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Government Benefits

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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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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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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Special Needs Trust with Babette and Fred (VIDEO)

By Estate Planning

 

Babette: One of the things that an elder law attorney specializes in is estate planning for a disabled beneficiary. Many of our clients have children or grandchildren who are suffering from various disabilities and receive governmental benefits. If they receive medicaid, they need to do a special needs trust in order for that beneficiary to be able to receive an inheritance and have their governmental benefits protected. We often work on a team approach doing the estate planning for a family that’s very concerned about a disabled beneficiary.
Fred: The special needs trust is a very exacting document. You must draft the document so that the beneficiary, that is, the disabled person, gets all the benefits from the trust that the creator of the trust intended but at the same time, does not get kicked off medicaid or another governmental benefit. The way you accomplish that is to give to the trustee, whether it be a family member or perhaps a trust department of a bank, the complete discretion as to whether or not to distribute income or principle benefits to the disabled beneficiary so long as everything is done in the best interests of the beneficiary.

September 29, 2010
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Social Security Checks May Get Smaller

By Elder Law, Government Benefits

Clients often come to our office to do Asset Protection Planning. Historically, we have been able to advise them that no creditor put a lien on their Social Security income.
Unfortunately, there is a new legislation that will allow federal agencies to place a lien on Social Security income. If a retiree receiving Social Security owes money to IRS, Veteran Affairs, Department of Education, Department of Agriculture, Army and Air Force Exchange Service or any other federal agency, such debt would result in reduction of his or her Social Security income. Social Security income can’t be reduced to below $750. Tax debts, however, have no floor.
We are afraid it will considerably reduce Social Security income of our elderly and/or disabled. The only recourse for our older and disabled Americans is to lobby against this law with their local legislators.
For more information see article in The Wall Street Journal, March 8, 2010 at This Link.

January 25, 2010
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Lower the Cost of Prescriptions for All Florida Residents with Florida Discount Drug Card

By Government Benefits

Good news! All Floridians can sign up for the Florida Discount Drug Card to save on their prescription medication. The Florida Discount Drug Card is now available to all Florida residents and is accepted at over 60,000 pharmacies nationwide. Florida residents who qualify based on age or income are eligible to receive additional savings.
You can easily sign up, print your card, locate a pharmacy, and compare prescription drug prices at www.floridadiscountdrugcard.com

January 25, 2010
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