Category

Health Care

CMS To Extend Existing Duals Demos, Invites Other States To Join

By | Health Care, IN THE NEWS, Medicaid, Medicare

Inside Health Policy (April 24, 2019)

The Centers for Medicare and Medicaid Services (CMS) has invited states that aren’t currently participating in the duals demonstration to talk with the agency about starting their own version, whether through the capitated financial alignment model, the managed fee-for-service model or some other state-specific model worked out with the agency. CMS also said it plans to allow states that are already in the demonstration to make some changes, if necessary, or to extend the ongoing-demo for multiple years. Justice in Aging attorney Georgia Burke was interviewed for the article and noted that she’s happy CMS intends to work with states to continue the ongoing demonstrations and hopefully drawing on lessons learned for new states to incorporate in their demos. She also praised CMS for encouraging multiple models, and touted CMS’ emphasis on stakeholder involvement and beneficiary protections. She also noted that passive demonstration enrollment and locking in participation are not a good idea because consumer choice is important. Justice in Aging will be looking for beneficiary ombudsman programs to be included in new demonstrations. This article is unavailable online. This is a summary.

Fact Sheet: CMS Regulations Set Ground Rules for D-SNP

By | DUAL ELIGIBLES, FACT SHEET, Health Care, Medicaid, Medicare, REPORTS

The Centers for Medicare and Medicaid Services (CMS) recently finalized rules implementing regulations governing minimum integration standards for Dual Eligible Special Needs Plans (D-SNPs) pursuant to the Bipartisan Budget Act of 2018. D-SNPs are Medicare Advantage plans that limit enrollment to individuals who are dually eligible for Medicare and Medicaid. With the permanent authorization of D-SNPs, we expect to see an increase of D-SNPs entering the market across the country.

Justice in Aging has analyzed the new regulations and created a new factsheet summarizing the major integration requirements including special considerations for advocates.

More Women Growing Old Poor In Phoenix, Mirroring National Trend

By | Economic Security, Health Care, IN THE NEWS, Safety Net Defense, SENIOR POVERTY

KJZZ Public Radio: More Women Growing Old Poor In Phoenix, Mirroring National Trend (April 17, 2019)

The rate of women 55 and older experiencing homelessness is on the rise in  Phoenix, Arizona. Shelters are serving more and more older women, following national trends. Justice in Aging’s Executive Director Kevin Prindiville states that “we’re seeing a very disturbing trend of individuals that lived middle-class lifestyles when they were working age, becoming poor for the first time when they’re older — and that’s a shift.” Contributing factors include a gender wage gap, domestic abuse, a “motherhood penalty,” and caretaking responsibilities. These factors are compounded by race, sexuality, and/or gender identity. Strengthening existing social programs like improving access to SNAP and expanding 401(k) participation to part-time employees would provide the support older women need to age in dignity.

Issue Brief: Older Immigrants and Medicare

By | Health Care, Health Care Defense, ISSUE BRIEF, Language Access, Medicare

Accessing the Medicare program as an older immigrant can be a complex and confusing process – especially when an immigrant is not a citizen, has limited work history, and limited English proficiency. Justice in Aging’s new issue brief, Older Immigrants and Medicare, is intended to provide advocates who work with older immigrants a summary of the policies and practices to help immigrants enroll in and pay for Medicare coverage.

The issue brief specifically covers the following topics and includes numerous hypothetical examples to illustrate the myriad of rules and scenarios older immigrants face when attempting to access Medicare:

  • Eligibility and enrollment, with particular attention to rules affecting non-citizens
  • Help paying for coverage
  • Post-enrollment issues potentially affecting immigrant beneficiaries
  • Language access rights and resources in Medicare

A Dental Benefit in Medicare: Examining the Need in California

By | CA Health Network Alert, IN THE NEWS, Medicare, Oral Health

California Dental Association: A Dental Benefit in Medicare: Examining the Need in CA (copyright April 2019)

Justice in Aging’s Executive Director Kevin Prindiville and Director of Health Team Amber Christ co-authored this paper that discusses the oral health care need of California’s older adults. Lack of access to affordable and comprehensive dental coverage has resulted in California’s older adults having a high prevalence of oral disease. The addition of a comprehensive dental benefit to Medicare Part B would help lower the rates of oral disease.

CMS Considering Regulation For D-SNP Look-Alike Plans

By | Health Care, IN THE NEWS, Medicaid, Medicare

Inside Health Policy (April 3, 2019)

The Centers for Medicare and Medicaid Services (CMS) is considering regulating duals special needs plan look-alikes because they get in the way of state efforts to integrate Medicaid and Medicare services through Medicare-Medicaid Plans or D-SNPs and are confusing for beneficiaries. The agency asked for advocates’ feedback on the impact of the D-SNP look-alikes—which don’t have to follow D-SNP requirements—on integration, beneficiary choice, competition, state Medicaid policy and other areas.

