Inside Health Policy: Beneficiary Groups Concerned CMS’ Nursing Home Guidance Could Lower Penalties [Article unavailable online] (8/23/17) New nursing home guidance issued by CMS in July includes two major penalty exceptions that concern beneficiary advocates. The exceptions sanction per-instance, instead of per-day, penalties for facilities with good compliance histories and situations where a single isolated incident causes harm to a resident. According to Justice in Aging’s Eric Carlson, per-day penalties provide erring nursing home with incentive to correct compliance issues and reduce noncompliance issues. He expects that nursing homes, under the new guidance, will face more per-instance penalties, instead of large, accumulating per-day penalties. “I’ve certainly seen situations in the past where a facility is willing to pay the penalty as a fee for doing business,” Carlson said.
Modern Healthcare: Patient advocates say Medicaid per capita caps would demolish long-term care for elderly (7/11/2017) Justice in Aging’s Jennifer Goldberg discusses the harmful consequences of the recent Senate bill aimed to repeal and replace the Affordable Care Act. “Over two-thirds of Medicaid spending is considered optional under federal law. If the federal government starves Medicaid through per capita caps, optional services will be the first to be cut.” Optional services include home-based care and adult day care.
California Healthline: California Lawsuit Aims To Protect Spouses Of Disabled From Financial Ruin (7/10/2017) Justice in Aging, along with partner advocacy groups, filed a lawsuit against the State of California for failing to implement a Medicaid federal spousal impoverishment law meant to protect patients and their partners from becoming impoverished while paying for in-home care. Plaintiffs seek to compel the State of California to implement the law back to January 1, 2014, to notify individuals who potentially were eligible for the protections of their rights, and to reimburse them for any out-of-pocket expenses they paid that should have been free.
Governing.com: As Demand for At-Home Care Grows, States Debate How to Pay for It (7/2017) Justice in Aging’s Kevin Prindiville discusses the increasing funding need for at home and in-community-based programs as older Americans opt to stay home. “The trend is shifting at every level to care at home and in community-based settings. People are increasingly asking for and expecting this.”
Money.com: What Would Happen to Seniors in Nursing Homes Under the Republican Health Care Bill? (6/29/2017) The Better Care Reconciliation Act, proposed by Senate Republicans to replace the Affordable Care Act, would result in an estimated $772 billion Medicaid cut. Medicaid provides a vital safety net to older adults, covering long-term care at home or in a facility. Justice in Aging’s Eric Carlson said, “It’s not like Medicaid systems have been rolling in cash under the current system, due to the need.” An estimated 2.2 million older Americans received Medicaid long-term care aid in 2011.
CBS News: The cuts to a major disability program in Trump’s budget (6/1/2017) The Trump administration’s 2018 budget proposes to cut $72 billion from Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) over the next ten years. SSDI provides benefits to American workers with a life-altering illness or disability. SSI provides basic support to low income seniors, low income children, and adults with disabilities. Justice in Aging’s Kate Lang said, “I feel like there’s a lot of language being used that reflects attitudes that somehow people with disabilities are faking it or are slackers or just don’t have the right attitude. Unfortunately there is a certain lack of sympathy or understanding of what life is like for people with disabilities, it seems.”
La Opinion: Piden que gobernador restaure cobertura completa de Denti-Cal (5/24/2017) Justice in Aging’s Amber Christ is quoted in this article regarding decreased Denti-Cal funding in California. The program, which covers about one-third of adults in California, suffered deep cuts amid a fiscal deficit in 2009. Many treatments required by adults are not covered. “It only includes complete dentures that really encourage providers to pull all the teeth out of someone’s mouth, even those teeth that are healthy, so that people can have the benefits that dentures cover,” said Amber Christ of Justice in Aging.
California Healthline: CMS Gives States Until 2022 To Meet Medicaid Standards Of Care (5/24/2017) The Trump administration has extended the deadline that requires states to meet Medicaid standards of care from 2019 to 2022. Justice in Aging’s Eric Carlson says that even with the extension there is still a lot of work to be done to bring states into compliance. “The state is going to have to pick up the pace to meet the even more relaxed deadlines. Even the current timeline doesn’t give us much margin for error.” The federal standards require states to provide beneficiaries with access to community life participation and ensure they have more housing options besides a nursing home.
Money.com: 5 Things to Know About Trump’s New Budget Plan (5/23/2017) President Trump’s budget proposal cuts an additional $610 billion from Medicaid along with the $839 billion in cuts under the American Health Care Act. Social Security Disability Insurance (SSDI) benefits, a program for American with significant disabilities that prevent them from working, will also be reduced. Additional proposed changes to SSDI include testing “new approaches to increase labor force participation.” Justice in Aging’s Kate Lang said that, “beneficiaries already get regular re-evaluations to maintain eligibility.”