Loading…
Timezone
Welcome to the 2020 PLAN Virtual Statewide Conference

All workshops will be presented virtually by webinar on the Zoom platform. You must register for individual workshop webinars by clicking the Register for the Webinar button appearing in the workshop description and completing the registration information to be admitted into the webinar.

Pennsylvania CLE credits will be available to attorneys who actively participate in webinars and indicate their participation through polls displayed periodically during the webinars.
Back To Schedule
Thursday, October 1 • 10:00am - 11:00am
Representing Clients in Medicaid Managed Care Appeals

Sign up or log in to save this to your schedule, view media, leave feedback and see who's attending!

Tweet Share
Feedback form is now closed.
Video Stream


Nearly all Pennsylvanians enrolled in Medicaid are in managed care. Medicaid managed care plans are the gatekeepers for health care services; making the crucial decisions to approve or deny services.

For decades we have observed managed care plans limit services (e.g., home health care) to medically fragile children. Now we are seeing older adults and people with disabilities enrolled in Community HealthChoices (CHC) whose managed care plans are denying them the level of home and community-based waiver services that they need to live safely at home.

Join us as we discuss how to represent clients in grievances and fair hearings challenging adverse benefit determinations by CHC, Physical HealthChoices and Behavioral HealthChoices managed care plans.
Speakers
PW

Pam Walz

Supervising Attorney, Health and Independence Unit, Community Legal Services
Pamela Walz is a Supervising Attorney in the Health and Independence Unit at Community Legal Services of Philadelphia (CLS), where she represents low-income older adults and younger adults with disabilities in matters involving access to publicly funded long term services and supports... Read More →
avatar for Amy Lowenstein

Amy Lowenstein

Supervising Attorney, Pennsylvania Health Law Project
Amy Lowenstein is a Supervising Attorney at the Pennsylvania Health Law Project (PHLP) where she focuses on improving access to Medicaid services—particularly in Pennsylvania’s managed long-term services and supports program—through policy analysis, systems advocacy, and direct... Read More →

Sample Grievance Discovery Req & Appearance pdf
Partial Approval Notice UPMC pdf
Guide to Letter of Medical Necessity for PAS pdf
2020 CHC Agreement Excerpts pdf
Full Denial Notice Keystone pdf
2020 10 01 MCO Appeals PowerPoint Slides pdf
Thursday October 1, 2020 10:00am - 11:00am EDT
Zoom .
  Health Law

Attendees (41)