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.
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.
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
Medicaid is under attack from all directions. From the proposal to impose cap Medicaid funding in American Healthcare Act (AHCA) and the drastic cuts proposed to Medicaid in the Trump Administration’s budget proposal, the threats to Medicaid are widespread. For older adults, Medicaid is a lifeline that ensures access to critical medical care and long-term services and supports. Slashing Medicaid would impact the entire health care system, including for those who have Medicare.