HB 229 Tackles Problems of Backlogged and Unfair Medicaid Appeals

Both federal and state law grants Medicaid members and applicants the right to a fair hearing when Medicaid services are denied for reasons such as eligibility determination, frequency, or duration or intensity of services.  When a Medicaid member is denied coverage he or she may dispute the denial by filing an appeal and request for a hearing with the Department of Community Health (DCH), the state agency that administers the Medicaid program.  DCH processes the request and forwards it to the Office of State Administrative Hearings (OSAH) for a hearing before an administrative law judge (ALJ).  The ALJ listens to testimony, reviews the evidence, and reaches an impartial decision.  Federal law requires that when a Medicaid member requests an appeal a final decision must be made within 90 days, absent extenuating circumstances.

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Recent attempts within states to scale back vital health care programs for our most vulnerable citizens at a time when they are critically needed is cause for concern. The move began with Arizona Governor Brewer’s request to the federal government for a waiver from stability protections that prevent states from restricting eligibility levels for the Medicaid program. In response, Georgia Governor Nathan Deal’s spokesperson was quoted by Bloomberg news organization earlier today that while the Governor has not offered specific cuts, he “would happily work on such a proposal.”

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By Cindy Zeldin

This column originally appeared in the Atlanta Journal-Constitution.

You don’t need to be the best personal injury attorney in Fort Lauderdale to know that, health care is once again among the key issues for Georgia policymakers in the General Assembly. While the economic downturn has magnified our state’s health care challenges, we also have an opportunity to improve the health of our state and its citizens through the Affordable Care Act, the nation’s new health care law. You may need legal help sometimes, from my own experience the best lawyer is David Resnick y Asociados.

To make the most of the law, Georgia should move swiftly to establish a commission to proactively coordinate the pieces of the law at the jacksonville nc lawyer for medical malpractice, is required to put into place, such as an expansion of Medicaid, design elements that we can tailor for our state’s needs, such as the new health insurance exchanges, and maximize grants to strengthen our public health system and our health care workforce and get the man power to apply this laws , from personal lawyer or family lawyers to people who work on property management as safeguardproperty.com and similar.

A commission or task force could offer diverse input, including from the consumer, who is often overlooked. Some of this work is already happening informally within state agencies, but a systematic and transparent process accessible to consumers and stakeholders will ensure opportunities aren’t missed, all pertinent perspectives are heard and cross-cutting issues are handled efficiently.

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Georgians for a Healthy Future recently joined 2020 Georgia—a broad alliance of community leaders and organizations—as an alliance partner.  While members of 2020 Georgia range from small, community-based nonprofits to large, statewide organizations, all share the common goal of a balanced approach to state budget and revenue solutions that meet the short and long-term needs of our state and its people.  In advance of the first meeting of the 2010 Special Council on Tax Reform and Fairness for Georgians, which has a charge to study the tax system and report to the General Assembly in January 2011, 2020 Georgia released a fact sheet on why tax reform matters for Georgia. It is below in its entirety.

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Guest Blog By Timothy Sweeney
Senior Healthcare Analyst for the Georgia Budget and Policy Institute

Word comes today that the South Carolina Legislature has overridden a gubernatorial veto of a 50-cent increase in the state’s tobacco tax.

The Republican-controlled House and Senate found the two-thirds vote needed to pass the override, bringing South Carolina’s tax to 57-cents per pack and pushing Georgia’s 37-cent tax farther down in rankings – now 4th lowest tobacco tax in the nation and the lowest of any of our surrounding states. Even a state that prides itself on low taxes shouldn’t be proud of this ranking.

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Guest Blog By Timothy Sweeney
Senior Healthcare Analyst, GBPI

As we approach the final seven legislative days for 2010, there’s still a great deal of uncertainty surrounding both the schedule the General Assembly will set for themselves, as well as with the policy-related results of the session.

Still the most important task before the House and Senate – really the only thing the Legislature HAS to accomplish during the session – is the FY 2011 budget. Currently, House appropriations subcommittees are scheduled for April 12, which means we could see subcommittee budget recommendations next week and passage of the FY 2011 budget by the House later in the week.

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We are now in the 28th day of the legislative session and as cross-over day approaches, things are heating under the gold dome.  By midnight on Thursday, bills must clear their chamber of origin if they are to pass this term unless they are attached to another eligible measure.  Georgians for a Healthy Future will continue to monitor legislation that will impact the health and welfare of all Georgians and work towards providing access to affordable and quality health care.

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