Thursday, August 24, 2017

Solomon Center Submits Comments to HHS

On August 17, 2017, a team of physician and attorney partners affiliated with the Solomon Center for Health Law & Policy at Yale Law School, including representatives of the New Haven Medical-Legal Partnerships (MLPs) and Yale New Haven Health, submitted comments to the U.S. Department of Health & Human Services Centers for Medicare and Medicaid Services. The comments respond to a proposed rule to modify regulations concerning physician compensation. The proposed rule, published in the Federal Register on June 30, 2017, would credit and expand incentives for clinicians to screen patients for “health-harming legal needs.” This would update the Merit-based Incentive Payment System (MIPS), which guides clinician compensation under Medicare.

Clinician screening for patient legal needs is a critical component of each of New Haven’s pioneering MLPs that integrate legal services into health care settings to address social determinants of health and advance holistic care and health equity. The Solomon Center has been at the forefront of the MLP movement in New Haven, co-founding three MLPs, and placing students in two more. The five New Haven MLPs serve distinct populations: children, immigrants, veterans, formerly incarcerated individuals returning to the community, and palliative care patients, across the continuum of care and life experiences. Dozens of Yale Law School students have worked in the MLPs since the program was founded in 2012.

With the support of the Solomon Center, its Senior Advisor, Tamar Ezer, and Executive Director, Katherine Kraschel, authored a public comment on this topic. The comment argues that CMS should, as proposed in the rule, recognize patient screening for “health-harming legal needs” as one of its “Practice Improvements that Engage Community Resources to Support Patient Health Goals.” It further states that the CMS should attribute the highest category weighting to legal screenings and thus most significantly increase clinician Medicare compensation for screening patients. This would also recognize the time, effort, and coordination required by clinicians to screen patients effectively and connect them to appropriate resources. Solomon Center Distinguished Visiting Scholar Emily Benfer contributed to the comments, along with partners from the Center for Children’s Advocacy, Connecticut Veterans Legal Center, New Haven Legal Assistance Association, Yale New Haven Health, and Yale School of Medicine.

“The proposed rule is an exciting development that finally recognizes the important health value of identifying and addressing legal needs in the context of Medicare," said Ezer. "We hope this recognition will also expand to Medicaid in the future, crediting clinicians for their critical participation in this work.”

The Solomon Center for Health Law and Policy at Yale Law School is the first of its kind to focus on intersection of law and the governance, practice, and business of health care. The Center brings together leading experts and practitioners from the public and private sectors to address cutting-edge questions of health law and policy, and to train the next generation of top health lawyers, industry leaders, policymakers, and academics.