UNM Hospital Stops Requiring Low-Income, Uninsured Patients to Pay 50 Percent Down Payment for Surgery

ALBUQUERQUE, NM–After months of intense pressure from advocates, the UNM Hospital Board of Trustees reversed a policy, implemented in May 2017, requiring low-income, uninsured patients to pay a 50 percent down payment before surgeries. As a result of the policy, the hospital cancelled many patients’ surgeries because the patients couldn’t come up with thousands of dollars upfront to repair hernias, torn knee ligaments, broken bones, and in one case, a hysterectomy.

“We are relieved that the Hospital Board of Trustees has finally decided to treat all people with the same compassion and standard of care that insured people receive,” said Michelle Melendez, director of EleValle: South Valley Healthy Communities Collaborative. “Requiring people to pay 50 percent upfront was inhumane and not consistent with the mission of our public safety net hospital, which receives $96 million per year in property tax revenue to help cover indigent patients.”

The EleValle collaborative, which is comprised of Casa de Salud, Centro Savila, and ACCESS, teamed up with the New Mexico Center on Law and Poverty, Juntos Para la Salud, and with patient navigators from Pathways to a Healthy Bernalillo County to educate the UNM Hospital Board of Trustees about the policy’s impact on low-income, uninsured residents of Bernalillo County. The Bernalillo County Commission and the state Legislative Health and Human Services Committee weighed in on the side of advocates.

“The hospital’s policies created an insurmountable barrier for low-income patients to get surgeries, impacting their livelihoods and forcing them to suffer through worsening medical conditions,” said Sireesha Manne, healthcare attorney at the New Mexico Center on Law and Poverty. “We are grateful for the collaborative effort of community groups, patient navigators, and policymakers to hold the hospital accountable to its public mission.”

The board voted unanimously at the hospital’s board meeting on Friday to change the hospital’s Patient Payment and Financial Assistance policies. It also voted unanimously to establish a new Discount Program Policy for low-income patients living in New Mexico who meet poverty guidelines, are ineligible for Medicaid, and unable to purchase private insurance on the Health Insurance Exchange.

The new policies reinstate the hospital’s affordable down payment schedule that had been in place from 2005 until May 2017. Pathways navigators became aware of the hospital’s change in policy when clients who were seeking help with food, housing, transportation, and other basic needs disclosed that they were unable to work because of knee injuries and other debilitating medical conditions but could not afford a 50 percent down payment.

The reinstated schedule allows patients to pay $25, $75, or $300, depending on their level of poverty, upfront for surgeries that have been deemed medically necessary by their healthcare providers. The patients are then required to make monthly payments on the balance owed, which could be tens of thousands of dollars.

At the Friday meeting, Jerry McDowell, UNM Hospital board chairman, said, “There are some basic values that I think guide us: Do no harm to the patient. Consistent with our public service mission, serve all individuals with fairness, respect and dignity. Strive for best in class for quality, safety, and care. There are also legal guidelines overarching.”

Human Services Department to Hold Hearing on Medicaid Cuts on Monday, October 30

ALBUQUERQUE, NM—New Mexico’s Human Services Department (HSD) will hold a hearing on the serious cuts the Medicaid program faces in the Centennial Care 2.0 waiver proposal on Monday, October 30 at the National Hispanic Cultural Center in Albuquerque. This will be the final public hearing on the issue.

The waiver proposal eliminates important coverage and health benefits and imposes new excessive patient fees in the form of co-pays and premiums on the working disabled, low-income adults living just above the poverty line, and children enrolled in the Children’s Health Insurance Program (CHIP). These fees will prevent people from seeking necessary healthcare and cause thousands of others to lose coverage.

