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Babette B. Bach, Esq. to Speak for the Jewish Foundation of Sarasota-Estate Planning Sarasota

By Estate Planning, Firm News, Medicaid Planning, Medicare

Babette Bach will be the keynote speaker for a seminar March 20, 2013 at the Jewish Foundation in Sarasota. Topics will include estate planning and the basic recommended documents to have in place, Medicare and Medicaid Planning.

Ms. Bach is looking forward to speaking to the members of the community on such an important topic. She appreciates the invite to lecture.

If you need legal advice for estate planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

March 14, 2013
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Babette B. Bach, Esq. to speak for the Women’s Club of the Palm Aire Country Club

By Estate Planning, Firm News, Medicaid Planning, Medicare

Babette Bach will be the keynote speaker for a seminar March 15, 2013 at the Palm Aire Country Club in Sarasota. Topics will include estate planning and the basic recommended documents to have in place, Medicare and Medicaid Planning.

Ms. Bach is looking forward to speaking to the members of the woman’s club on such an important topic. She appreciates the invite to lecture.

If you need legal advice for Estate Planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

March 5, 2013
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Medicare and Medicaid Benefit Program Recipients Wonder how Reform Will Affect Benefits in 2013

By Medicaid Planning, Medicare

The end of the year approaches and uncertainty grows.  Policy leaders in the U.S. have yet to reach an agreement on a policy package which will help the U.S. economy avert the pitfalls associated with the scheduled spending cuts and tax increases.

One side calls for increased tax, another for reduced government spending.  The budget remains deadlocked.  Many Americans want to know how political policy revisions will affect the deficit and supplemental programs.

State and federally funding programs, such as Medicaid and Medicare, remain on the table for revisions and recipients are concerned.

Medicare spending totaled $492 billion in 2012 and that total is expected to rise over the next 10 years.  Health care costs continue to skyrocket.  This rise plus incline in lifespan is playing havoc on the deficit.  Both Republicans and Democrats believe that reform is needed.  Measures must be taken to improve Medicaid and Medicare.  Experts believe there is not enough time in 2012 to work out a long tem solution.  Short term deals will be made regarding the end of the year budget with long term plans being reviewed after the New Year.

If you need advice for Medicare or Medicaid planning, estate planning, probate and trust administration or VA benefits, please contact our office at (941) 906-1231 for an initial consultation.

December 9, 2012
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Babette B. Bach, Esq. to Speak at the Institute of Advanced Medicine

By Firm News, Medicaid Planning, Medicare

 Babette Bach will be the keynote speaker for a seminar on November 21, 2012 at the Institute of Advanced Medicine in Sarasota, Florida.  Topics will include Medicare and Medicaid, along with elder law advice on financial matters and asset protection planning.

Ms. Bach is looking forward to speaking to the members of the hospital staff on such important topics.

If you need legal advice for estate planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

November 16, 2012
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Babette B. Bach, Esq. to Speak on Medicare Changes for 2013 Post-Election

By Firm News, Medicare

 Babette Bach will be the keynote speaker for a seminar on November 14, 2012 at Kobernick House in Sarasota, Florida regarding potential Medicare changes in 2013.  Topics will include potential Medicare changes now that the election is over, what is already in place despite the election and what could change after the election based on the outcome of the election.

Ms. Bach is looking forward to speaking to the community on such an important topic.

If you need legal advice for estate planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

November 12, 2012
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Babette B. Bach, Esq. to Speak for Suncoast Paralegal Association

By Firm News, Medicaid Planning, Medicare, Veterans Affairs

 Babette Bach will be the keynote speaker for a seminar on November 12, 2012 at Marina Jacks in Sarasota, Florida for our local Suncoast Paralegal Association.  Topics will include Medicare and Medicaid benefits, along with Veterans Benefits and Estate Planning.

Ms. Bach is looking forward to speaking to the members of the association on such important topics.  She appreciates the invite to lecture to paralegals from all fields of the law.

