The ADA is a potentially powerful tool for putting health care decision-making into a civil rights context. This presentation will clarify how the ADA statute, federal regulations, and court decisions can be applied to four dimensions of managed care: physical accessibility, communication accessibility, benefit design issues, and methods of administration. Many of these issues have been addressed in the Oregon Medicaid prioritization process, New York Medicaid ADA Compliance Guidelines, DeSario case on "exclusive" lists of treatment in Connecticut's Medicaid program, Anderson case dealing with physical and communication accessibility in Pennsylvania's Medicaid managed care program, and the Zomora case dealing with protections for health care providers associated with persons with disabilities in private managed care plans in Texas. This presenter has developed ADA checklists for five audiences including managed care plans, health care providers, patients with disabilities in managed care plans, consumer advocacy organizations, and health care regulators and policy makers, in order to identify managed care policies, procedures, and practices that are potentially in violation of the ADA. This presentation will discuss how the combination of ADA checklists from different stakeholders can be used as screening tools to identify discrimination on the basis of disability in managed care, promote reasonable accommodations in managed care within the guidelines of the ADA to ensure that persons with disabilities have an equal opportunity to benefit from covered services, and create some important precedents that can lead to greater public accountability for health outcomes for all enrollees in managed care.
Learning Objectives: At the conclusion of the presentation, participants should be able to recognize dimensions of discrimination on the basis of disability in managed care, identify reasonable accommodations to ensure that persons with disabilities have an equal opportunity to benefit from covered services, and develop strategies for using the ADA to increase public accountability in managed care
Keywords: Managed Care, Disability
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Center on Disability and Health in Washington, DC
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.