Through this research project we looked at the barriers people with disabilities are encountering in managed care arrangements, by assessing healthcare difficulties which resulted in formal complaints and/or litigation. We also assessed how federal and state nondiscrimination and other regulations are being used to protect people with disabilities from discrimination in the healthcare environment. We elicited data by (1) tracking complaints and grievances voiced through protection & advocacy and similar legal service programs; (2) analyzing nondiscrimination laws and other legislation to ascertain their effect on the delivery of health care to people with disabilities in managed care arrangements; and (3) tracking litigation. We found that many people with different types of disabilities are encountering, reporting, and documenting similar healthcare difficulties, including: (1) restricted access to durable medical equipment and new technologies, disputes over medical necessity of services; (2) limitations on the types of physicians that qualify as primary care providers (specialist vs. generalist); (3) lack of sign-language interpreters during physician visits; (4) uninformative content in service denial notices; among others. The Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973 have been used to varying degrees of success in challenging barriers in managed care arrangements. Commercial managed care plans that serve people with disabilities are often not familiar with the broader definition of covered services, medical necessity, and various due-process rights available under Medicaid. Many of these healthcare barriers that people with disabilities are encountering, though, are not specific to managed care settings. See www.ilru.org
Learning Objectives: 1) Identify barriers that people with disabilities experience in managed care arrangements. 2) Understand how disability nondiscrimination laws have and should be used to address these barriers.
Keywords: Disability, Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.