Category

REPORTS

New Fact Sheet: The Dangers of AHCA for Older Adults

By | FACT SHEET, Health Care, Medicaid, REPORTS | No Comments

Because of the Affordable Care Act (ACA), more older adults get health insurance coverage and receive the supports they need to remain in their homes as they age. The American Health Care Act (AHCA), the Republican “repeal and replace” bill, would take away health insurance for 24 million Americans and cut Medicaid funding by 25 percent over the next ten years.

The bill poses many dangers for older adults today and in the future, as it would:

  • Raise the costs of insurance and health care
  • Put pressure on state budgets
  • Lead to cuts in services
  • Undermine the financial stability of Medicare

Read our fact sheet for more information

QMB Identification Practices: A Survey of State Advocates

By | ISSUE BRIEF, Medicare, REPORTS | No Comments

Ensuring that Qualified Medicare Beneficiaries (QMBs) are not illegally billed for Medicare costs requires improvements on many fronts. One important piece is better identifying QMBs and informing both QMB consumers and their providers that they are subject to billing protections. Justice in Aging is pleased to share two new important resources contributing to that effort.

QMB Identification Survey
The new issue brief, authored by legal services attorney Peter Travitsky, looks at practices in 13 states in identifying QMBs. It finds that, although several states provide no QMB identification cards, others offer examples of best practices to ensure that QMB consumers and their providers know their protected status. The survey was supported by a post-fellowship grant from the Borchard Foundation Center on Law and Aging.

Incorporating QMB protections into Medicare notices
In October 2017, the Medicare program will be rolling out revised Medicare Summary Notices (MSNs) to QMB consumers and revised remittance advice notices to providers. On both notices, for each covered service, a notation will show that the individual is a QMB and that the co-insurance responsibility for each service is zero. To prepare providers for the revised system, CMS released a new Medicare Learning Network Matters article, Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System. As the new system is implemented, the article will be a useful tool for advocates to share with providers and their billing departments.

Visit the improper billing webpage, where you can find many more resources including a toolkit that with model letters to providers, an issue brief on recent improvements in QMB reporting and enforcement, recordings of past webinars on QMB billing and other valuable tools, including an improper billing tracking form that you can use to report instances of improper billing to inform our advocacy.

Fact Sheet: Medicaid Caps & Cuts Harm Older Women

By | FACT SHEET, Medicaid, REPORTS | No Comments

Medicaid provides essential care for women throughout their lives—from family planning and maternal health services to nursing home care. However, yesterday, on International Women’s Day, committees in Congress were busy marking up a GOP ACA replacement bill that will fundamentally change the way Medicaid is funded, making it harder for both older and younger women to be able to pay for health insurance, visit their doctors, and receive long-term care.

These changes to our health care system will make care unaffordable and inaccessible for many, but women will be disproportionately impacted. We laid it out in this new fact sheet, Medicaid Caps and Cuts Harm Older Women, produced in partnership with our friends at the National Partnership for Women & Families. Read and share this fact sheet with other advocates, lawmakers, and others.

For more recent Justice in Aging health care defense resources visit this page. If you missed our webinar on Medicaid cuts and caps earlier this week, you can watch the recording here.

Fact Sheet: Supplemental Security Income (SSI)

By | FACT SHEET, Income Network Alert, REPORTS, Social Security | No Comments

Millions of seniors and people with disabilities rely on Supplemental Security Income (SSI) to make ends meet. There are people relying on SSI to survive in every community in the country. The majority of SSI recipients are women, and the program is especially beneficial for people of color and people with limited English proficiency. It’s also an essential safety net for older adults who do not receive sufficient Social Security income because they worked in low-wage or seasonal jobs, or stayed home from work to care for family members.

With leaders in Congress intent on cutting safety net benefits, it’s critical that advocates proactively educate lawmakers, the media, and fellow advocates about the important role SSI plays in ensuring that some of the most vulnerable people in our communities can meet their basic needs for shelter, food, and other necessities.

Please use this new Justice in Aging SSI fact sheet that shows who relies on SSI, why it’s important, and the dangers cuts to the program would pose for low-income families and communities.

If you would like us to insert statistics specific to your state and/or congressional district please email us for assistance.

Fact Sheet: Denti-Cal for Adults

By | CA Health Network Alert, FACT SHEET, Oral Health, REPORTS | No Comments

In May 2014, dental benefits were partially restored for adult Medi-Cal recipients and are delivered through the Denti-Cal program. Unfortunately, many Medi-Cal recipients do not know they have dental coverage. Those who do know they have coverage often do not know what treatment they can obtain and have a hard time accessing benefits.

This new fact sheet, Denti-Cal for Adults, explains the basics of Denti-Cal coverage, how to access benefits, and provides a summary of what benefits are covered.

Please share broadly both within your own organization and with the consumers and clients you serve.

Fact Sheet: Medicaid Funding Caps Would Harm Older Americans

By | FACT SHEET, Medicaid, REPORTS, Uncategorized | No Comments

On February 16, 2017, Republicans released their latest proposal outlining their ideas to repeal and replace the Affordable Care Act. This proposal radically changes the Medicaid program by capping the amount states will receive in federal funding to deliver healthcare to low-income individuals. These capped proposals, either block grants or per-capita allotments, aim to catastrophically cut Medicaid and eliminate important consumer protections currently in place.