If you need legal advice for estate planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

November 6, 2012
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Landmark Decision for Medicare Recipients Increasing Medicare Coverage for Home Care and Skilled Nursing Rehabilitation

By Elder Law, Government Benefits, Long-Term Care, Medicare

Historically well informed Elder Law advocates have challenged the denial of Medicare coverage for a full 100 days in skilled care after a three night hospital stay under the premise that this common practice is not consistent with federal law.  Finally this denial of coverage may end thanks to a landmark class action settlement.

            Those receiving rehabilitation in skilled care or Medicare home care have historically been told that coverage will end when the patient is no longer showing signs of improvement.  However, neither Medicare law nor any Medicare regulations require the patient show a likelihood of improvement.  But this became “the” accepted practice due to provisions of the Medicare manual and guidelines use by Medicare contractors which suggested that coverage should be denied or terminated when a patient reaches a plateau or is not improving or is stable.

            This settlement should result in increased Medicare coverage for rehabilitation in skilled care and home care if the services are needed to “maintain the patient’s current condition or prevent or slow further deterioration.”

            Under a proposed settlement expected to be approved by a Federal Judge this week,  Federal officials will rewrite the Medicare manual to make it clear that Medicare coverage of nursing and therapy services does not turn on the presence or absence of an individual’s potential for improvement but is based on the patient’s need for care.

            While this may increase the Medicare budget it is an honest reflection of what the law is currently.  Is it an honest correction of a misapplication of regulations interpreting the law.

Many beneficiaries may now be able to continue Medicare home care and thereby avoid skilled care.  In these cases, Medicare costs may actually be reduced by keeping the patient at home.  Many more patients should be able to receive the full 100 days of skilled nursing services, so long as the care is required to maintain the patient’s current condition.

If you need legal advice for estate planning, Medicaid planning & Medicare, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

October 26, 2012
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People with Medicare Beware- COBRA is Not Coverage as a “Current” Employee

By Medicare

There is an increase in the number of Medicare beneficiaries who are delaying beyond age 65 to enroll in Medicare Part B.   They are thinking that because they pay for and receive health coverage under COBRA that they do not need to enroll in Medicare Part B.  This is incorrect and comes with heavy penalties.

The beneficiary who does not enroll during the initial enrollment period at their 65th birthday must wait to enroll in the next general enrollment period (January-March) and the coverage does not begin until July 1st of that year.  Further, there is a 10% late penalty assessed to the standard monthly premium for every 12 months of delayed enrollment in Part B.  This penalty has no durational limit, so it continues for the lifetime of the Medicaid beneficiary.

Beneficiaries may, however, qualify for a Special Enrollment Period to enroll in Plan D if the drug coverage they had under COBRA is considered creditable coverage.  The individual will have to pay a penalty if there is a continuous period of 63 days or longer after the individual’s initial enrollment period.

If you need legal advice for probate and trust administration, tax advice, estate planning, Medicaid planning, or VA planning, please contact our office for an initial consultation at (941) 906-1231.

September 13, 2012
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New Face to Face Meeting Requirements for patients receiving Medicare, Home Care or Hospice

By Long-Term Care, Medicare

New Face to Face Meeting Requirements for patients receiving Medicare, Home Care or Hospice

By Babette B. Bach Esquire, Sarasota, FL

A requirement that health care providers have a face-to-face meeting with patients was added as a Medicare payment requirement for home health and hospice care by the Affordable Care Act (ACA). Implementation of the requirement was effective April 1st 2011.The Face-to-Face requirement is intended to be a tool for reducing fraud and abuse by assuring that physicians or other healthcare providers have actually met with potential home health patients to determine their specific care needs.

The specifics of the Face-to-Face requirement for home health care are included in CMS regulations that were issued on November 17, 2010.  The regulations establish that a face-to-face encounter must have “occurred no more than 90 days prior to the home health start of care date or within 30 days of the start of the home health care by including the date of the encounter.” The certification of the need for home health care must include an explanation as to why the physician’s clinical findings support the need for home health care, including that the patient is homebound and the need for either intermittent skilled nursing services or therapy. Regulations provide that a face-to-face encounter can be by tele-health as provided in the Social Security Act.

