Long-term services and supports (LTSS) are vital to millions of Americans. According to a Department of Health & Human Services Research Brief, of persons turning age 65 today, 52 percent will need some form of LTSS in the future. In many cases, the necessary LTSS will be funded through Medicaid. The financing and quality of LTSS often depend upon Medicaid laws and policies. Despite the importance of these laws and policies, they often are not well known among both consumers and aging network professionals. Read More
When: Monday, October 2, 2017 at 11:00 a.m. PT/ 2:00 p.m. ET.
Medicare providers are prohibited from billing Qualified Medicare Beneficiaries (QMBs) for any Medicare co-payments or deductibles. This includes most dual eligibles. However, the problem of improper billing persists.
A significant change in Medicare Summary Notices (MSNs) and in provider remittance notices starts in October. The change is designed to give QMBs more protection from bills that they should not have to pay and help providers determine who should not be billed. The revised MSNs will show that the QMB’s payment responsibility is zero for each Medicare-covered service and denote that the zero cost is due to the individual’s QMB status. Remittance notices to providers will also show that no remaining amount is due from the beneficiary, and eligibility query systems will provide clear information on a patient’s QMB status. The notices are meant to make it easier for both providers and consumers to understand payment responsibilities.
This free webinar, Breakthrough Changes in Improper Billing of QMBs—What Advocates Need to Know, will explain the changes in detail. The webinar is co-sponsored by NCOA Center for Benefits Access. It will include:
- a general overview of improper billing,
- help for advocates and counselors understand how to interpret the revised MSNs,
- how to understand what provider billing offices see, and
- tips and resources if your client continues to receive improper bills.
Kim Glaun, Medicare-Medicaid Coordination Office, Centers for Medicare and Medicaid Services
Georgia Burke, Directing Attorney, Justice in Aging
Denny Chan, Staff Attorney, Justice in Aging
The webinar will take place on Monday, October 2, 2017 at 11:00 a.m. PT / 2:00 p.m. ET.REGISTER NOW
Dual eligible individuals, those with both Medicare and Medicaid coverage, represent the most medically needy and costly population for both Medicare and Medicaid. In an effort improve health outcomes and reduce healthcare spending, the Centers for Medicare and Medicaid Services (CMS) has been testing financial alignment demonstrations in thirteen states to better coordinate and integrate care for dual eligibles. Read More
Understanding Medicaid is a key to understanding the health and long-term care delivery system for older adults. Every year, over 6 million older Americans rely on Medicaid every year to pay for necessary health services. Over two-thirds of all older adults who receive long-term care at home or in a nursing facility, participate in the Medicaid program. Read More
Focused on class members with open claims
When: August 10, 2017
Hart v. Berryhill (Colvin) is a Social Security and SSI disability class action that challenged the Social Security Administration’s continued use of medical reports from Dr. Frank Chen even after he had been disqualified from performing medical examinations for Social Security because of serious deficiencies in his reports. The settlement, which was approved on April 25, 2017, provides an opportunity for new disability determinations for many class members.
Implementation of the settlement has begun. Social Security mailed the first wave of notices to class members with open claims to inform them of their rights under the settlement in mid-July. A second, larger wave of notices for people whose claims have been closed will likely go out in mid-September.
To help advocates in assisting Hart class members, Justice in Aging is holding a number of trainings on the process of obtaining relief under the settlement. This first training focuses on the first wave of notices that went out in July 2017 to class members with open claims (meaning that there was an active administrative appeal in process on the claim involving the Dr. Chen report, as of April 25, 2017). It briefly reviews the settlement relief for all class members, and then goes into detail about the relief for class members with open claims, and considerations about whether to request relief.
You can read more about the case and the settlement agreement here.
Gerald McIntyre, Special Counsel, Justice in Aging
Trinh Phan, Senior Staff Attorney, Justice in Aging
Why do many clients receiving Supplemental Security Income (SSI) benefits only receive $490 each month instead of $735, and what can we do about it? In many cases, the reason is “in-kind support and maintenance” (ISM). A person who receives shelter and food from a friend or family member they live with is receiving in-kind support and maintenance. The Social Security Administration (SSA) counts that support as income and lowers their benefit.
An increasing number of older consumers are struggling with unmanageable debt. Debt collectors are using aggressive tactics to pursue older adults with limited resources, making it critically important for legal services attorneys to understand protections that may help their clients. Bankruptcy may help older consumers eliminate debt and preserve income needed to pay rent, buy food, and keep the lights on. Read More
The Victims of Crimes Act (VOCA) supports crime victims programs that assist victims of sexual assault, spousal abuse, child abuse, or other previously underserved victims of crimes. In recent years, VOCA has supported elder abuse programs, including certain specified legal assistance expenses that help crime victims.
The Legal Assistance Developer (LAD) position plays a key role in ensuring legal services for older persons with greatest social and economic needs in each state. In our first webinar—Legal Assistance Developer 101, we explored some key aspects of the developer job including how to target legal assistance to those who need it most and how to prioritize the most critical issues for legal help. Read More
Supported Decision-Making (SDM) is a person-centered planning and person-driven decision-making model that can be used as an alternative to guardianship, to help individuals retain their legal rights. SDM emphasizes personal choice based on information and advice from trusted advisors. Read More