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Federal Legislation for Seniors and the Disabled

Monday, August 24, 2015

On NOTICE: Obama Signs Law Requiring Hospitals to Warn of Costly Medicare Loophole

Many Medicare beneficiaries are being transferred to nursing homes only to find that because they were hospital outpatients all along, they must pick up the tab for the subsequent nursing home stay -- Medicare will pay none of it. 

The new law, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, does not eliminate the practice of placing patients under “observation” for extended periods, but it does require hospitals to notify patients who are under observation for more than 24 hours of their outpatient status within 36 hours, or upon discharge if that occurs sooner. Read more.

Wednesday, March 27, 2013

Discount Drug Plans May Not Be Saving Medicare Money

Preferred-pharmacy plans that promise lower prices for people who agree to buy theirprescription drugs from certain stores may be costing the U.S. Medicare program more money to support, pharmacists said.

While Medicare patients get reduced co-payments in the plans, offered by companies including UnitedHealth Group Inc. (UNH)and Humana Inc. (HUM), the insurers are shifting the burden of those discounts onto the federal government, according to an analysis today by the National Community Pharmacists Association. The agency that runs Medicare told insurers in a Feb. 15 letter that it has begun to scrutinize the costs of preferred pharmacies.

Full story:

Friday, April 8, 2011

HIPAA Violation Results in $4.3 Million Fine to Covered Entity

From the Frederick County Times:

Cignet of Prince George’s County Fined $4.3 Million For Violating HIPAA

The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a Notice of Final Determination finding that Cignet Health of Prince George’s County, Md., (Cignet) violated the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HHS has imposed a civil money penalty (CMP) of $4.3 million for the violations, representing the first CMP issued by the Department for a covered entity’s violations of the HIPAA Privacy Rule.

Tuesday, February 1, 2011

Social Security and Welfare Benefits Going Paperless

In May, the government will no longer pay someone eligible for benefits with a mailed check. Instead, the money will be electronically deposited directly into a bank account or made accessible by a debit card. And by March 2013, the 10 million people who receive checks, out of 70 million people in all, must switch over to direct deposit or use a card.

For the government, the policy is in line with a trend toward paperless banking that will curb theft and save $120 million a year in costs.

But the first of the month won’t be the same anymore.

The change will have social and cultural impact. Some recipients have resisted it because they cannot open an account, or simply because they feel more comfortable with a check in hand.

Full story,

Tuesday, November 23, 2010

Some States Weigh Unthinkable Option: Ending Medicaid (WSJ, 11-22-2010)

Huge budget shortfalls are prompting a handful of states to begin discussing a once-unthinkable scenario: dropping out of the Medicaid insurance program for the poor.

Elected and appointed officials in nearly a half-dozen states, including Washington, Texas and South Carolina, have publicly thrown out the idea. Wyoming and Nevada this year produced detailed studies of what would happen should they withdraw from the program. Wyoming found that Medicaid accounts for 63% of the state's nursing-home revenue.

The idea of abandoning Medicaid as a solution is so extreme that even proponents don't expect any state will follow through, but officials are floating the discussions because dire budgetary pressures have forced them to at least look at even the most drastic options.

Tuesday, October 19, 2010

Health care law fact check: Medicaid and health spending

Starting in 2014, the new health care law will require participating states to cover everyone earning 133 percent of the poverty level or less through Medicaid. It is estimated that this will bring 16 million to 23 million more people into Medicaid. The federal government will pick up nearly all the cost of these newly eligible beneficiaries, starting at 100 percent from 2014 to 2016 and gradually decreasing its share to 90 percent from 2020 onwards.

The impact of this mandate could vary considerably. States such as Texas and Alabama that have had narrow eligibility rules will add far more people to their rolls. But they will also get a lot more federal dollars to cover the extra cost. States such as Massachusetts and New York, whose current rules are more expansive, may see fewer new enrollees, but initially they'll get less federal help to cover them.

Such states could also see savings because many people they have been helping will be eligible for federal subsidies to buy insurance on state-based exchanges.

So what's the bottom line? Estimates vary widely.

Read the whole story:

Saturday, July 17, 2010

Statement by Assistant Secretary Greenlee on the 45th Anniversary of the Signing of the Older Americans Act

The following statement was issued on July 14, 2010 via the Department of Heath and Human Services Administration on Aging eNews Letter:

Statement by Assistant Secretary Greenlee on the 45th Anniversary of the Signing of the Older Americans Act

On July 14, 1965 President Johnson signed the Older Americans Act into law.  Sixteen days later, on July 30, he signed legislation creating Medicare and Medicaid.  These three programs, along with Social Security enacted in 1935, have served as the foundation for economic, health and social support for millions of seniors, individuals with disabilities and their families.  Because of these programs, millions of older Americans have lived more secure, healthier and meaningful lives.  The Older Americans Act has quietly but effectively provided nutrition and community support to millions. It has also protected the rights of seniors, and in many cases, has been the key to independence. 

In 1965, there were about 26 million Americans age 60 and over.  Today, there are 57 million older Americans 60 and over, with many more on the immediate horizon.  Our senior population is not only growing larger, but becoming more diverse.  Adults over 80 are our fastest growing group, and many will need long term care.  Reliance on family members, who currently provide 80 percent of the long term care assistance for our nation's seniors, will increase.

The historic enactment of the Affordable Care Act (ACA) by President Obama on March 23, 2010 provides us with another tremendous opportunity to harness the successes and progress of the last four decades to further improve the health and lives of older Americans and support their caregivers.  The ACA represents the biggest change in our national health care delivery system since 1965.   And just as they were in 1965, the programs of the Older Americans Act - and our national aging network of state, tribal and community-based organizations, service providers, volunteers and family caregivers - will be called upon to complement, support and enhance these changes.  How successfully we weave these multiple responsibilities together will say much for how we will care for seniors in the future.    

The Maine Center for Elder Law is a practice of Perkins Thompson, P.A. The Center assists clients with Medicaid (MaineCare) Planning, Special Needs Planning, Estate Planning, and Probate, Estate & Trust Administration matters in York County, Cumberland County and nearby Maine counties.

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