IN THE NEWS

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.

Legal Help – Aging Matters

By | IN THE NEWS, Safety Net Defense

Nashville Public Television: Aging Matters (April 18, 2019)

The need for legal assistance is high for older adults. Many find accessing affordable legal aid difficult. Watch the video above to learn more about how legal aid organizations provide older adults with the legal help they need to age with dignity and support. Justice in Aging’s Deputy Director Jennifer Goldberg and Staff Attorney Fay Gordon are featured in the video.

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.

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.”

Lawsuit over observation status, SNF payment finally going to trial

By | IN THE NEWS, LITIGATION, Medicare

McKnight’s Long-Term Care News: Lawsuit over observation status, SNF payment finally going to trial (March 29, 2019)

A lawsuit, co-counseled by Justice in Aging, may go to trial which could have significant implication for providers and patients. The lawsuit involves a group of individuals having to pay out of pocket for skilled nursing facility care because Medicare would not cover it. The patients received needed care but were classified as under “observation status” and were not formerly admitted as inpatients resulting in large medical bills.

California Lawmakers Introduce a Trio of New Health Care Bills Focused on Older Adults

By | IN THE NEWS, Medicaid

Politico Pro: California Lawmakers Introduce a Trio of New Health Care Bills Focused on Older Adults (March 4, 2019)

The state of California has introduced three bills meant to help low-income seniors relying on Medi-Cal to cover health care costs. If passed, seniors over age 65 and people with disabilities would qualify for free coverage.

“Obamacare expanded coverage and affordability provisions for low-income people, but many of those benefits don’t apply to seniors once they reach age 65”, said Justice in Aging’s Senior Staff Attorney Claire Ramsey. “It’s about making Medi-Cal fairer and work better for older adults. We’re trying to stabilize their income and their financial security.” This article is behind a paywall. This is a summary.

Why The Possibility Of TennCare Converting To A Block Grant Has Opponents Growing Worried

By | IN THE NEWS, Long Term Care, Medicaid

Nashville Public Radio: Why The Possibility Of TennCare Converting To A Block Grant Has Opponents Growing Worried (March 13, 2019)

Health care advocates worry that Tennessee will be one of the first states to seek a block grant for its Medicaid program. A block grant is a lump sum that would allow the state greater flexibility in spending federal money. However it is capped and would not increase even if the Medicaid population grew. Currently, the federal government pays for two-thirds of the expenses of Tennessee’s 1.3 million beneficiaries.

“It would be a radical, catastrophic change to Medicaid,” said Justice in Aging’s Directing Attorney Eric Carlson. “The problem with the block grant is you eliminate everything… you’re eliminating all these protections. You’re locking down the revenue at a level that almost assuredly is insufficient.”

Are Assisted Living Facilities Regulated?

By | IN THE NEWS, Nursing Homes

The Nursing Home Abuse Podcast: Are Assisted Living Facilities Regulated? (March 03, 2019)

On March 3, an episode of the Nursing Home Abuse Podcast featured Justice in Aging Directing Attorney, Eric Carlson, as a guest. The podcast is a project of two attorneys in Georgia. The episode was Are Assisted Living Facilities Regulated? Beginning at around 5:37, Eric talks about the differences between assisted living and nursing facilities, noting that more people who need higher levels of care are living in assisted living facilities than in previous years. Eric covers the regulatory framework for assisted living facilities, making clear that the laws governing assisted living facilities are different from state-to-state, as opposed to nursing homes, which are regulated by the federal government as the primary payor for nursing home care. The result is that, as more people with higher health care needs are relying on assisted living facilities, they may not be getting the care they need. This is due to lack of staff medical training and lack of government oversight. His advice to individuals and families when considering an assisted living facility is to explicitly ask the management about current and future care needs to get information about how the facility will handle the care needs of the individual who will be living there.

Older Californians and State of the State

By | IN THE NEWS, NEWS

San Francisco Bay Times: Older Californians and State of the State (February 22, 2019)

This article discusses California’s rising older adult population and CA Governor Newsom’s plan to support them. Newsom’s Master Plan aims to restore and expand services for older adults and adults with disabilities. The article cites statistics from Justice in Aging’s Older Women and Poverty report including, older adults in poverty, or on the brink of poverty, overwhelmingly are women, women of color, and LGBTQ women. Read the full article.