Category

Health Care

Issue Brief: Medicaid Enrollees Put at Risk When State Medicaid Programs Assume Support from Family Caregivers

By | Health Care, Health Care Defense, ISSUE BRIEF, Medicaid

A new Issue Brief reveals how states’ assumptions often deprive Medicaid recipients of needed assistance.

Under Medicaid law, all assistance by friends and family members must be voluntary. This brief, based on a review of over 100 administrative decisions in several states, shows how Medicaid programs violate this law to the detriment of people on Medicaid. Medicaid programs often deny services based on family assistance that is not available. This puts lives at risk, increases the chances that a beneficiary will have to be institutionalized, and forces families to make impossible choices between caring for a family member and going to work.

The issue brief outlines states’ responsibility to respect the voluntary nature of assistance, examines how some states approach the issue, and suggests public policy responses to ensure that states authorize adequate assistance.

Rachel Gershon, of the University of Massachusetts Medical School’s Center for Health Law and Economics co-authored this paper with Justice in Aging attorney, Eric Carlson. The paper is part of a post-fellowship project with Justice in Aging and the Borchard Foundation Center on Law and Aging. 

Free Webinar: Improvements to the Qualified Medicare Beneficiary Program (QMB) – Part Two

By | Health Care, Medicare, WEBINAR, Webinar Trainings

Part 2: Tuesday, September 25, 2018 at 11:00 a.m. PT / 2:00 p.m. ET.

The Qualified Medicare Savings Program (QMB) helps low-income Medicare beneficiaries pay for their health insurance by covering Part A and B premiums and cost-sharing. State Medicaid programs, which administer QMB, have a responsibility to screen for eligibility, but many individuals still face challenges enrolling into the QMB program. Another challenge is that even after beneficiaries are enrolled in the program, some Medicare providers, in violation of federal law, bill QMBs for costs covered by Medicare. In the past two years, the Centers for Medicare and Medicaid Services (CMS) has implemented a number of changes to the QMB program, which touch both beneficiaries and providers, and are designed to reduce improper billing.

This two-part webinar, The Qualified Medicare Beneficiary Program: Eligibility, Challenges, and New Developments, provides an overview of the QMB program and eligibility criteria. The webinar also covers challenges to eligibility and under-utilization, and reviews the recent CMS administrative changes intended to curb improper billing.

Part Two of the two-part webinar provides:

  • An overview of the improper billing rules under the QMB program
  • A review of the recent CMS administrative changes

Who Should Participate: 

  • Aging and legal advocates, community-based providers, health plan leadership, and others wanting to learn more about the QMB program and improper billing.

Presenters:
Georgia Burke, Justice in Aging
Denny Chan, Justice in Aging

Part Two took place on Tuesday, September 25, 2018.

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Additional Materials

Free Webinar: Improvements to the Qualified Medicare Beneficiary Program (QMB) – Part One

By | Health Care, Medicaid, Medicare, WEBINAR, Webinar Trainings

Part 1: Monday, September 24, 2018 at 11:00 a.m. PT / 2:00 p.m. ET.

The Qualified Medicare Savings Program (QMB) helps low-income Medicare beneficiaries pay for their health insurance by covering Part A and B premiums and cost-sharing. State Medicaid programs, which administer QMB, have a responsibility to screen for eligibility, but many individuals still face challenges enrolling into the QMB program. Another challenge is that even after beneficiaries are enrolled in the program, some Medicare providers, in violation of federal law, bill QMBs for costs covered by Medicare. In the past two years, the Centers for Medicare and Medicaid Services (CMS) has implemented a number of changes to the QMB program, which touch both beneficiaries and providers, and are designed to reduce improper billing.

This two-part webinar, The Qualified Medicare Beneficiary Program: Eligibility, Challenges, and New Developments, provides an overview of the QMB program and eligibility criteria. The webinar also covers challenges to eligibility and under-utilization, and reviews the recent CMS administrative changes intended to curb improper billing.

Part One of the two-part webinar:

  • Provides an overview of the QMB program, including eligibility and utilization
  • Looks at challenges to enrollment, including state enrollment procedures and data transfer issues
  • Discusses recent improvements in enrollment procedures for individuals who need QMB because they do not have premium-free Medicare Part A.

Who Should Participate: 

  • Aging and legal advocates, community-based providers, health plan leadership, and others wanting to learn more about the QMB program and improper billing.

Presenters:
Georgia Burke, Justice in Aging
Denny Chan, Justice in Aging

Part One took place on Monday, September 24, 2018.

WATCH THE RECORDING
DOWNLOAD THE POWERPOINT

Additional Materials

Fact Sheets: New Resources on How Trump’s Public Charge Impacts on Older Adult Immigrants

By | CA Health Network Alert, Economic Security, FACT SHEET, Health Care, Medicaid, Social Security

Advocates are preparing to respond to a new “public charge” rule from the Trump Administration that would put immigration status at risk if an immigrant seeks access to an array of programs that support health, nutrition, and economic stability.

If implemented, this rule would harm older immigrants, their families, and caregivers. The rule would make it much more difficult for U.S. citizens and residents to welcome aging parents or other family members into the country. Seniors and their families may be afraid to go to the doctor or get helping paying for food or rent. Additionally, many immigrant older adults work as caregivers for very low pay. This rule would make it harder for them to access benefits like Medicaid and SNAP (Supplemental Nutrition Assistance Program).

