Category

Medicaid

Issue Brief: Cal MediConnect-Unmet Need and Great Opportunity in

By | Health Care, ISSUE BRIEF, Medicaid, mltss

CalMediConnect, launched in 2014, is California’s dual eligible demonstration and seeks to integrate Medicare and Medicaid benefits under one health plan. One of its purposes is to better meet the needs of dual eligibles by increasing access to long-term services and supports (LTSS) and providing other value-added services, known in the demonstration as Care Plan Options (CPO). However, evaluation data and beneficiary experience indicate that more can be done to provide care for dual eligibles enrolled in the program. Justice in Aging recently obtained data via a Public Records Act request from California’s Department of Health Care Services that includes LTSS referrals and the number and type of CPO services plans are providing members.

Our issue brief, Cal MediConnect: Unmet Need and Great Opportunity in California’s Dual Eligible Demonstration, provides a brief overview of the Cal MediConnect program and examines the health plan referral data for LTSS and CPO services obtained through the Public Records Act request. It concludes with recommendations for policymakers on ways to strengthen Cal MediConnect through improving access to LTSS and CPO services. These recommendations are of interest to those following Cal MediConnect as well as advocates and stakeholders in other states with their own dual eligible demonstrations.

Read the brief.

Fact Sheet: Make the Expanded Spousal Impoverishment Protection Permanent

By | FACT SHEET, Health Care, Home & Community Based Services, Medicaid, REPORTS

Married seniors and adults with disabilities overwhelming want to live at home and age in place. Increasingly, federal and state Medicaid rules have prioritized home and community-based services (HCBS) which allow people to stay in their homes and in their communities. Congress recently helped these efforts by expanding a Medicaid eligibility rule, known as the spousal impoverishment protection, to individuals eligible for HCBS. The protection makes it possible for an individual who needs a nursing home level of care to qualify for Medicaid while allowing their spouse to retain a modest amount of income and resources. However, the expansion of the spousal impoverishment protection is set to expire on March 31, 2019 unless Congress acts. This means that individuals who qualified under the expanded protection may lose access to Medicaid and to their HCBS and may be left with no choice but to move into institutional long-term care, away from their spouses.

Letting the spousal impoverishment protection expire will hurt families and force more people out of their homes and their communities. We urge Congress to make the expanded spousal impoverishment protection permanent so seniors and people with disabilities can age in place and with dignity.

Justice in Aging has created a fact sheet on the importance of the expanded HCBS spousal impoverishment protection and calling on Congress to make it permanent so seniors and people with disabilities can age in place and with dignity.

Fact Sheet: Medicare Plan Enrollment Changes for Dual Eligibles and Low-Income Subsidy Recipients in California

By | CA Health Network Alert, FACT SHEET, Health Care, Medicaid, Medicare

The Centers for Medicare and Medicaid Services (CMS) issued new rules that limit enrollment and disenrollment from Medicare Advantage and Part D prescription drug plans for low-income Medicare beneficiaries. Previously, dual eligibles – individuals with Medicare and Medi-Cal coverage – and beneficiaries who receive the low-income subsidy (LIS) to make Part D prescription drug coverage more affordable could make enrollment changes any time throughout the year. The new rule, which became effective January 1, 2019, limits enrollment changes to once per quarter.

Justice in Aging has created a factsheet that explains these changes in detail and how they impact low-income Medicare beneficiaries in California.

Florida Faces ADA Lawsuit Over Medicaid Wait List

By | Health Care, IN THE NEWS, In-Home Supportive Services, LITIGATION, Long Term Care, Medicaid, Person-Centered Care Planning, SENIOR POVERTY

WJCT News/WUSF Health: Florida Faces ADA Lawsuit Over Medicaid Wait List (January 2, 2019)

Justice in Aging has filed a class action lawsuit against Florida’s Agency for Health Care Administration. Currently, older adults and people with disabilities could wait up to 3.5 years to access in-home health care. Justice in Aging wants Florida to develop more in-home care services for people and increase the capacity of the services it has. Litigation Director Regan Bailey said “it’s a need that’s growing. And the way to meet that need is to provide more community-based services because you can serve many more people for the same money in the community versus in a nursing facility.”

