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ISSUE BRIEF

Why Many Nursing Facilities are Not Ready for Emergency Situations

By | Health Care, ISSUE BRIEF, Nursing Homes, REPORTS | No Comments

As Hurricanes Harvey, Irma, and Marie have shown us, nursing facility residents can be particularly at risk during natural disasters. The hurricanes resulted in death and injury in nursing facilities across the region, including 12 deaths in one Florida facility.

Justice in Aging created an issue brief, Why Many Nursing Facilities are Not Ready for Emergency Situations, which discusses existing federal and state law, and makes seven recommendations to address gaps in current law.

As the brief outlines, these deaths and injuries could have been prevented through advance planning and emergency preparedness.

Read the Brief

Health Savings Accounts Won’t Help Most Older Adults

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

Proposals to expand the use of Health Savings Accounts (HSAs) have been raised repeatedly in the health care debate. This new issue brief looks at how expanding HSAs would impact the affordability of health care coverage for low and moderate income older adults by examining how HSAs would have functioned under one proposal, the Better Care Reconciliation Act (BCRA), had it become law.

The paper finds that the combination of HSA contributions and premium costs can easily reach 20% to 30% of an older adult’s income. It concludes that HSAs are not a path to affordable health care for older adults. Read the brief.

How States Can Prevent Evictions When Implementing Federal HCBS Regulations

By | Health Care, Home & Community Based Services, ISSUE BRIEF, REPORTS | No Comments
This new issue brief discusses how states should implement the new federal Home and Community-Based Services (HCBS) regulations in order to prevent improper evictions.

In 2014, the Centers for Medicare and Medicaid Services (CMS) released regulations that set standards for the settings in which HCBS are provided. To implement these regulations, each state must have a transition plan approved by CMS by March 2019, with full compliance required by March 2022.
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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

Health Care on the Chopping Block: How Older Americans Will Suffer Under Senate Republicans’ Proposal to Cap Medicaid Funding

By | ISSUE BRIEF, REPORTS | No Comments

On Thursday, June 22, 2017, Senate Republicans revealed the Better Care Reconciliation Act of 2017, their version of the American Health Care Act (AHCA) that was passed by the House last month, and was intended to repeal and replace the Affordable Care Act.

Our new Issue Brief, Health Care on the Chopping Block: How Older Americans Will Suffer Under Senate Republicans’ Proposal to Cap Medicaid Funding, provides a detailed description of how Medicaid is currently funded, what the bill proposes, and how the cuts will play out for older adults.

Cuts to Multi-Recipient Households Push Older Adults & Their Families Deeper into Poverty

By | ISSUE BRIEF, REPORTS, SENIOR POVERTY, Social Security, Supplemental Security Income | No Comments

Our new issue brief Cuts to Multi-Recipient Households Push Older Adults & Their Families Deeper into Poverty outlines who’s most affected and discusses how these cuts would discourage families with older adults and people with disabilities from helping one another out by sharing their homes.

The cuts would push already poor families deeper into poverty, force people onto the streets or into institutions, and result in costly administrative burdens for the Social Security Administration (SSA).

Read and share the brief.

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.

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, Health Care Defense, 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.