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Katrina Cohens

WEBINAR: Implementation of Hart v. Berryhill (Colvin) – Class action settlement

By | Income Network Alert, Social Security, Supplemental Security Income, WEBINAR | No Comments

Focused on class members with open claims

When: August 10, 2017

Hart v. Berryhill (Colvin) is a Social Security and SSI disability class action that challenged the Social Security Administration’s continued use of medical reports from Dr. Frank Chen even after he had been disqualified from performing medical examinations for Social Security because of serious deficiencies in his reports. The settlement, which was approved on April 25, 2017, provides an opportunity for new disability determinations for many class members.

Implementation of the settlement has begun. Social Security mailed the first wave of notices to class members with open claims to inform them of their rights under the settlement in mid-July. A second, larger wave of notices for people whose claims have been closed will likely go out in mid-September.

To help advocates in assisting Hart class members, Justice in Aging is holding a number of trainings on the process of obtaining relief under the settlement. This first training focuses on the first wave of notices that went out in July 2017 to class members with open claims (meaning that there was an active administrative appeal in process on the claim involving the Dr. Chen report, as of April 25, 2017). It briefly reviews the settlement relief for all class members, and then goes into detail about the relief for class members with open claims, and considerations about whether to request relief.

You can read more about the case and the settlement agreement here.

Presenters:
Gerald McIntyre, Special Counsel, Justice in Aging
Trinh Phan, Senior Staff Attorney, Justice in Aging

WATCH THE WEBINAR
DOWNLOAD THE POWERPOINT
READ THE ALJ GUIDANCE

Court Certifies Nationwide Class in “Observation Status” Case

By | Health Care, Medicare, PRESS RELEASE | No Comments

Decision in Alexander v. Price Means Medicare Patients Could Gain Right to Appeal Placement on “Observation Status” and Avoid Large Medical Bills

August 1, 2017 – Eighty-four-year-old Nancy Niemi of North Carolina was hospitalized for 39 days earlier this year after her doctor sent her to the emergency room. It took weeks to stabilize her blood pressure and she experienced serious complications. But unbelievably, Ms. Niemi was categorized as an outpatient on “observation status” for her entire hospitalization, and she therefore lacked the three-day inpatient stay Medicare requires for coverage of her subsequent, very expensive care at a nursing home. Ms. Niemi’s son tried to help her challenge her lengthy placement on observation status, but Medicare does not allow beneficiaries to appeal this issue. She still owes thousands of dollars to the nursing facility. However, due to the federal court decision issued July 31, 2017, she is now a member of a nationwide class of hospital patients who may gain the right to appeal their placement on observation status.
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In Reckless and Irresponsible Move, Senate Votes to Proceed on Repeal of the ACA

By | Health Care, Medicaid, PRESS RELEASE | No Comments

Below is a statement by Executive Director Kevin Prindiville of Justice in Aging

Today, the Senate took a reckless and irresponsible step towards gutting healthcare for older adults and others, and removing critical consumer protections that save lives. With Vice President Pence casting the tie-breaking vote, the Senate voted to begin a curtailed 20-hour debate on several bills that would drastically change our health care system, stripping coverage from millions of Americans and cutting over $750 billion from Medicaid. Any bill that emerges from such a chaotic process would have devastating effects on older Americans and their families.
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Bill in Congress Aims to Address Poverty Among Older Adults and People with Disabilities

By | PRESS RELEASE, Supplemental Security Income | No Comments

Washington, DC—(July 19, 2017) 85-year-old Ortencia boils soup bones with vegetables she gets from the food bank to stretch her weekly food allotment and stay healthy. 61-year old Carey endures numerous aches and pains to carry groceries home from the bus, the cheapest form of transportation. Both struggle to survive on Supplemental Security Income (SSI), a need-based program administered by the Social Security Administration (SSA) that provides a very basic income to older adults and people with disabilities. Major provisions of the program haven’t been updated since it was created in 1972, and as the program fails to keep up with the cost of living, the 8.3 million people who rely on it to pay rent, buy food, and meet other basic needs keep falling further below the poverty line.

