Category

FACT SHEET

California’s Master Plan For Aging: Prevent and End Elder Abuse in California

By | FACT SHEET, Long Term Care, Nursing Homes, REPORTS

California has committed to developing a Master Plan for Aging in order to meet the needs of older adults today and for generations to come.

The fourth in this series of papers, Prevent and End Elder Abuse in California, offers specific policy recommendations, including improved data collection and sharing, increased cooperation among government entities, simpler advance planning, and establishing robust consumer protections—all of which work together to prevent elder abuse. We are grateful to partners at the California Elder Justice Coalition, with whom we worked to develop these recommendations.

FAQ: Part D Drug Co-Pays and Refunds for Certain California Dual Eligibles

By | CA Health Network Alert, FACT SHEET, Health Care, Medicare, REPORTS

In 2012, the Affordable Care Act expanded the Part D Extra Help Program, also known as the Low-Income Subsidy (LIS), so that dual eligibles enrolled in certain Home and Community-Based Services (HCBS) should not be charged any co-pays for Part D covered drugs. However, since 2012, some California duals enrolled in Community-Based Adult Services (CBAS) and in San Mateo’s Multipurpose Senior Services Programs (MSSP) have been improperly charged co-pays. The Centers for Medicare & Medicaid Services (CMS) and California’s Department of Health Care Services (DHCS) is beginning to work with Part D and Medicare Advantage plans so that these dual eligibles are properly assessed co-pays and retroactively reimbursed for any improper amounts collected.

Justice in Aging created an FAQ for advocates to answer key questions about the implementation of these refunds.

California’s Master Plan For Aging: Address Senior Hunger by Maximizing CalFresh and the Hold Harmless Food Benefits

By | CA Health Network Alert, FACT SHEET, REPORTS, SENIOR POVERTY

California has committed to developing a Master Plan for Aging in order to meet the needs of older adults today and for generations to come.

The third in this series of papers, Addressing Senior Hunger by Maximizing CalFresh and the Hold Harmless Food Benefits, offers specific policy recommendations for addressing troubling senior hunger trends, and the low utilization among seniors of available benefits.

California’s Master Plan For Aging: Increase Income for Seniors and People with Disabilities who Receive SSI/SSP

By | FACT SHEET, Long Term Care, REPORTS, SENIOR POVERTY, Supplemental Security Income, Toolkit

California has committed to developing a Master Plan for Aging in order to meet the needs of older adults today and for generations to come.

The second of the Master Plan for Aging series of papers, Increase Income for Seniors and People with Disabilities who Receive SSI/SSP, offers three specific policy recommendations for addressing the rising income inequality leading to a lack of retirement security, and for addressing the recession-era cuts that pushed SSI recipients below the poverty line.

Fact Sheet: Coverage Changes for Opioid Treatment Services for Dually Eligible Individuals

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

As of January 1, 2020, Medicare Part B covers a new Opioid Treatment Program (OTP) benefit. This means Medicare beneficiaries now have access to methadone for medication-assisted treatment (MAT) in an out-patient setting, along with counseling and other opioid use disorder (OUD) treatment services delivered by a certified OTP provider.

For individuals dually eligible for Medicare and Medicaid, this new coverage means that Medicare is now the primary payer for these OUD treatment services. The Centers for Medicare & Medicaid Services (CMS) has issued guidance to OTP providers, MA plans and to states to help ensure that dually eligible individuals who are currently receiving these OUD treatment services do not experience interruptions in care.

Justice in Aging’s new fact sheet describes the new OTP benefit and how it affects dually eligible individuals access to treatment for OUD. Advocates working with dually eligible individuals or other Medicare beneficiaries receiving or in need of OUD treatment services should become familiar with these changes to help clients navigate and identify any issues.

For example:

  • OTP providers and MA plans are prohibited from billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing for OTP services. In addition, all people enrolled in Original Medicare should not pay any cost-sharing for OTP services once they have met their Part B deductible.
  • States, MA plans, and providers should be following guidance to ensure continuity of care for dually eligible beneficiaries who are currently receiving OTP services.
  • State Medicaid programs cannot exclude or deny coverage of transportation (NEMT) for dually eligible individuals to Medicare-covered benefits, including OTP services.

Please let us know if you observe any issues with these changes in Medicare coverage of OUD treatment services. Your feedback helps us identify systemic issues and work with CMS to resolve them.

California’s Master Plan For Aging: Make Medi-Cal More Affordable

By | FACT SHEET, Long Term Care, Medicaid, Toolkit

California has committed to developing a Master Plan for Aging in order to meet the needs of older adults today and for generations to come. Justice in Aging will release a series of short papers containing specific policy recommendations, developed with partners, that the Master Plan for Aging must include to meet its goals to advance equity, increase economic security and safety, and improve access to quality, affordable health care and LTSS programs.

The first in this series of papers, Make Medi-Cal More Accessible and Affordable, offers eight specific policy recommendations for improving Medi-Cal in order to ensure that every low-income older adult in California is able to access high quality, affordable health care. This paper was developed with developed with partners at Disability Rights California and Western Center on Law & Poverty.

 

FAQ: Adding a Dental Benefit to Medicare Part B

By | FACT SHEET, Health Care, Medicare, Oral Health, REPORTS

As Justice in Aging has been engaged in advocacy to add an oral health benefit to Medicare Part B, we’ve received a number of questions from advocates and others about how older adults currently access oral health benefits, what coverage the various parts of Medicare offer, and what adding an oral health benefit to Medicare Part B would look like.

We created a new resource, Adding a Dental Benefit to Medicare Part B: Frequently Asked Questions, to answer these common questions.

Fact Sheet: Open Enrollment for 2020 Coverage through Medicare & Covered California—Basics for Advocates

By | Affordable Care Act, CA Health Network Alert, FACT SHEET, Health Care, Medicare, REPORTS

Justice in Aging has updated our California fact sheet that provide the essential information advocates for older adults need to know about this year’s open enrollment periods for both Medicare and the Affordable Care Act Marketplaces. Changes consumers make to either their Medicare or Marketplace coverage during open enrollment will take effect January 1, 2020.

Fact Sheet: Open Enrollment for 2020 Coverage through Medicare & the Marketplace—Basics for Advocates

By | Affordable Care Act, FACT SHEET, Health Care, Medicare, REPORTS

Justice in Aging has updated our national fact sheet that provide the essential information advocates for older adults need to know about this year’s open enrollment periods for both Medicare and the Affordable Care Act Marketplaces. Changes consumers make to either their Medicare or Marketplace coverage during open enrollment will take effect January 1, 2020.

Issue Brief & Fact Sheet: What’s at Stake for Older Adults When States Eliminate Retroactive Medicaid Coverage?

By | Affordable Care Act, FACT SHEET, Health Care, ISSUE BRIEF, Long Term Care, Medicaid

Retroactive Medicaid coverage is a key financial protection that helps older adults and others who develop sudden illnesses or long term care needs access the care they need right away. It is a smart policy intended to protect low-income people from crushing medical debt in instances where they need emergency medical or long-term care and cannot apply for Medicaid immediately. But several states are eliminating this protection through Medicaid demonstration waivers approved by the federal government.

A new Justice in Aging issue brief—Medicaid Retroactive Coverage: What’s at Stake for Older Adults When States Eliminate This Protection?—discusses typical situations that cause older adults to need Medicaid retroactive coverage, and how the policy helps them access care, while protecting them from financial hardship. The issue brief also delves into how states are using waivers to eliminate this coverage, which states are doing so, and how older adults, their families, and health care providers are harmed when the coverage is eliminated. A companion fact sheet provides a higher level view of the issue.