WHAT:
HSD Hearing on the Centennial Care 2.0 Waiver Proposal

WHEN:
5:30-7:30 p.m., October 30, 2017

WHERE:          
National Hispanic Cultural Center’s Bank of America Theatre
1701 4th Street SW
Albuquerque, NM, 87102

Call in Number: 1-888-757-2790
Participant code: 991379#

WHO:

  • HSD staff
  • Abuko Estrada, attorney at the New Mexico Center on Law and Poverty and other groups against the waiver
  • Public Comment

Healthcare Repeal Effort Comes to an End, Saving Medicaid Funds for New Mexico

WASHINGTON DC— Republicans in Congress decided today to end their push on the Graham-Cassidy bill to repeal the Affordable Care Act, because they do not have enough votes in their party to pass it through the Senate. Their decision comes after the Congressional Budget Office released a preliminary report yesterday that concluded millions of Americans would lose their healthcare coverage under the legislation, mostly due to significant cuts to Medicaid. The bill would have ended Medicaid Expansion for low-income adults and resulted in New Mexico losing billions of federal dollars over the next ten years.

“Medicaid has greatly improved the physical and economic health of New Mexico,” said Sireesha Manne, an attorney with the New Mexico Center on Law and Poverty. “This bill suffered the same problems as older versions. It would have ripped away healthcare coverage from millions of people and permanently damaged Medicaid – a cornerstone of our healthcare system.”

The bill would have ended the Medicaid Expansion that provides healthcare coverage to more than 255,000 low-income adult New Mexicans, and resulted in New Mexico losing $9 billion federal dollars by the year 2027, according to the nonpartisan research group Avalere. The bill capped funding for the entire Medicaid program and eliminated tax credits that help people buy insurance. States would have been allowed to let insurance plans stop covering essential health benefits and to charge more to consumers with pre-existing conditions.

“New Mexico would have been forced to pay billions more in healthcare costs or slash Medicaid coverage for more than 230,000 people and cut services for the most vulnerable populations – including children, seniors, and people with disabilities,” said Manne.

The bill faced widespread opposition from state officials, consumer groups, and medical and industry groups. It also proved to be unpopular among Americans, with a CBS News Poll showing 52% of respondents disapproving the bill and only 20% in approval. A statewide poll conducted in New Mexico earlier this year by Research & Polling, Inc. found that nearly three-quarters of New Mexicans are opposed to reducing federal funding for Medicaid, and four out of five voters believe Medicaid is “important” or “very important” to residents.

Urgent Action Alert: Stop Damaging Fees for Our Families!

Governor Martinez and the Human Services Department (HSD) are moving forward on a proposal that would create unnecessary obstacles to healthcare by charging higher fees to patients that get Medicaid.

HSD’s proposal requires low-income patients be charged co-pays each time they receive medical care – including for prescriptions, surgeries and other doctor visits. The proposal specifically targets children in the Children’s Health Insurance Program (CHIP), working disabled individuals, and adults living near poverty, with co-pays that range anywhere from $2 to $8 for each prescription drug to $50 for hospital care. Co-pays for “non-preferred” prescriptions and “non-emergency” use of the emergency room are also proposed for all Medicaid patients regardless of income.

This idea was rejected by HSD’s own panel of stakeholders and experts last summer. It has also received strong criticism from various community organizations, healthcare provider associations, and patients through both written and public comment.

The proposal should be withdrawn because:

  • A wide body of research shows that co-pays, even in “nominal” amounts, prevent people from getting needed medical care.
  • Costs add up quickly for families and children with multiple health needs – especially for people with disabilities or chronic health conditions.
  • The costs often shift to healthcare providers that choose to treat patients when they cannot afford the co-pay.
  • Our healthcare system and state budget will see long-term negative effects due to increased administrative costs and increased use of more expensive healthcare services.

Please call and urge your networks to contact Governor Martinez – (505) 476-2200 – and tell her to stop the Medicaid co-pay proposal. We should be making Medicaid better, not creating barriers for our families to get the healthcare they need!

 

HSD to Hold Public Hearing Tomorrow on Proposal to Increase Medicaid Co-Pays

Tomorrow at 9 a.m., New Mexico Human Services Department (HSD) will hold a public hearing to gather comment on its proposal to increase co-pays for Medicaid patients. This proposal faced opposition from HSD’s own stakeholder group when proposed last year and still faces widespread opposition.