States will be forced to make difficult choices regarding what services they can deliver and what populations they will be able to serve, placing increased pressures on state budgets. Crucial programs that allow seniors to age at home rather than receiving care in institutional settings are at risk.

This latest replacement proposal does not come close to the improved coverage and affordability offered through the ACA for older adults. The plan will increase the cost of care and limit access to health care for older adults, especially low-to-middle income older adults. Specifically, the plan decreases tax credits, reintroduces high-risk pools for the most sick, and increases the availability of health savings accounts that provide little benefit for low to middle income consumers.

Justice in Aging has developed a new fact sheet showing how cuts to Medicaid through capped Medicaid funding would hurt older adults. For more detailed information on how capped funding would impact older adults, see our issue brief.

Fighting Improper Billing of Dual Eligibles: New Strategies

By | ISSUE BRIEF, REPORTS | No Comments

Doctors, hospitals, and other providers often bill dual eligible Medicare beneficiaries and Qualified Medicare Beneficiaries (“QMBs”) for services that should be covered under Medicare or Medicaid. This practice of improper billing is illegal and can cause low-income beneficiaries to go into debt, skip needed medical care, or end up without sufficient funds to pay for necessities like food and rent.

Justice in Aging has created several new resources that advocates can use to stop providers from billing their clients improperly. Today we’re releasing all of our improper billing resources together as a toolkit on our website. In the Improper Billing Toolkit, you’ll find a new issue brief including a chart of improper billing regulations organized by state, several model provider letter templates, including California-specific letters, all of the trainings we have presented on the topic, as well as resources from CMS on improper billing.

Improper billing of QMBs has been a persistent problem across the country that Justice in Aging and other advocates have been working to stop. We’ve worked with CMS to improve its provider education efforts and internal processes, and provided advocates with previous trainings and resources. We’ve made progress but more remains to be done.

That’s why we created this robust toolkit for you to use to help your clients and to share broadly with other advocates.

Medicaid Funding Caps Would Harm Older Americans

By | Health Care, ISSUE BRIEF, Medicaid, REPORTS | No Comments

Recent months have seen increased discussion of proposals to cap federal Medicaid spending. Under these proposals, the federal government would provide limited funding through either block grants or per capita payments to states, and states would have broad discretion to set their own Medicaid standards.

A new issue brief from Justice in Aging explains how these proposals would harm older Americans. The caps would result in a dramatic reduction in federal funding for Medicaid, and these crippling cuts would be exacerbated by the loss of longstanding federal protections. Potential consequences include loss of services, cutbacks in eligibility, unaffordable health care costs, and diminished quality of care.

The issue brief provides careful analysis of both the “cap” proposals and the protections of existing Medicaid law. Many of the proposals tout the “flexibility” of giving almost complete discretion to states. As the issue brief highlights, however, consumer protections in current Medicaid law are vital to older Americans’ health and financial security.

Section 1557: Strengthening Civil Rights Protections in Health Care

By | Affordable Care Act, Health Care, ISSUE BRIEF, REPORTS | No Comments

So many health care protections are at risk in the months ahead, including Section 1557, the provision in the Affordable Care Act (ACA) that specifically applies civil rights protections to health care settings.

This ACA provision has already been targeted, as a nationwide preliminary injunction issued on December 31 by a Federal District Court in Texas prohibits the Department of Health and Human Services (HHS) from enforcing the provisions in the implementing regulations that pertain to transgender discrimination and discrimination based on termination of pregnancy. The temporary order leaves the rest of Section 1557 intact, although some in the new administration and the new Congress would like to go further, seeking to repeal Section 1557 as part of a broader ACA repeal effort.

Justice in Aging has prepared a brief summary of the extent to which the injunction is likely to impact programs that affect older adults.

Justice in Aging also created an issue brief that discusses how Section 1557 and the HHS implementing regulations affect programs that serve older adults. The brief looks at discrimination protections around language access for beneficiaries with limited English proficiency, sex and gender discrimination, disability discrimination and discrimination based on age and race, with examples of how those provisions could play out for older adults using the Medicare or Medicaid benefit.

Why the Recently-Revised Nursing Home Regulations are Vital for Nursing Home Residents

By | FACT SHEET, REPORTS | No Comments

Consumer protection is a critical part of federal oversight for nursing facilities. The federal government issued revised nursing facility regulations in September, and most provisions became effective on November 28. The regulations are the product of over four years of work by the Centers for Medicare & Medicaid Services, including significant modifications in response to public comments received in mid-2015.

The new fact sheet, Why the Recently-Revised Nursing Home Regulations are Vital for Nursing Home Residents, provides a quick overview of some of the important new provisions, so that stakeholders and policymakers can better understand the revised regulations’ important role in improving nursing facility care. The revised regulations provide many benefits to nursing facility residents, including an increased focus on addressing a resident’s needs and preferences.

This fact sheet was developed by Justice in Aging in partnership with The National Consumer Voice for Quality Long-Term Care.