Abraham Lincoln University (ALU) law student, Melissa Hall, proves that a legal education can enhance almost any career path you’re on! As an independent dental practitioner and business owner, Mrs. Hall specializes in care for developmentally disabled and elderly patients. So when California’s Department of Healthcare Services made drastic cuts to state-funded denti-cal providers about 2 years ago and she was slowly forced to fire most of her staff, Mrs. Hall used her legal savvy to scrutinize these cuts. Mrs. Hall noted with frustration “I burned through any reserves I had just to keep my employees paid” so she brought her research to her husband’s law firm, The Hall Law Corporation, where it was discovered that the Department of Healthcare Services (DHCS) did, in fact, violate filing procedure with the federal government.
Ultimately, Mrs. Hall, along with eight other registered Dental Hygienists in Alternative Practice (RDHAP) filed a lawsuit against DHCS in October of 2017 for allegedly not seeking federal approval before cutting Medicaid provider rates.
Mrs. Hall explained that “any time the government makes changes to the budget, they are required to submit them to the FEDS. This is law. They didn’t do that, so this was our only real shot to create a case against them since providers can’t effectively sue the government under a ruling created by Scalia.” Mrs. Hall was brought in as a plaintiff for the case, and her husband’s firm, The Hall Law Corporation, along with the AARP Foundation Litigation, jumped on board to act as co-counsel to represent RDHAP.
The good news is that, according to a press release submitted by AARP last month, RDHAP won their case against DHCS! The release summarizes that “Judge Strobel concluded that ‘the substantial cut in the periodontal maintenance rate,’ as well as the State’s new x-ray policy for nursing home and intermediate care residents was a ‘material change’ in California’s Medi-Cal policy and operations that mandated prior approval from the federal government which DHCS failed to obtain. The order will allow the hygienists to continue to provide life-saving dental care for residents of skilled nursing homes and intermediate care facilities.”
The bad news is that, according to Mrs. Hall, DHCS is planning on filing an appeal on Judge Strobel’s ruling, so the healthcare nightmare is hardly over. The main issue is that these cuts to Medicaid are preventing disabled and elderly individuals with chronic dental issues from getting the aid they need, ultimately worsening their conditions. “The state should be held to a higher standard,” Mrs. Hall said during her interview “They shouldn’t be able to appeal a case like this which prevents so many people from getting the care they need and deserve. I’m just so mad about what the state health department has done, it’s unjust and shameful.” AARP’s release noted that, in addition to decreasing the rate for perio-maintenance by 68%, the state also implemented a new X-Ray diagnostic requirement, which makes receiving adequate care even harder.
According to the Department of Healthcare Services, the provider cuts affected 100,000 people currently using Medicaid.
Good oral care isn’t just about having healthy teeth, according to an interview with AARP and Lead plaintiff, Judy Boothby, “who has cared for these patients for over 30 years, ‘Without proper oral care, they are in jeopardy of losing their remaining teeth so they can’t eat or talk.’ AARP Foundation attorney Barbara Jones also noted that ‘Multiple studies indicate that lack of proper dental care can exacerbate several chronic diseases linked to poor oral health, such as diabetes and pneumonia.’ Kirsten Roling, DDS, a dentist who has dedicated her career to high-risk underserved patients, advised the court that: ‘Approximately one in ten cases of death from pneumonia in elderly nursing home residents may be prevented by improving oral hygiene.’”
Mrs. Hall has seen extreme cuts to health care provider rates over the past two years, which has not only impaired her business but the health of her patients who she can no longer afford to treat. What is heartening about Mrs. Hall’s experience, however, is that instead of accepting defeat by a state department, which let’s face it, most of us would have done, she did the necessary research, wrangled support and focused all of her passion and experience on fighting for her business and her patients. Her goal is to keep fighting until denti-cal patients and providers get the payout that they are owed.
Melissa Hall is due to graduate from ALU’s school of law school in 2020 and has managed to keep her business while studying online and taking care of 3 children. Working as a plaintiff for a case against the government has been very exciting, frustrating and eye-opening for her, but it has also inspired her to explore potential political positions so that she can continue to seek changes to government-subsidized healthcare regulations. Mrs. Hall’s experience has surely taught her how empowering knowledge of the law can be and we are excited to see what she accomplishes in the future.