Over 20 groups and individuals have signed on with the New Mexico Center on Law and Poverty in comments submitted to HSD opposing the proposal, including the New Mexico Medical Society, New Mexico Academy of Family Physicians, New Mexico Pediatric Society, New Mexico Coalition to End Homelessness, and Parents Reaching Out among others. These groups assert that a wide body of research has shown that such fees decrease access to necessary medical care, shift costs to providers, and will have negative consequences for our healthcare system and state economy.

The aforementioned comments on the proposal can be found here.

What:   Public Comment Hearing

Who:     HSD

When:  Friday, July 14, 2017 at 9 a.m. MST

Where: Rio Grande Conference Room, Toney Anaya Building, 2550 Cerrillos Road, Santa Fe, NM 87505

Public Hearings on Human Services Department’s Medicaid Plan Ongoing  

ALBUQUERQUE, NM — Public hearings start this week on the Human Services Department’s (HSD) recently released plan for the future of Medicaid in New Mexico – Centennial Care 2.0.

More information about Centennial Care 2.0 can be found on the HSD website here.

The Center on Law and Poverty has released a packet of information detailing alarming changes from the plan that will be harmful and costly to our families and the State that can be found here. Stakeholders are expected to be present to provide public comment at the hearings.

HSD Public Hearings

  • June 14th – Albuquerque – 3:30-5pm – CNM Workforce Training Center (5600 Eagle Rock Ave. NE, Albuquerque, NM 87113)
  • June 19th – Silver City – 4:00 – 6:00 pm – WNMU – GRC Auditorium (1000 W. College Ave., Silver City, NM 88061)
  • June 21st – Farmington – 4:30 – 6:30 pm – Bonnie Dallas Senior Center (109 E. La Plata St., Farmington, NM 87401)
  • June 26th – Roswell – 4:30 – 6:30 pm – Roswell Public Library (301 N. Pennsylvania Ave., Roswell, NM 88201)

Tribal Consultation Hearing

  • June 23rd – Albuquerque – 9:00am – noon – Indian Pueblo Cultural Center (2401 12th Street NW, Albuquerque, NM 87104)

New Study Shows Devastating Consequences for New Mexico under Latest Healthcare Bill

New Mexico will be forced to make tough choices under the Republican healthcare bill in Congress that slashes federal funding for Medicaid. A new study shows that the bill’s plans to reduce federal Medicaid funding would require the state to come up with an additional $427 million annually to maintain healthcare coverage for its 900,000 residents enrolled in Medicaid. If it can’t or won’t, more than 250,000 New Mexicans could lose their coverage and become uninsured.

The study, released today, was conducted by Dr. Kelly O’Donnell, an economist with the Robert Wood Johnson Foundation at UNM and is available here.

The bill drastically lowers the federal funding match for Medicaid expansion adults and permanently caps funding on the entire program, resulting in a loss of $11.4 billion in federal revenues and more than 30,000 jobs by 2026. It’s an understatement to say that this would devastate New Mexico’s healthcare system and economy.

The bill reneges on the federal government’s long-standing commitment to funding Medicaid. And President Trump promised on the campaign trail that he would not cut Medicaid, yet his administration has revived negotiations for the bill after it failed to garner enough votes among House Republicans last month. The latest proposal, in addition to decimating Medicaid funding, would also remove important consumer protections like allowing insurance companies to charge higher rates for people with pre-existing conditions and eliminating coverage of essential services like mental health and maternity care.

Congressman Pearce has not taken a position on the legislation. He should take a look at this study because the consequences for New Mexico will be drastic.

ACTION ALERT: Ask New Mexico’s Leaders to Stand Up for our Healthcare

We’ve all been working hard to build a great healthcare system for New Mexicans. Along the way, we have seen significant gains for our state for which we are thankful.

  • 95% of our children in New Mexico have healthcare coverage now, mostly because of Medicaid.
  • Over 250,000 adults gained coverage from the Medicaid Expansion in 2014.
  • Medicaid supports over 50,000 jobs in our healthcare sector and keeps clinics, hospitals and caregiving agencies open in our state.
  • • Medicaid saves costs for everyone by covering uninsured people and offering preventive and life-saving care.

