Legal Aid Society

Projects, Units & Initiatives

Health Law Unit

The Health Law Unit’s mission is to ensure low-income New Yorkers can live their healthiest lives. We provide direct legal services and advocate for informed policy change. We assist our clients in securing access to health insurance and to culturally competent health care, defend and expand patient rights, and empower individuals navigating the health care system, striving to further social, racial, and economic equity for our clients and communities.

We operate a Statewide helpline and assist with a range of legal issues, including problems with: eligibility for public health insurance programs; denials or reductions of health care benefits and services; access to health care services for individuals who are uninsured; federal health care reform; medical debt issues; and disability rights and discrimination.

A Historic Dental Settlement

The Legal Aid Society, Willkie Farr & Gallagher LLP, and Freshfields Bruckhaus Deringer LLP reached a settlement in Ciaramella v. Zucker – a federal class action lawsuit brought against the New York State Department of Health on behalf of Medicaid recipients in New York who were denied coverage for medically necessary dental care by New York State. The settlement will affect roughly five million individuals statewide. Most significantly, it ends the strict limit denying coverage for crowns and root canals to individuals with more than four pairs of teeth, an archaic policy not aligned with modern US dental practice.  Learn More.

Our Impact

The Health Law Unit recently assisted Ms. M with an issue relating to an alleged overpayment of Medicaid benefits. Ms. M was originally referred to the Society by a City Council Member after she received a notification from the Human Resources Administration (HRA) that she owed more than $55,000 for the cost of Medicaid coverage she received when she was allegedly ineligible. Ms. M’s Medicaid eligibility determination was complicated both by her working overtime at her job, and also by changes in her household size when she had both formal and informal custody of several of her grandchildren. After 2 years of negotiation, first with HRA and then their retained private law firm, we were able to secure a settlement that offered Ms. M a payment plan for reduced sum – and peace of mind.

Partnerships

The Legal Aid Society’s Health Law Unit (HLU) is an active member of the Transgender Health Advocacy Working Group, formed in 2017 as a collaboration of medical providers, legal advocacy organizations, and community-based organizations and advocates that serve transgender and gender non-binary (TGNB) communities. The working group is committed to ensuring that health insurance plans—including Medicaid-managed care plans—comply with laws and regulations regarding the coverage of gender-affirming care for TGNB Medicaid beneficiaries. The Working Group’s advocacy with the New York State Department of Health (DOH) about systemic problems with approvals of care by the plans led to the publication of DOH guidelines in June of 2018 that further clarified the way Medicaid managed care plans must apply existing regulations, strengthening our clients’ access to care.