Representative Grijalva (D-AZ) introduced the SSI Restoration Act of 2017 in Congress today, with the support of 36 representatives and more than 80 organizations. The SSI Restoration Act puts forth solutions intended to help people like Ortencia and Carey make ends meet. The act increases the amount of money individuals can receive to supplement their income from both employment and non-employment sources; it increases the amount of assets individuals and couples can save for emergencies to a limit that’s more in line with today’s dollars; it repeals a provision that discourages people from seeking help from family; and removes the marriage penalty, among other adjustments.
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CBO Score Confirms Latest ACA Repeal Bill Will Lead to Devastating Coverage Losses and Sharply Higher Premiums

By | Health Care, Medicaid, PRESS RELEASE | No Comments

Below is a statement by Executive Director Kevin Prindiville on the Obamacare Repeal Reconciliation Act of 2017 (ORRA)

Today the non-partisan Congressional Budget Office (CBO) confirmed what we already knew: repealing the Affordable Care Act and delaying replacement will wreak havoc on our health care system. According to the CBO’s report, the Senate’s latest bill would strip coverage from 32 million Americans and cause health insurance premiums to nearly double in the next decade.
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Justice in Aging’s Statement on Senate ACA Repeal Efforts

By | Health Care, Medicaid, Medicare, PRESS RELEASE | No Comments

Senate leadership has announced that they will no longer move forward with the Better Care Reconciliation Act (BCRA) of 2017. Instead, they seek to proceed to a vote to immediately repeal the Affordable Care Act, and delay replacement to a later date.

While we are relieved that the BCRA, and its unprecedented cuts to Medicaid, is off the table, repealing the ACA remains a terrible idea that would harm older adults—especially in the absence of a meaningful replacement bill.

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Patient advocates say Medicaid per capita caps would demolish long-term care for elderly

By | IN THE NEWS, Long Term Care, Medicaid | No Comments

Modern Healthcare: Patient advocates say Medicaid per capita caps would demolish long-term care for elderly (7/11/2017) Justice in Aging’s Jennifer Goldberg discusses the harmful consequences of the recent Senate bill aimed to repeal and replace the Affordable Care Act. “Over two-thirds of Medicaid spending is considered optional under federal law. If the federal government starves Medicaid through per capita caps, optional services will be the first to be cut.” Optional services include home-based care and adult day care.

California Lawsuit Aims To Protect Spouses Of Disabled From Financial Ruin

By | CA Health Network Alert, IN THE NEWS, In-Home Supportive Services, Long Term Care, Medicaid, Nursing Homes | No Comments

California Healthline: California Lawsuit Aims To Protect Spouses Of Disabled From Financial Ruin (7/10/2017) Justice in Aging, along with partner advocacy groups, filed a lawsuit against the State of California for failing to implement a Medicaid federal spousal impoverishment law meant to protect patients and their partners from becoming impoverished while paying for in-home care. Plaintiffs seek to compel the State of California to implement the law back to January 1, 2014, to notify individuals who potentially were eligible for the protections of their rights, and to reimburse them for any out-of-pocket expenses they paid that should have been free.

Proposed Cuts to Medicaid Put Medicare Savings Programs At Risk

By | ISSUE BRIEF, Medicare, REPORTS | No Comments
For low-income older adults who are eligible for Medicare but can’t afford the premiums, co-pays, and deductibles, Medicare Savings Programs (MSPs) have been a lifeline–making it possible for millions to get Medicare-covered care. However, the huge cuts to Medicaid that both the House and Senate ACA-repeal plans propose could cause states to limit participation in the program, causing many to be priced out and lose access to care.

MSPs currently reach over 7 million people with Medicare. Many are too poor to afford Medicare but do not qualify for other Medicaid programs. This issue brief discusses how the program is structured and administered and outlines how cuts in Medicaid could force cuts to the program. Read More

Medi-Cal Recipients Sue California for Failing to Ensure Seniors and People with Disabilities Can Stay in Their Homes

By | Medicaid, PRESS RELEASE | No Comments

July 6, 2017 – The State of California has failed to implement a federal law that requires Medi-Cal to implement eligibility rules intended to prevent one spouse from going broke while paying for at-home care for a spouse with a disability, according to a class action lawsuit filed today, Kelley v. Kent (LA. Super. Ct.).

When one spouse has chronic conditions requiring home-based care, the other spouse must balance the cost of that care against the couple’s basic needs. The federal law allows a person to get needed home-based services in certain instances in which a couple has income or resources higher than the typical maximum limit to qualify for Medicaid. Though the federal rule has been in effect for three and a half years, California has failed to implement it, forcing many families to teeter on the brink of financial ruin in an effort to care for their loved ones at home. The case was filed in Los Angeles Superior Court today by Bet Tzedek, Justice in Aging, Disability Rights California, and Western Center on Law and Poverty with pro-bono partner McDermott Will & Emery.

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