As we move forward, we cannot afford to lose our gains. We lost over $330 million for healthcare and over 3,000 jobs this year for failing to adequately fund Medicaid. Now with uncertainty about healthcare at the national level, we must work harder than ever to protect and strengthen our healthcare.

Please call our leaders and ask them to fully fund Medicaid. It will only take a few minutes. Let them know why you are thankful for Medicaid.

Governor Susana Martinez – (505) 476-2200
Senator John Arthur Smith, Chair of Legislative Finance Committee – (575) 546-4979
Representative Patty Lundstrom, Member of Legislative Finance Committee – (505) 722-2980

Please call this week – before December 9th. The Legislative Finance Committee and the Executive branch are putting together state budget proposals for next year. It’s important these individuals hear from you this week.

Judge Holds NM Human Services Chief in Contempt

human-services-departmentOriginally published in the Albuquerque Journal September 28, 2016
https://www.abqjournal.com/854783/judge-finds-contempt-in-hsd-legal-case.html

SANTA FE – A federal judge held New Mexico’s top human services official in contempt Tuesday for failing to comply with court orders aimed at improving the administration of food aid and Medicaid health care benefits.

The contempt order against Human Services Secretary Brent Earnest by U.S. District Court Judge Kenneth Gonzales upheld findings that the cabinet secretary did not diligently attempt to comply with court orders concerning the handling of Medicaid benefit renewals, eligibility for immigrants, training for agency employees and other administrative requirements.

The judge, in his Tuesday order, also said objections filed by the agency were without merit and that the overall direction of the case was troubling.

“It remains clear that HSD and its officials have failed to exercise the leadership, control and managerial oversight to effectively come into compliance with the court orders,” Gonzales wrote.

However, a spokesman for the Human Services Department, which runs the federally funded Supplemental Nutrition Assistance Program, or SNAP, took issue with at least part of the judge’s order.

“We strongly disagree with the judge’s characterization of the department, which doesn’t take into account all of our efforts to resolve long-standing issues – some of which are three decades old and occurred under several administrations,” HSD spokesman Kyler Nerison said. “However, we are pleased that the court has agreed with us to bring in an outside monitor to help resolve those issues.”

“Regardless, we are going to continue providing services to New Mexicans who need it the most,” he added.

The contempt finding accompanies the judge’s earlier approval of plans for a court-appointed special master to help ensure federally funded benefits are administered properly amid internal investigations by state and federal agencies into allegations that food aid applications were falsified.

The civil contempt order carries no additional sanctions or penalties.

Sovereign Hager, an attorney at the New Mexico Center on Law and Poverty and advocate for aid beneficiaries in the litigation, said the order sends a strong message nonetheless.

“I think this is a message that if things don’t work out with a special master and the state doesn’t come into compliance, the court will look to harsher remedies,” she said.

New Mexico has one of the nation’s highest poverty rates, and there were more than 536,000 New Mexicans receiving food assistance benefits under SNAP, which was formerly known as food stamps, as of July, according to HSD. That figure was up by more than 7 percent – or nearly 36,000 people – from a year earlier.

The judge’s contempt order is the latest twist in a 1988 lawsuit. Earlier this year, a series of hearings were conducted by U.S. Magistrate Judge Carmen Garza, who had been tasked with monitoring compliance with a consent decree in the lawsuit and previous court orders.

Those hearings showed potential problems with the SNAP program, including testimony that state intake workers had been ordered to falsify income for some applicants, effectively denying them emergency benefits.

The testimony prompted criticism of Gov. Susana Martinez’s administration by top legislative Democrats and party officials, including a call from Sen. Gerald Ortiz y Pino, D-Albuquerque, the chairman of the interim Health and Human Services Committee, for Earnest to resign.

Earnest took over as HSD secretary – after Martinez picked him for the job – in December 2014 after the agency’s former secretary stepped down.

Read the Order from Judge Gonzales here.