Report: Older Women & Poverty

By | Economic Security, Health Care, Health Care Defense, Health Disparities, Health Equity, Long Term Care, Medicaid, Medicare, Nursing Homes, Oral Health, Safety Net Defense, SENIOR POVERTY, Social Security, Special Report, Supplemental Security Income

Because of structural inequities that impact women more than men, a significant percentage of older women are struggling to stay out of poverty.

There are 7.1 million older adults living in poverty in the United States, with nearly two out of three of them being women. Women like Venorica, who is working three jobs at the age of 70, and Vicky, who once ran a successful business with her husband, are struggling to stay afloat.

A new Justice in Aging report surveys the reasons more women are aging into poverty than men, discusses the support systems that are in place to help older women, and recommends ways we can strengthen and expand those support systems. The brief is accompanied by videos of women telling their own stories. Older women have cared for us and worked hard all of their lives. It’s imperative that we enact policies so they don’t have to struggle to make ends meet.

READ THE REPORT
WATCH THE VIDEOS HERE

Free Webinar: The Impact of Medicaid Work Requirements on Family Caregivers and Older Adults

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

When: Thursday, December 13, 2018 from 10am – 11 am PT/ 1 pm -2pm ET.

Medicaid is an important source of health insurance coverage for many of the 40 million family caregivers in the United States who do not have access to other affordable coverage options. However, many states are in the process of designing or implementing policies that require family caregivers and others who are eligible for Medicaid to work a certain number of hours per month or qualify for an exemption to maintain their health coverage. Despite “caregiver” exemptions, these burdensome work requirements will cause many family caregivers who are in fact eligible for Medicaid to lose their coverage.

This webinar highlights key findings from a new Justice in Aging issue brief. We discuss our state-by-state survey of how Medicaid work requirements apply to family caregivers and analysis of the particular harms they will cause to family caregivers and the older adults they care for.

Closed captioning is available on this webinar. 

Learn more and read the brief

Who Should Participate:
Aging, family caregiver, and legal advocates and others wanting to learn more about how Medicaid work requirements impact family caregivers and older adults.

Presenters:
Natalie Kean, Staff Attorney, Justice in Aging
Lynn Friss Feinberg, Senior Strategic Policy Advisor, AARP Public Policy Institute

Moderator: 
Jennifer Goldberg, Directing Attorney, Justice in Aging

This webinar took place on Thursday, December 13, 2018 from 10am – 11 am PT/ 1 pm-2pm ET.

WATCH THE WEBINAR
DOWNLOAD THE POWERPOINT

Issue Brief: Medicaid Work Requirements and Family Caregivers

By | Health Care, Health Care Defense, ISSUE BRIEF, Medicaid, REPORTS, Safety Net Defense, SENIOR POVERTY

Medicaid Work Requirements can cause family caregivers to lose their health coverage, putting their health and the health of the older adults they care for in jeopardy.

With Thanksgiving on the horizon, our thoughts are on families and the 40 million family caregivers who provide care to an adult family member. Medicaid is an important source of health insurance coverage for those family caregivers who do not have access to other affordable coverage options. However, many states are in the process of designing or implementing policies that require family caregivers and others who are eligible for Medicaid to work a certain number of hours per month or qualify for an exemption to maintain their health coverage.

Implications for family caregivers

Low-income family caregivers may be unable to work sufficient hours at a paid job because of their caregiving responsibilities and may not qualify for the state’s exemptions. As a result, many will lose access to health care they need to maintain their own health, harming both their own well-being and the well-being of the older adults they care for.

A new Justice in Aging issue brief provides a state-by-state survey of how Medicaid work requirements apply to family caregivers and explains the harms they will cause to family caregivers and the older adults they care for.

READ THE BRIEF

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 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.