Wednesday, February 2, 2011

Urgent legislative alert: proposed Hawaii bills put medical decisions in the hands of those who profit from them

The attorney who wrote the letter I am attaching has represented my daughter Hannah, and several of the other children who I have helped to advocate for home medical care.  Governor Abercrombie seems to be trying to get this legislation, which appears very anti-consumer, through quickly and silently.

Dear all:
I apologize for this lengthy correspondence.  THIS IS A VERY CRITICAL ISSUE.  I am asking you to submit testimony opposing a bill in the Legislature that is being heard by the House Committee on Health Friday at 9:00 a.m. 
Please forward the attached to anyone you like.  Inexplicably, the Abercrombie Administration has introduced bills in both houses to repeal the part of the Patients Bill of Rights known as the “external review.”  Simply put, we have a law that provides for a hearing on a pretty level playing field if your health plan denies care your doctor is recommending, or refuses to pay for emergency or other care you have already received.  The review is local and the patient can afford to retain legal counsel and experts to help present the case because the Commissioner can award the fees and costs incurred in the case (in other words, patients don’t have to pay fees and costs to get benefits rightfully due them, and if they lose, they still don’t have to pay).  
Feel free to use the draft testimony attached.  The deadline for submitting testimony is Thursday at 4:00 p.m.  It would be great if you could be there in person.  (We will have additional opportunities to put on more testimony.)  Feel free to personalize the testimony with your external review story.  I have just given you a skeleton that has information about the bills and the external review process we now enjoy.

Over the past 10 years, Arleen and I have won many cases, often with life threatening issues, for patients through the external review.  These days, many cases do not go to the review process because we are able to settle them with the plan and get the care.  That is one of the very positive effects the law has had (it has taken years, but is now very effective).

This year the health plans have come forward with legislation to get repeal the external review and also a bill to make patients pay attorneys’ fees and costs (more about that bill later).

This bill, HB 1047, proposes to outsource reviews to the mainland under a complex 67-page process.  Patients will not have an advocate supporting them as they do in the external review.  They will be on their own.  They will also have no right to appeal a decision (not sure that is even constitutional).  Do you think the health plans want this bill passed?
HB 1047, the first of these bills to come up, is being heard Friday morning at 9:00 a.m. by the House Committee on Health.  I have attached two things:  the hearing notice and a draft testimony that you can use for the form and also for the email and fax address.
I plan to present testimony from across the state and am traveling to the neighbor islands to collect video stories, but because the Legislature moves fast these bills come up for first  hearing quickly,   Petitions are being gathered and I will present them.  Nonetheless, the Committee needs to hear from a broad base of consumers that this bill is a bad idea.
I have not attached a copy of the bill.  You can get it online and I encourage you to do so.  It is 76 pages.

Full disclosure:  the external review comprises part of my practice.  Arleen and I have funded our patient advocacy for the past 10 years in part with the fees the Commissioner has awarded.  On the other side of the coin, I will not be able to continue advocating for patients against benefit denials if the external review is repealed.

I hope you will help me oppose this really damaging legislation.  As I said, I have not discerned a reason for the Abercrombie Administration’s instigation of this legislation.  The justification it is offering is that it will create a uniform process but that is simply patently false.  One quarter of a million people who have the right now will be excluded.  Half a million will have to submit to various other processes.  Uniformity is not the reason.
Rafael del Castillo

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About Me

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.