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.
Throughout the entire COVID-19 pandemic, the Health Law Unit has advocated with the city, state, and federal government for policies that recognize and accommodate the enormous challenges our clients are facing in maintaining their Medicaid coverage and access to health care benefits. We have led a group of advocates who speak regularly with the NYC Human Resources Administration (HRA) about Medicaid policies and practices during the pandemic. This advocacy has led to hugely positive developments for our clients in how Medicaid applications, continuing eligibility, and access to services are handled during the emergency. The workgroup has addressed areas such as the numerous extensions of Medicaid eligibility during the emergency, the pausing of Medicaid overpayment investigations, and the implementation of complex new processes for applying for home care.
In October, HRA announced its intention to resume billing on Medicaid overpayment settlement agreements on November 1, despite earlier commitments to pause billing until the end of the federal emergency. We wrote to HRA Commissioner Steve Banks urging him to reconsider and HRA reversed course.
We provided written testimony on behalf of the Civil Practice for a January 12 City Council hearing on vaccine distribution, pointing to the lack of transparency in the vaccine distribution process and the ways in which the City and State have failed to effectively distribute the vaccine to our vulnerable client communities.
We have also advocated with the State Department of Health through frequent meetings and written communications, pushing for state policies that maintain and preserve our clients’ benefits.
Unfortunately, the State has pushed forward with changes to the Medicaid program that we believe threaten access to care during this challenging time. We have submitted comments to the state and federal government numerous times about these changes, which, among other impacts, change the eligibility for Medicaid services in ways that could ultimately result in people with disabilities and elderly individuals who could safely live in the community ending up in nursing homes
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 in 2015 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.
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.