Category

REPORTS

New Fact Sheet: SSI in California

By | FACT SHEET, REPORTS, Supplemental Security Income | No Comments

California has the highest rate of senior poverty in the nation; increasingly more older Californians struggle to make ends meet and stay in their homes, and senior homelessness is on the rise. Over a million California seniors and people with disabilities rely on Supplemental Security Income (SSI) to help them meet their basic needs. There are people who depend on SSI to survive in every community in the state. The majority of SSI recipients are women, and the program is critical for many people of color and people with limited English proficiency. It’s also an essential safety net for nearly 300,000 California retired older adults who receive some Social Security, but not enough, because they worked in low-wage or seasonal jobs, or stayed home from work to care for family members.

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

With leaders in Congress intent on cutting benefits like SSI, 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 state can meet their basic needs for shelter, food, and other necessities. Given the significant number of low-income older adults in California, Justice in Aging recently launched two new projects to improve access to and utilization of SSI benefits among older adults across the state. We are building a strong coalition of statewide advocates who are informed about and trained in the details of the SSI program, including how SSI reduces homelessness, and working toward systemic improvements of the program.

New Fact Sheet: New Guidance on Spousal & Survival Benefits for Married LGBT Individuals

By | FACT SHEET, LGBT, REPORTS, Social Security | No Comments

On March 1, 2017 the Social Security Administration (SSA) announced that it would reopen its decisions to deny spousal or survivor’s benefits to individuals who had been married to someone of the same sex, and whose marriage wasn’t recognized because of a discriminatory state or federal ban on marriage.

This ruling and policy applies not only to individuals who were denied benefits after the Supreme Court struck down federal discrimination against same-sex spouses (in United States v. Windsor in 2013) and state discrimination (in Obergefell v. Hodges in 2015), but also to individuals who applied for and did not receive benefits before these Supreme Court decisions because of the discriminatory laws in effect at the time they applied.

A new Fact Sheet on this guidance includes more detailed information about who is affected by the new guidance, who isn’t, and what advocates and their clients should do to get their cases reopened.

This fact sheet was authored in collaboration with our partners at SAGE, Lambda Legal, and the National Committee to Preserve Social Security and Medicare.

New Fact Sheet: The Dangers of AHCA for Older Adults

By | FACT SHEET, Health Care, Health Care Defense, 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, Health Care Defense, 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, Health Care Defense, Medicaid, REPORTS | 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.

New Fact Sheet: Medicare Part D – 2017 Transition Rights

By | FACT SHEET, Medicare, REPORTS | No Comments

The Centers for Medicare and Medicaid Services (CMS) requires that sponsors of Medicare Part D prescription drug plans provide beneficiaries with access to transition supplies of needed medications to protect them from disruption and give adequate time to move over to a drug that is on a plan’s formulary (medication list), file a formulary exception request or, particularly for Low Income Subsidy (LIS) recipients, enroll in a different plan.

Transition rules apply to stand-alone Medicare Prescription Drug Plans (PDPs), Medicare Advantage Plans with Prescription Drug Coverage (MA-PDs), and Medicare-Medicaid Managed Care Plans participating in the Dual Eligible Financial Alignment Demonstrations.

Transition rules are particularly important for low-income beneficiaries who were automatically reassigned to new plans, which may or may not cover their medications.

In addition, all plans change their formularies each year, so even people who remain in the same plan may find that their plan no longer covers their medications or has newly imposed utilization management requirements.

To assist advocates with transition issues, this fact sheet sets out the CMS minimum requirements for all plans.

For further information, contact Georgia Burke, gburke@justiceinaging.org.

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.