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Managed Care & Persons with Disabilities & Chronic Illnesses

The Americans with Disabilities Act


George Lyon, J.D., Associate General Counsel, Office of the General Counsel Civil Rights Division, U.S. Department of Health and Human Services, Washington, DC.

In this session, George Lyon discussed the relevant provisions and some of the implications of the Americans with Disabilities Act (ADA) and other discrimination statutes with respect to initiatives enrolling persons with disabilities into managed care arrangements.

Mr. Lyon began by providing an overview of the Act and then took a more detailed look at its Title II, which prohibits discrimination by public entities, including State and local governments and their "instrumentalities" (which, in turn, may include contractors such as health plans). He also discussed the prohibitions against discrimination contained in Section 504 of the Rehabilitation Act of 1973, which preceded the ADA.

Mr. Lyon then discussed possible problem areas that States must keep in mind when designing their managed care initiatives, including:

  • The establishment of separate or different programs for persons with disabilities.
  • Eligibility requirements based on disability.
  • Outcomes-based distinctions.
  • Physical accessibility issues.


Helen L. v. Albert L. DiDario [online]. 46 F.3d 325. Available from the Internet:

Alexander, et al. v. Choate, et al. [online]. 469 U.S. 287, 105 S.Ct. 712. Available from the Internet:

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