If the face-to-face encounter occurred within 90 days of the start of care, but was not related to the primary reason that the patient requires home health services, or if the patient has not seen the certifying practitioner within the 90 days, the practitioner must have a face-to-face encounter with the patient within 30 days of the start of the home health care.

If you need legal advice for estate planning, Medicaid planning, or VA planning, please contact our office for an initial consultation.

 

Babette B. Bach, Esquire, Board Certified Elder Law

Bach & Jacobs, P.A.

240 S. Pineapple Avenue, Suite 700

Sarasota, FL 34236

941-906-1231

941-954-1185 facsimile

www.bachjacobs.com

 

June 11, 2012
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Frequently Asked Questions about the Americans with Disabilities Act

By Elder Law, Government Benefits, Medicare
The Americans with Disabilities Act (ADA of 2008 is a federal law that prohibits discrimination against individuals with disabilities.)
To whom does the Act apply?
Title 1 of the ADA covers employment by:
private employers with 15 or more employees, state and local government and Federal sector
In addition, most states have their own laws prohibiting employment discrimination on the basis of disability.
A two-step process is used to determine whether an individual with a disability is qualified:
  • Determine whether the individual satisfies the prerequisites for the position such as possessing the appropriate educational background, etc;
  • Determine whether or not the individual can perform the essential functions of the position held or desired.
When is cancer a disability under the ADA?
Cancer is a disability under the ADA when it or its side effects substantially limit(s) one or more of a person’s life activities.The ADA includes 2 non-exhaustive lists of “major life activities.”
Walking, seeing, breathing, working, reading, bending and communicating
The second list includes major bodily functions (immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine and reproductive functions)
Even when cancer itself does not substantially limit any major activity (such as when it is diagnosed and treated early), it can lead to the occurrence of impairments that may be disabilities.
Do employers have full access to medical information?
Title 1 of the ADA limits an employer’s ability to ask questions related to disability or conduct medical examinations at 3 stages: pre offer, post offer, and during employment.

  • An employer may not ask whether the job applicant has or had cancer or about treatment related to cancer prior to making a job offer.
  • An employer can ask an applicant questions pertaining to the performance of the job (whether he can lift weight, can travel out of town; whether he/she can work rotating shifts, etc.)
  • A person with cancer is permitted to request an accommodation after becoming an employee, even if she did not ask for one when applying for the job or after receiving the job offer.
  • With limited exceptions, an employer must keep confidential any medical information it learns about an applicant or employee.
  • Telling co-workings that an employee is receiving a reasonable accommodation amounts to a disclosure of the employee’s disability.
What protection is there against discrimination?
Employers and their agents may not discriminate against a qualified individual with a disability because of such disability in any aspect of the employment relationship.
Focus is on the following: hiring, pay, benefits, segregation, advancement, discharge, training, testing and contractual arrangements.
What is reasonable accommodation?
Employer must reasonably accommodate a qualified individual with a disability unless to do so would cause an undue hardship.  There is no precise definition of reasonable accommodation.
Examples include: making existing company facilities accessible; permission to work at home; modification of office temperature; permission to use work telephone to call doctors; reallocation or redistribution of marginal tasks to another employee; job restructuring; reassignment to a vacant position; medical leave; providing qualified readers or interpreters; acquisition or modification of equipment or devices.
BUT! An employer is not obligated to provide personal use items such as glasses or hearing aid.
What does undue hardship mean?
Undue hardship means an action requiring significant difficulty or expense in, or resulting from, the provision of the accommodation.Factors to be considered:

  • The overall financial resources of the employer;
  • The number of persons employed by the employer;
  • The nature and cost of the accommodation needed, etc.
How is this legally enforced?
Any person who believes that his/her employment rights have been violated on the basis of disability and wants to make a claim against an employer must file a charge of discrimination with the US Equal Employment Opportunity Commission (EEOC).
May 13, 2010
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