Justice in Aging has a new fact sheet that provides an overview of the harms to older adults, their families, and caregivers that the Trump Administration’s changes to the “public charge” rule pose.  A California fact sheet provides an overview of these harms looking at California-specific data and programs.

AARP’s Asian American Pacific Islander Community Honors Denny Chan with its 2018 Hero Award

By | Health Care Defense, PRESS RELEASE, Safety Net Defense, SENIOR POVERTY
Oakland, CA (August 20, 2018) –Justice in Aging is proud to announce that the Asian American and Pacific Islander Community of AARP has honored Justice in Aging attorney Denny Chan with its annual Hero Award.

Every year, for the past three years, the AARP AAPI Hero Awards have recognized volunteers and non-profit organization staff members who work tirelessly behind the scenes serving Asian Americans and Pacific Islanders over 50 years of age. The award was announced on Facebook on August 16. You can watch the winning video about Denny’s good work on behalf of low-income older adults. Read More

Fact Sheet: SSA Clarifies Handling of Medicare Part A Conditional Applications

By | FACT SHEET, Health Care, Medicare, Social Security
Many people do not have enough work history to qualify for premium-free Medicare Part A benefits, however there is still an option for low-income individuals to get their Medicare Part A premiums paid.

A new Justice in Aging fact sheet details how they can enroll in the Qualified Medicare Beneficiary (QMB) Program to get their Medicare premiums paid through their state Medicaid program. Enrolling in QMB can be confusing for people without Part A coverage and often requires visits to both the Social Security Administration office and the state’s Medicaid program offices. A further complication is that many Social Security offices have used conflicting and incorrect procedures or provided misinformation to applicants. Read More

How to Access Care for a Senior Who Doesn’t Speak English

By | Health Care, Health Equity, IN THE NEWS, NEWS

Caring.com: How to Access Care for a Senior Who Doesn’t Speak English (Aug. 2, 2018) For older adults who don’t speak English, accessing the health care they need can be difficult. However, seniors have the legal right to interpretation and translation services from health care providers that receive federal dollars through a provision of the Affordable Care Act. The problem is, seniors often do not know they have this right or how to exercise it. Justice in Aging attorney, Denny Chan lays out for this article what rights LEP seniors have, while the adult day care provider, On Lok Lifeways offers an good illustration of what culturally competent care for seniors with limited English can look like. “It’s an anxious time for people who don’t speak English as their primary language because there’s been a number of efforts to chip away at the protections they have,” said Chan. Read the full article.

Advocate Guide: Accessibility in Medicaid Managed Care

By | Advocate's Guide, Health Care, Medicaid, mltss

States require managed care plans who serve Medicaid enrollees to establish and maintain an internal grievance and appeal and fair hearing system. As states begin to incorporate new federal regulations into their Medicaid rules, there’s opportunity for advocates to help shape those rules to ensure that older adults and people with disabilities have equal access to the grievance and appeal and state fair hearing systems, as mandated by Section 504 of the Rehabilitation Act (“Rehab Act”), the Americans with Disabilities Act (“ADA”), and Section 1557 of the Affordable Care Act (“ACA”).

Disability Rights Education and Defense Fund (DREDF), Justice in Aging and National Health Law Program (NHeLP) collaborated on a new Advocates Guide to Accessibility in Medicaid Managed Care Grievances, Appeals, and State Fair Hearing. This new Advocates’ Guide, provides guidance on how the federal framework can be made fully accessible to Medicaid beneficiaries who are older and/or have disabilities.

Links to three accessible versions of the guide can be found below.

 

Press Release: White Paper Stresses Importance of Oral Health Care Benefit for Older Adults

By | Health Care, Medicare, Oral Health, PRESS RELEASE

Washington, DC 2018 – Justice in Aging, along with a diverse group of partners, released a white paper, An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care. This white paper is an interprofessional, collaborative effort written and published by leaders in the consumer, healthcare and dental fields, including the American Dental Association, Center for Medicare Advocacy, the Dentaquest Foundation, Families USA, Justice in Aging, Oral Health America and the Santa Fe Group.

With an expected 72.1 million seniors living in the United States by 2030, An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care, outlines the need for oral health care coverage for Medicare recipients and the importance of it being integrated with, and elevated to, the same importance as the rest of health care in Medicare. Read More

White Paper: An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care

By | Health Equity, ISSUE BRIEF, Medicare, Oral Health

Oral health is an integral part of overall health. Oral health problems can adversely affect one’s ability to maintain optimal nutrition, self-image, social interactions, and mental and physical health. Oral health problems can lead to chronic pain, tooth loss and serious infections. Poor oral health can even worsen chronic medical conditions such as heart disease and diabetes.

Older adults need timely and affordable access to dental care in order to maintain their health and well-being, yet, there is currently no mechanism for most older adults to access care. Contrary to what many believe, Medicare does not include an oral health benefit. Most older adults cannot afford to purchase private oral health insurance or pay out-of-pocket for the care they need. As a result, 70 percent of Medicare recipients have limited or no dental coverage, and fewer than half see a dentist each year.

A new White Paper, An Oral Health Benefits in Medicare Part B: It’s Time to Include Oral Health in Health Care discusses how a Medicare Part B dental benefit would close disparities in dental use and expense between the uninsured and insured and among older adults with few financial resources and limited oral health education. The paper also details how such a benefit could be structured and the legislative changes that would need to happen before such a benefit could be established.