Elder Law

July 25, 2018

CMS Expands Grace Period for Medicare Late Enrollments

The Centers for Medicare and Medicaid Studies recently announced it has extended its grace period to remove or reduce financial penalties for those late to switching their insurance from plans on the Affordable Care Act (ACA) to Medicare. As a result of moving the deadline, seniors and those on disability now have until September 30, 2018 to switch over from their ACA marketplace insurance plans to Medicare without having to pay increased Medicare premiums or reimburse the federal government for ACA subsidies.

For most Americans, Medicare eligibility begins at age 65 and are automatically signed up if already receiving Social Security benefits but not if the individual is already receiving health insurance through their job or spouse’s employment. If neither of these scenarios apply, individuals need to enroll in Medicare within six-months (three-months before or after) turning 65-years old.

Failing to enroll in Medicare in a timely manner can lead to very expensive penalties including increases to Medicare Part B premiums as much as 10 percent for each full 12-month period the individual should have been enrolled. The Medicare Rights Center (MRC), a nonprofit consumer service organization that works to ensure access to affordable health care for older adults, estimates that if someone turned 65 in 2010 and delayed signing up for Medicare until 2018, premiums would be $227, which is 70 percent higher than the base Part B premium of $134.

July 22, 2018

New Medicare Rules Seek to Address Chronic Re-hospitalization of Nursing Home Patients

by Ettinger Law Firm

Starting later this year, the federal government will begin penalizing nursing homes accepting tax dollars for hospitalizations that regulators believe are preventable and end up costing the patient and health care system in the long run. The new rules are the other half of policies instituted by the Center for Medicare and Medicaid Studies (CMS) aimed at reducing patient readmissions by either rewarding or penalizing hospitals and now nursing homes based on their rates of Medicare rehospitalization rates.

According to the U.S. Department of Health and Human Services, one in four long term nursing home patients are hospitalized each year and these hospitalization rates are rising. One in five Medicare nursing home patients “boomerang” back into the hospital within 30-days of being released. The Department of Health and Human Services believes many of these hospitalizations are preventable and are costly to Medicare and, to a lesser extent, Medicaid.

Nursing home residents are especially vulnerable to the risks that accompany repeat hospitalizations and transfers, including medication errors and hospital-acquired infections. This revolving door of patients returning to hospitals soon after discharge often occurs because of a lack of communication between treating physicians at hospitals and healthcare providers at the nursing homes once patient return.

July 20, 2018

New Jersey Congressman Introduces Proposal for Medicare Long Term Care Insurance Benefit

by Ettinger Law Firm

Ranking Democratic member of the House Energy and Commerce Committee Frank Pallone, Jr. of New Jersey recently introduced a new proposal aimed at tackling the rising costs of long term health care insurance to give seniors a better life. Under the current system, Medicare only covers very limited long-term care and support for seniors until a senior eventually qualifies for the Medicaid program after they have depleted all of their financial resources.

If adopted, the The Medicare Long-Term Care Services and Supports Act would enact multiple measures to help seniors get the care they need without depleting their finances. Among other things, The Act would includes incentives for people to seek care at home and give much needed relief to overburdened family caregivers by compensating these individuals for lost income other retirement benefits, and career opportunities if they have to cut back on work hours or leave the workforce.

The Act would establish a standard cash benefit within Medicare for anyone who is eligible for Medicare and those under the age of 65-years old who meet certain disability thresholds and begin after a two-year waiting period that functions as a deductible. The proposed legislation would allow individuals to use their self-directed benefits towards all long-term services and supports, including nursing facility care, adult daycare programs, home health aide services, personal care services, transportation, and assistance provided by a family caregiver.

July 16, 2018

Anthony Bourdain Leaves Bulk of Estate to Daughter but Wife Could Contest

by Ettinger Law Firm

According to reports, celebrity chef Anthony Bourdain has left the bulk of his $1.2 million estate to his young daughter, which will be placed into a trust that will make two payouts over her lifetime. Bourdain’s estranged wife, on the other hand, was named executor to the estate will receive his personal effects including furniture, cars, books, and even his frequent flier miles which could be quite valuable given the deceased’s career as a professional traveller.

Documents filed with the Manhattan Surrogate’s Court indicate Bourdain’s estate was worth $1.21 million, including $425,000 in savings, $35,000 in brokerage money, $250,000 in personal property and $500,000 in “intangible property” which includes royalties. Media outlets report that Bourdain’s 11-year-old daughter is the primary beneficiary of his trust which will distribute assets when she is 25 and 30, and disperse the remaining balance when she turns 35 years old.

Establishing trusts for minors is a very common practice in estate planning as it is meant to these young persons do not become overwhelmed by receiving an inheritance all at once, which could lead to financial mismanagement. In the meantime, a guardian appointed by the Surrogate Court will safeguard the younger Bourdain’s estate until the final payouts are made. While all this may seem straightforward, experts reviewing Bourdain’s estate situation believe it may be subject to complications, including potential challengers by the spouse.

May 24, 2018

New York End-of-Life Agency Allows Refusal of Food and Water Directive

by Ettinger Law Firm

Recently, the board for End Of Life Choices New York approved an aggressive new document that would allow individuals to stipulate in advance that they may refuse food and water should they develop dementia at some point. The goal of the directive is to allow individuals to speed up their death in late-stage dementia, if they so choose.

Despite being considered a terminal illness, states that already have end of life directives in place do not have laws that cover the condition, putting the new policy into uncharted ethical waters that have not been explored. The move comes as patients across New York and the rest of the country seek alternative options to address the very real possibility that they may become incapacitated with a severely debilitating condition.

