The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
NEW YORK, Nov. 28 -- The Medicare Rights Center issued the following news release:
Today marks the launch of the Coalition to Protect the Rights of New York's Dually Eligible. This is a diverse union of interests and perspectives consists of health, aging and disability advocates, along with community- and faith-based organizations. New York State will transition at least 124,000 men and women who are dually eligible for Medicare and Medicaid into new managed care insurance plans by 2014. The new coalition will work with insurers, provider groups, and state and federal policymakers to protect the rights of these vulnerable individuals. The coalition's work, critical in New York, is also expected to help inform the development and implementation of proposals to manage the care of dually eligible beneficiaries across the country.
The convening of this new coalition comes at a critical moment as the Centers for Medicare & Medicaid Services (CMS) and the New York State Department of Health (NYSDOH) finalize a demonstration proposal that promises to change the way people with Medicare and Medicaid, also known as dual eligibles, receive their health care. The proposal will take effect on January 1, 2013, and holds the promise of better coordinated health care for dually eligible beneficiaries and lower costs for both New York State and the federal government. But New York will face a number of challenges as it works to bridge the Medicare and Medicaid programs, and a unified, beneficiary-focused voice is critical for carrying the concerns and stories of dual eligibles to Albany and Washington, DC.
To address this need, the new coalition's steering committee, consisting of the Medicare Rights Center, Center for Disability Rights, Center for Independence of the Disabled NY, Community Service Society of NY, Empire Justice Center, Legal Aid Society, New York Association on Independent Living, and Selfhelp Community Services, has welcomed dozens of health care and disability stakeholders to participate in a broader coalition to represent beneficiaries and serve as an important actor in both the construction and implementation of the managed care demonstration. The coalition has been made possible through a generous grant from the New York State Health Foundation.
The steering committee members listed above have already provided formal comments to state and federal agencies outlining concerns and highlighting the promising elements of New York's demonstration proposal. They have also won seats on state workgroups charged with hammering out the details of the managed care demonstration. Significantly, this engagement has already led to several improvements to the state's original proposal, including:
a decreased number of beneficiaries affected by this yet untested new model
the authorization of multiple managed care models to be tested as part of the demonstration, rather than just one
the offering of additional benefits, not covered under original Medicare or Medicaid, to help keep people with long-term care needs in the community rather than in nursing homes and related institutions.
"Through our participation in state workgroups, our coalition steering committee has brought the voice of Medicare and Medicaid beneficiaries to the table, focusing on health plan quality, appeals and due process, and health plan notices and enrollment," said Joe Baker, President of the Medicare Rights Center. "Today's launch of the full coalition amplifies our voice and the voices of thousands of New Yorkers with Medicare and Medicaid."
"This demonstration project is an opportunity to support the independence of people with disabilities and to put the right incentives in place so that people are able to live in the community," said Leah Farrell, Manager of Government Affairs at the Center for Disability Rights. "To achieve this, a unified advocacy voice is needed and this coalition can help ensure that any effort to coordinate the care of dually eligible New Yorkers takes into account the needs and rights of people with disabilities."
"Empire Justice Center is excited about the proposal's potential for integrating two very complex programs and ultimately improving care for consumers," said Trilby de Jung, Senior Attorney for the Empire Justice Center. "However, for this proposal to succeed, it will be absolutely critical for the state to get input from beneficiaries, their families and their advocates. That is the goal of this new coalition - to bring these most important voices to the table."
TNS MD66 121201-4126312 61MariaDonald