In a call letter CMS said state commenters were unanimous in saying that D-SNP look-alikes get in the way of the comments reinforce that the proliferation of D-SNP look-alike plans impedes progress toward developing products that meaningfully integrate Medicare and Medicaid benefits for dually eligible individuals. Justice in Aging attorney Georgia Burke was interviewed for the article and said, “we are pleased CMS has identified that the look-alikes are impeding progress toward integrating Medicare and Medicaid benefits and we hope CMS moves quickly to rein in the look-alikes.”

Free Webinar: California Legislative and Budget Proposals that Affect Low-Income Older Adults

By | Economic Security, Health Care Defense, WEBINAR

When: Thursday, March 21, 2019 from 3pm-4pm PT

Join us for a discussion of California budget and legislative proposals this year that could make concrete improvements to the economic security and health care of low-income older adults. This webinar, California Legislative and Budget Proposals that Affect Low-Income Older Adults, provides an overview of a number of key proposals, and offers advocates information on how they can engage in the process.

One package of bills has been introduced that would work together to make Medi-Cal more fair and equitable and create more stability for seniors and people with disabilities. You can read about those bills here. Justice in Aging will be releasing additional materials on 2019 California legislative proposals and their impact on older adults soon.

Who Should Participate:

Aging and legal advocates, community-based providers, local government partners, and others wanting to learn more about economic security and health care proposals that impact low-income older adults.

Presenters:

Trinh Phan
Senior Staff Attorney, Justice in Aging

Claire Ramsey
Senior Staff Attorney, Justice in Aging

This webinar took place on Thursday, March 21, 3:00-4:00 PM.

WATCH THE WEBINAR
DOWNLOAD THE POWERPOINT

Fact Sheets: California Senior Legislative Package 2019

By | CA Health Network Alert, Health Care, Health Care Defense

California legislators have introduced a number of budget and legislative proposals that, if enacted, would work together to improve the health and long-term care system that serves the state’s older adults, and help advance greater economic security for the most vulnerable older adults who are grappling with some of the nation’s highest housing costs.

One package of bills has been introduced that would work together to make Medi-Cal more fair and equitable and create more stability for seniors and people with disabilities. Read about those bills here. For more detail on each bill, you will find a series of fact sheets below.

We will keep advocates updated as these and other proposals move through the process.

Issue Brief: Cal MediConnect-Unmet Need and Great Opportunity in

By | Health Care, ISSUE BRIEF, Medicaid, mltss

CalMediConnect, launched in 2014, is California’s dual eligible demonstration and seeks to integrate Medicare and Medicaid benefits under one health plan. One of its purposes is to better meet the needs of dual eligibles by increasing access to long-term services and supports (LTSS) and providing other value-added services, known in the demonstration as Care Plan Options (CPO). However, evaluation data and beneficiary experience indicate that more can be done to provide care for dual eligibles enrolled in the program. Justice in Aging recently obtained data via a Public Records Act request from California’s Department of Health Care Services that includes LTSS referrals and the number and type of CPO services plans are providing members.

Our issue brief, Cal MediConnect: Unmet Need and Great Opportunity in California’s Dual Eligible Demonstration, provides a brief overview of the Cal MediConnect program and examines the health plan referral data for LTSS and CPO services obtained through the Public Records Act request. It concludes with recommendations for policymakers on ways to strengthen Cal MediConnect through improving access to LTSS and CPO services. These recommendations are of interest to those following Cal MediConnect as well as advocates and stakeholders in other states with their own dual eligible demonstrations.

Read the brief.

Fact Sheet: Make the Expanded Spousal Impoverishment Protection Permanent

By | FACT SHEET, Health Care, Home & Community Based Services, Medicaid, REPORTS

Married seniors and adults with disabilities overwhelming want to live at home and age in place. Increasingly, federal and state Medicaid rules have prioritized home and community-based services (HCBS) which allow people to stay in their homes and in their communities. Congress recently helped these efforts by expanding a Medicaid eligibility rule, known as the spousal impoverishment protection, to individuals eligible for HCBS. The protection makes it possible for an individual who needs a nursing home level of care to qualify for Medicaid while allowing their spouse to retain a modest amount of income and resources. However, the expansion of the spousal impoverishment protection is set to expire on March 31, 2019 unless Congress acts. This means that individuals who qualified under the expanded protection may lose access to Medicaid and to their HCBS and may be left with no choice but to move into institutional long-term care, away from their spouses.

Letting the spousal impoverishment protection expire will hurt families and force more people out of their homes and their communities. We urge Congress to make the expanded spousal impoverishment protection permanent so seniors and people with disabilities can age in place and with dignity.

Justice in Aging has created a fact sheet on the importance of the expanded HCBS spousal impoverishment protection and calling on Congress to make it permanent so seniors and people with disabilities can age in place and with dignity.