The new document would allow patients one of two options should they find themselves in an assisted living situation with dementia. The first would allow patients to accept so-called comfort feeding by providing oral food and water if they patient appears willing to accept the nourishment. The second, would stipulate that the patient would receive no food or water, even if he or she appears to accept the feedings during the final stages of dementia.

May 20, 2018

HHS Secretary Asks Former CVS Executive to Help Agency Lower Drug Prices

by Ettinger Law Firm

Health and Human Services Secretary Alex Azar recently tapped former CVS executive Daniel Best to lead the agency’s effort to help lower drug prices for millions of Americans on Medicare coverage. Best was most recently a vice president of industry relations for the company’s Medicare Part D business and included CVS’s prescription drug plans, Medicare Part D plans and other clients.

“Daniel Best recognizes what President Trump and I, and every American know: prescription drug prices are too high,” Azar said in a statement announcing the appointment. “He has the deep experience necessary to design and enact reforms to lower the price of medicines that help Americans live healthier and longer lives.”

At a March 19 speech in Manchester, New Hampshire, President Donald Trump reaffirmed his pledge to lower prescription drug prices. “If you compare our drug prices to other countries in the world, in some cases it’s many times higher for the exact same pill or whatever it is, in the exact same package made in the exact same plant,” President Trump said during the speech. “We’re going to change that.”

May 17, 2018

CMS Issues New ID Cards, Announces Increased Payments to Private Plans

by Ettinger Law Firm

The Centers for Medicare and Medicaid Studies (CMS) recently made a pair of announcements regarding changes to some of the important services the agency offers to millions of seniors across the country. Both of which aim to improve customer experience for CMS enrollees and help combat the threat of identity theft against those seeking vital medical treatments paid for in part by the federal government.

To help protect seniors from identity theft, CMS has begun phasing in new Medicare cards that no longer display enrollees’ Social Security numbers. Pennsylvania residents will be among the first to receive the new cards that assign each person a randomly generated eleven-digit number.

Social Security numbers are vital for accessing key financial information, medical records, and legal documents and should a Medicare enrollee’s card fall into the wrong hands, it could result in a serious case of identity theft. The new cards are tied directly to existing accounts so those who receive the new cards will have all their medical information will still be available with their doctors.

May 14, 2018

Connecticut Man’s Challenge to Still Living Father’s Estate Fails

by Ettinger Law Firm

A federal court in Connecticut recently dismissed a lawsuit brought by a Connecticut man who felt jilted after being excluded from his still-living father’s estate on the grounds the plaintiff had yet to suffer any actual injury. The case is a cautionary tale for both testators and heirs in situations where familial tensions can manifest themselves into lengthy and expensive court battles that may end up doing little to resolve tensions.

The petitioner in this case filed suit against his father, sisters, and PNC Bank which was acting as the trustee to the father’s living trust. The petitioner alleged his sister, who was acting as the testator’s health care proxy and using a general power of attorney to make financial decisions, asserted undue influence on the testator to exclude him from the estate.

Unfortunately for the plaintiff in the case, the federal judge ruled that his lawsuit failed to live up to the basic principles of when and why courts can hear cases. The judge determined that because the plaintiff’s father was still living and he had yet to be excluded from any expected inheritance, the testator’s last will and testament could not be invalidated as of yet.

May 10, 2018

Survey Reveals Many Americans’ Expectations on Social Security Benefits Differ from Realities

by Ettinger Law Firm

A recent survey conducted by Nationwide Mutual Insurance Company reveals just how far apart the expectations Americans have for their Social Security benefits are compared to the actual payments they will receive upon retirement. According to the survey by Nationwide’s Retirement Institute, more than half of the 1,0000 retirees or soon to be retirees surveys intend to rely on their Social Security benefits as their main source of income during their golden years and may fall well short of their needs.

The results give experts pause for alarm, particularly because of the gap between what those surveyed expect to receive and what they are actually likely to get when they apply for their retirement benefits. Future retirees expect to receive $1,628 per month in Social Security benefits but are more likely to receive $1,257 each month, a difference of almost 30 percent. However, this could be due in part to the fact that those surveyed intended to retire at 66 while many Americans recently retired at 62 which limited their benefits and brought the nationwide average down.

The survey also reveals major disconnects future retirees have about other financial aspects on retirement. Other surveys revealed that almost 40 percent of those on the cusp of retirement do not intend to spend any of their Social Security benefits on health care, an optimistic but unlikely outcome given recent trends in senior health care costs. A recent report by Fidelity Investments showed retired couples will likely spend up to $280,000 on healthcare over the remainder of their lives.

May 7, 2018

New Medicaid work requirements could cause family caregivers to lose their coverage

by Ettinger Law Firm

Proposed work requirements to Medicaid eligibility could result in some family caregivers losing their vital coverage, according to a recent analysis of Kentucky’s reforms by advocacy group Justice in Aging. Medicaid is vital to helping caregivers take care of their own health while caring for a loved one but depending on how states implement work requirements or defines “work,” family caregivers may end up losing their health insurance or face additional hurdles to keep it.

Caregivers are unpaid individuals like spouses, partner, family members, friends, or neighbors involved in assisting others with activities of daily living and/or medical tasks. The selfless work they do for others in need is vital to the health and wellbeing of the individual and cannot be taken for granted or impeded by barriers that would cause widespread hardship.

According to the National Alliance for Caregiving and AARP, an estimated 43.5 million caregivers have provided unpaid care to an adult or child in the last year and of that number, 34.2 million Americans have provided unpaid care to an adult age 50 or older in the same time period. The majority of caregivers care for one other adult while about one in six care for two-adults. About 15.7 million adult family caregivers care for someone who has Alzheimer’s disease or other dementia.