Client Resource: Pennsylvania Health Law Project (PHLP): A Free Resource for Families Who Need Help Appealing Service Denials

By Danna Casserly, Staff Attorney, Pennsylvania Health Law Project

The Pennsylvania Health Law Project (PHLP) is a statewide center of legal expertise and advocacy devoted to increasing access to publicly-funded health care coverage and services. PHLP provides free advice and representation to individuals across the state who are experiencing problems with their Medical Assistance (MA) services, including their home health services.

If MA denies, reduces, or terminates a client’s home health services, the client has a right to challenge that denial by filing an appeal.

The MA appeal process can be complicated. There are multiple levels of appeal, including a grievance, an external review, and a fair hearing. PHLP understands that families often don’t have the time to take on these appeals on their own, or they may feel confused, daunted, or frustrated by the

process. PHLP will work with families, along with their home health agency, doctors, and other providers to try and get the denial overturned through the appeal process.  In some cases, PHLP may even go with the family to the appeal hearing.

There is no income limit to qualify for help from PHLP and all services are completely free of charge.

If your client’s MA services are denied, please urge them to call PHLP’s Helpline at 800-274-3258 for assistance. More information can be found on PHLP’s website at www.phlp.org.

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