

May 1, 2020
In This Issue:
SSI Beneficiaries With Kids: Act By May 5th To Get
Your Dependent’s Stimulus Payment!

 
In April, the federal government began sending stimulus payments to individuals as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Most people receive $1,200, plus another $500 for each of their children under age 17. There has been confusing and conflicting information released on this subject, especially as it pertains to recipients of Social Security benefits.

SSI recipients with dependent children who are seeking the extra $500 payment per child need to complete the IRS “Non-Filer” application form online by May 5.  SSI recipients will receive their $1,200 stimulus money automatically, but the money for any children under 17 will be delayed if the Non-Filer Application form is not completed by May 5.

Read more on our website.
Health Insurance Coverage Options Following COVID-19 Layoffs 
 
Pennsylvanians have several health insurance options through the Affordable Care Act (ACA), Medicaid and the Children's Health Insurance Program (CHIP) during the COVID-19 pandemic. Special Enrollment Periods (SEP) through the ACA are available to consumers who experience various life changes, including the loss of employer-sponsored health care coverage. Medicaid and CHIP coverage are available to families and individuals that meet the eligibility requirements for those programs.  

Read more on our website.
Impact of COVID-19 Financial Assistance to Households
on Health Insurance Eligibility

 
The federal Coronavirus Aid, Relief, and Economic Security (CARES) Act includes financial assistance to stimulate the economy and assist those struggling during the economic downturn resulting from the COVID-19 emergency.  The two main types of financial assistance for individuals and families are stimulus payments and expanded unemployment compensation.  Here we summarize whether and how each impacts eligibility for Medicaid, CHIP, and subsidized Marketplace insurance.

Read more on our website.
Updates on Community HealthChoices
 
The 180-day continuity of care period for Community Health Choices (CHC) partcipants getting long-term services and supports (LTSS) at home ends on June 30, 2020. After that date, CHC plans can change participants’ LTSS providers and CHC plans can terminate, reduce, or change the type and amount of LTSS partcipants receive. This assumes that the state has lifted the COVID 19 emergency by June 30th.  If the state of emergency remains in place on July 1, CHC plans cannot reduce LTSS.

Read more on our website.
PA’s Medicaid Enrollment Could Increase by 1 Million

By the end of April more than one million Pennsylvania residents had filed unemployment compensation claims since the coronavirus began taking a severe toll on the economy.  This economic downturn is expected to impact Medicaid, according to the Kaiser Family Foundation, since households that lose significant income can qualify for Medicaid.  According to Kaiser, when the unemployment rate peaked at 10 percent in October 2009 during the Great Recession, Medicaid enrollment and spending increased significantly across the nation.

Read more on our website.
Spotlight On: The PHLP Helpline
 
PHLP’s Helpline calls have decreased during the COVID-19 crisis, yet we know anxiety about health is increasing.  We want you to know that we are still here for you during this crisis; we’ll help you to fight for the healthcare you deserve.  You can call our Helpline at 1-800-274-3258 Monday, Wednesday, or Friday from 8 a.m. to 8 p.m. or email us anytime at staff@phlp.org



Read more on our website.
Medical Assistance (MA) Coverage of Over-the-Counter (OTC) Medications

PHLP often hears from clients who pay out of pocket for over-the-counter (OTC) medications as well as from social workers and advocates seeking information about programs that cover them at minimal or no cost.

Medicaid, Medical Assistance in Pennsylvania and referred to here as MA, covers OTC medications. A list of 15 medication categories can be found at 55 PA Code § 1121.53 (d), but the list is not exhaustive or comprehensive.

Read more on our website.
Some Medicare Patients Under “Observation Status” Gain Right to Appeal
 
On March 24th a federal court in a nationwide class action ruled that Original Medicare beneficiaries who have their status in the hospital switched to “observation status” after being admitted into a hospital as “inpatients” have the right to appeal that change to Medicare.  The decision is important because Medicare will only cover post-hospitalization nursing facility care for patients who were hospitalized as “inpatients” for at least three consecutive days before being transferred to a nursing home. 

Read more on our website.
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PHLP is a non-profit law firm that represents Pennsylvanians who need help getting or keeping Medicaid.  Through our Helpline, we serve thousands of individuals from across the state each year.  Across four decades, we have been standing with vulnerable Pennsylvanians and helping them access one of the basic necessities of life: health care.

Contact our Helpline: 1-800-274-3258
Copyright © 2020 Pennsylvania Health Law Project. All rights reserved.

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