All Posts By

Katrina Cohens

Free Webinar: The Qualified Medicare Beneficiary (QMB) Program—An Update for Advocates: Part 1 of 2

By | Health Care, Medicaid, Medicare, WEBINAR, Webinar Trainings

When: Tuesday, July 23, 2019 11 am-12 pm PT/2-3 pm ET

The Qualified Medicare Beneficiary (QMB) program provides significant Medicare cost savings to low income individuals, including payment of Medicare premiums and protection from liability for any Medicare co-insurance or deductibles for health services. Those enrolled in the program also are automatically enrolled in the Part D Low Income Subsidy program (LIS). Despite its value, the QMB program is chronically under-enrolled. Many eligible individuals don’t know about the program or face barriers when they try to enroll. Those who are enrolled often face difficulties in accessing QMB protections.

This two-part webinar series gives advocates updated information on the QMB benefit and tools to use to ensure that their clients are enrolled and can use the benefit effectively.

Part One provides an overview of the QMB program, including eligibility criteria and program basics and focus on the specifics of QMB billing protections. We focus on recent improvements that make it easier for QMBs and their advocates to understand their payment responsibilities and the tools available to address problems with providers who improperly bill QMBs. We also distinguish between the QMB program and a Medicaid agency’s Part B buy-in agreement, and discuss QMB issues in Medicare Advantage.

Part Two will focus on enrollment. It will look at barriers to QMB enrollment, including problems that have arisen in various states and advocacy approaches, especially for individuals with Medicaid linked to Supplemental Security Income. We will explore both ways to untangle individual problems and ways to work with your state to improve QMB enrollment systemically.

Who should participate:
Aging and legal advocates, community-based providers and others who counsel older adults on health benefits.

Presenters:
Denny Chan, Senior Staff Attorney, Justice in Aging
Georgia Burke, Directing Attorney, Justice in Aging

WATCH THE WEBINAR
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Issue Brief: D-SNP Look-Alikes – A Primer

By | DUAL ELIGIBLES, ISSUE BRIEF, Medicaid, Medicare, REPORTS

More dual eligibles—individuals with Medicare and Medicaid—are enrolling in a certain type of Medicare Advantage plan as a result of aggressive marketing efforts targeting dual eligibles. This type of plan, known as a Dual Eligible Special Need Plan (D-SNP) Look-Alike, threatens to undermine promising advancements in integrated care for duals made possible by the Affordable Care Act (ACA). D-SNP look-alikes are not subject to the regulations governing D-SNPs and therefore have no responsibility to coordinate Medicare and Medicaid benefits. Because they are marketed aggressively almost exclusively to duals, they draw dual eligibles away from coordinated options and place responsibility on the consumer to navigate two separate delivery systems, potentially exacerbating disruptions and gaps in care.

Justice in Aging created this issue brief, Dual Eligible Special Need Plan Look-Alikes – A Primer, to help educate advocates working with dual eligibles about the impact of these plans on dual eligibles and to request that advocates report experiences with D-SNP look-alikes to Justice in Aging and CMS.

This new issue brief:

  • Outlines some key requirements of D-SNPs;
  • identifies the basic characteristics of D-SNP look-alikes;
  • discusses problems look-alikes are causing for dual eligibles; and
  • proposes ways to restrict them in the Medicare market.

Free Webinar: Changes to the Rule Implementing the Health Care Rights Law and the Impact on Older Adults

By | Health Care, WEBINAR, Webinar Trainings

When: Wednesday, July 10, 2019 11 am-12 pm PT/2-3 pm ET​

The Trump Administration has published a proposed rule to eliminate key nondiscrimination protections under the Health Care Rights Law (Section 1557 of the Affordable Care Act) for LGBTQ seniors, people with limited English proficiency and others in health care settings. If finalized, this rule change would increase the likelihood that older adults would experience discrimination in accessing health care and make it harder for them to seek redress in the face of that discrimination.

This webinar, Changes to the Rule Implementing the Health Care Rights Law and the Impact on Older Adults, begins with an overview of the Health Care Rights Law. It then discuss the Trump Administration’s proposed changes to the regulations implementing the law and the ways in which those changes would be particularly harmful to older adults. As outlined in our new resource, “Five Frequently Asked Questions about the Health Care Rights Law and Proposed Changes,” those changes include attempting to eliminate the rights of LGBTQ seniors, rolling back protections for limited English proficient (LEP) older adults, and limiting the way that victims of any type of discrimination can seek redress under the law.

The proposed rule is open for a 60-day public comment period through August 13, 2019. In the coming weeks, Justice in Aging will add resources and tools to this page to help advocates respond. 

Who should participate:
Aging and legal advocates, advocates serving LGBTQ and LEP communities, community-based providers, health plan leaders, and others wanting to learn more about changes to the regulations implementing the Health Care Rights Law and the impact on older adults.

Presenter:
Denny Chan, Senior Staff Attorney, Justice in Aging
Natalie Kean, Senior Staff Attorney, Justice in Aging

WATCH THE WEBINAR
DOWNLOAD THE POWERPOINT

Issue Brief: 10 Year Check-Up: The Affordable Care Act Has Enhanced Access to Quality Health Care for Low-Income Older Adults

By | Health Care, ISSUE BRIEF, Language Access, Medicaid, Medicare, Nursing Homes, REPORTS

As the U.S. Court of Appeals for the 5th Circuit prepares to decide the constitutionality of the Affordable Care Act (ACA) this week, it’s time for a check-up on how the law has expanded affordable coverage for low-income older adults. Our new issue brief, 10 Year Check-Up: The Affordable Care Act Has Enhanced Access to Quality Health Care for Low-Income Older Adults, discusses all the ways this landmark legislation has improved the health and economic security of older adults. The brief also discusses how the ACA has become so ingrained in the overall health system, that without the law, the system itself would collapse.

The issue brief provides a detailed look at how the ACA has expanded affordable coverage through Medicaid to more people and made it possible for more older adults to age at home and in their communities instead of in nursing facilities. Under the ACA, older adults also are protected against being charged more for pre-existing conditions and being denied essential health benefits. Low-income older adults who receive both Medicaid and Medicare get better care coordination and more help with prescription drugs. Additionally, the ACA expanded Civil Rights protections for LGBTQ and limited English proficient seniors, and stepped up oversight of nursing facilities, among other protections.

This paper shows how, after 10 years, the ACA is woven deeply into every health care program on which older adults rely. Without it, more older adults would lose their coverage, pay more for premiums and prescription drugs, be at greater risk of institutionalization, and lose many ground-breaking consumer protections. We must continue to work together to strengthen and protect this foundational program.

Steps to join the Learning Collaborative

By | Medicare, Oral Health

Step 1: First, you must join the Oral Health Progress Equity Network (OPEN) by requesting a login here. OPEN is a national network of individuals and organizations to advance oral health for all individuals.

Step 2: After you have joined OPEN and logged in to the network,

    • Click on “Communities” on the top toolbar
    • Click on “All Target, State, and Work Group Communities”
    • Click on “Network Response Teams”
    • Once you are on that page, scroll down to find the AMDLC, and click on “Request to Join Community”

Once you are subscribed to the AMDLC community, you will receive a call invitation.

Please reach out to Stacey Chazin at schazin@anohc.org with any questions.

Advocates Guide: In-Home Supportive Services (IHSS)

By | Advocate's Guide, CA Health Network Alert, In-Home Supportive Services, REPORTS

The In-Home Supportive Services (IHSS) program is a Medi-Cal program in California that pays for in-home care for people with disabilities, including children, adults, and seniors. The purpose of this vital program is to provide services and supports that help people remain safely in their homes and living in the community.

Justice in Aging is releasing a new Advocates Guide about the IHSS program for advocates and individuals who provide assistance to older adults, children, and adults with disabilities. Written with significant support from Disability Rights California, the guide provides in-depth information about the IHSS program and is divided into eight chapters:

  • IHSS Program Overview;
  • Eligibility and Applying for IHSS;
  • Medi-Cal Programs and IHSS;
  • IHSS Services Overview;
  • Types of Services;
  • IHSS Providers;
  • Post-Eligibility Issues;
  • and Appeals and Hearings.

New Budget Boosts Health Coverage For Low-Income Californians

By | CA Health Network Alert, Health Care, IN THE NEWS, Medicaid, Medicare, Social Security

Kaiser Health News: New Budget Boosts Health Coverage For Low-Income Californians (June 25, 2019)

California’s new state budget for 2019-20 includes funds that will help about 25,000 low income older adults and people with disabilities get full Medi-Cal coverage. In the past, older adults had to meet stricter requirements to qualify for Medi-Cal than adults under 65. Regarding the past eligibility rules, Justice in Aging’s Directing Attorney Amber Christ said, “We call this the senior penalty, because basically you’re being penalized with a stricter eligibility limit based fully on your age or disability.” The new budget will also restore five areas of Medi-Cal coverage: audiology, optical services, podiatry, incontinence supplies and speech therapy.

Benefits on the Line

By | IN THE NEWS, Medicare, Safety Net Defense, SENIOR POVERTY, Social Security, Supplemental Security Income

The American Prospect: Benefits on the Line (June 19, 2019)

The Trump Administration has proposed to change how inflation is calculated, moving from the Consumer Price Index for All Urban Consumers (CPI-U) to Chained Consumer Price Index for All Urban Consumers (chained CPI). This change in how poverty is measured would have drastic negative consequences for millions of low-income people, older adults, and people with disabilities. Many would become ineligible for benefits or would receive less assistance as chained CPI lowers the poverty line. Justice in Aging’s Directing Attorney Tracey Gronniger says that, “It would hurt people who are so close to getting help. All of sudden, you have hundreds of thousands of people who are told, ‘Now you’re not poor anymore.’”

FAQ: Five Frequently Asked Questions About the Health Care Rights Law and Proposed Changes

By | FACT SHEET, Health Care, Health Care Defense, LGBT, REPORTS

The Trump Administration has published a proposed rule to eliminate key nondiscrimination protections under the Health Care Rights Law (Section 1557 of the Affordable Care Act) for LGBTQ seniors, people with limited English proficiency and others in health care settings. If finalized, this rule change would increase the likelihood that older adults would experience discrimination in accessing health care and make it harder for them to seek redress in the face of that discrimination.

This FAQ, “Five Frequently Asked Questions about the Health Care Rights Law and Proposed Changes,” outlines the changes including attempting to eliminate the rights of LGBTQ seniors, rolling back protections for limited English proficient (LEP) older adults, and limiting the way that victims of any type of discrimination can seek redress under the law.