Tuesday, May 31, 2011

Handicap Remodeling or Relocating

Robert and Anne purchased the family home thirty years ago, and their plan was to live there through retirement. They had furnished their home with restored antiques acquired from their many trips together. It was one of their cherished antique coffee tables that Robert tumbled over, breaking his hip.  Now with his return from the hospital in a wheelchair, Anne faced the overwhelming task of making their home both accessible and safe.

Remodeling for wheelchair entrances, organizing household furnishings and daily living items or downsizing and moving to a smaller living area are colossal tasks that are many times thrust on senior home owners.  Sometimes the need to do this is brought on by injury or age related illness. Home and yard maintenance can become a daunting chore for even the healthiest of seniors, calling for a decision whether to downsize.

There is a large and growing industry of specialists who understand these challenges of elderly homeowners and are ready and willing to help with remodeling, organizing or the sale of the home and with the move to a new location.

A professional organizer provides skills in making the home safe and manageable. Relocating furniture, removing hazards such as electrical cords, throw rugs, heavy objects on shelves that might fall are some of the ways they make a home more senior friendly.  They specialize in helping seniors part with items that clutter or have no valued use, so to make rooms less crowded or to make ready for a move to a smaller living space.

Handicap remodeling services and senior safety services offer help in adding wheelchair ramps and widening doorways. Bathrooms are made more accessible and safe, with hand rails, walk-in bath facilities and easier access to toilets.

If moving to a smaller retirement home or care facility is the best solution there is another senior specialty provider to call on called a Seniors Real Estate Specialist.

The Senior Real Estate Specialist concentrates more on a complete service package for the sale of the property and/or the purchase of a new living arrangement. The specialist also arranges for the services of a relocation specialist or Senior Move Manager to provide a complete, stress-free package for the elderly homeowner.

A move often requires downsizing and getting rid of a tremendous number of acquired possessions. The relocation specialist or Senior Move Manager, as they are often called, will typically provide a turnkey operation that includes assessing and identifying items to keep, arranging for auction or other disposal, cleaning the home, moving the belongings and setting up the new residence. The manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.

All the help available to seniors may in itself be overwhelming.  How do seniors choose the right service provider for their needs?  How do they know they will hire someone qualified, responsible and honest?  Area Agencies on Aging and State Better Business Bureaus are good resources to check out available service providers.

Family, friends and religious leaders can be valuable resources to seniors in referring service providers and helping to manage the hiring and supervision.

The National Care Planning Council’s website www.longtermcarelink.net provides educational articles and information on eldercare providers throughout the nation.  Other resources you may be interested in, include
this Aging at Home guide and recipes for Senior citizens.

Image: FreeDigitalPhotos.net

Friday, May 27, 2011

New Veteran Bill Would Increase Pension Benefits for Some Couples

The Honoring All Veterans Act of 2011 – introduced yesterday by Senator Richard Blumenthal (D-CT) –seeks to improve health care, education, employment, and housing for veterans.  “Our military men and women have kept their promises to our country, and now we must keep faith with them, not only in words but in deeds,” said Blumenthal.

The Aid and Attendance Pension Benefit Rates for 2011:
  • Up to $1,644 per month for a single veteran
  • Up to $1,949 per month for a married veteran or a veteran with one dependent
  • Up to $1,057 per month for an un-remarried widowed surviving spouse
For some couples, aid and attendance benefits may increase.  The Bill passed the House May 23rd and will need to pass the Senate next.   The legislation seems to be on the fast track to becoming law.  GovTrack reports, “the vote was held under a suspension of the rules to cut debate short and pass the bill, needing a two-thirds majority . . . [usually reserved] . . . for non-controversial legislation. The totals were 380 Ayes, 0 Nays.”
  • An Independent Board would review DOD/VA transition problems including benefits.
“Our nation must keep faith with men and women who serve and sacrifice for our freedom. Unfortunately and unconscionably, America is still failing them and their families by tolerating unemployment, homelessness and inadequate health care,” said Blumenthal.

“This legislation comes from listening to and working with veterans and their families. While the Honoring All Veterans Act addresses many critical needs, it is only an opening salvo in a sustained, unceasing campaign to ensure that no veteran is left behind. It is a down payment on a larger debt,” said Blumenthal, according to politicalnews.me. “Our military men and women have kept their promises to our country, and now we must keep faith with them, not only in words but in deeds.”

Wednesday, May 25, 2011

Medicaid Fraud Audit Targets Schizophrenia Drug

First, lawmakers in Utah expressed concern over the state’s Medicaid expenditures.  Then, Utah State health officials were asked to investigate and control alleged fraud.  Now, critics are questioning whether measures went too far, and some are expressing a sentiment that these audits paint an inaccurate picture of fraud…the millions of dollars sought to be recouped by officials stem from clerical errors and involve anti-psychotic drugs used by Schizophrenics. 
As a result of an audit that targeted dozens of the largest pharmacies in Utah, The Salt Lake Tribune reported that millions of dollars’ worth of drugs were paid for by Medicaid, but should not have been. 

We are not talking about drugs that usually make headlines.  Seroquel (also known as Quetiapine), is an anti-psychotic, and was one of two drugs at the center of the audit. 

“Quetiapine tablets and extended-release (long-acting) tablets are used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions),” according to the National Center for Biotechnology Information.

Authorities in Utah say anti-psychotic drugs worth $1.2 million were billed to Medicaid, but should not have been.

This may serve as a wakeup call and could lead to more clerical oversight, but will it do anything to really bring costs under control? That much remains to be seen.

“Medicaid spends more on atypical antipsychotics than any other drug class,” say Utah health authorities.

The Tribune quotes one pharmacy owner as saying, “we’re talking about a situation where the right medications are going to the right patients as prescribed. Is that fraud?" 

Image: Pixomar / FreeDigitalPhotos.net

Friday, May 20, 2011

FREE Living Trust Plus Seminar: How to Protect Your Assets from the Expenses of Probate and Long Term Care

Tomorrow is another one of our FREE Living Trust Plus Seminars! Registration for this event will close today at 5:30 p.m., but don't worry--if you missed it, we will be having another one on Saturday, July 23rd.

This Seminar is open to the public and will take place at the Mason Inn Conference Center and Hotel in Fairfax, Virginia from 10:00 a.m. to 12:00 p.m. In it, I'll discuss how you can avoid "the nightmare of probate" with proper and timely estate planning, as well as how to protect your hard-earned assets from the devastating effects of long term care. In addition to that, this Saturday I'll also be discussing proper estate planning for graduating high school seniors, and what that means for you as a parent.

Register now to reserve your seat for the next Living Trust Plus Seminar taking place on July 23rd on our website.

Tuesday, May 10, 2011

What is the Individual Mandate? Plus: Oral Argument Audio from 4th Circuit Court of Appeals Released

Today, two key cases concerning the constitutionality of the hotly debated federal health care law took place in the U.S. 4th Circuit Court of Appeals.  The two cases: Liberty University v. Geithner, No. 10-2347, and Commonwealth v. Sebelius, No. 11-1057.  The audio of the oral arguments are now available for download! Click here to listen.
The federal government brought out its big gun: Acting Solicitor General Neal K. Katyal, a “top appellate lawyer,” according to Virginia Lawyer’s Weekly.  Dean Mathew D. Stayer of Liberty University Law School and Virginia Solicitor General E. Duncan Getchell Jr. argued against Katyal. 

is the District Court Opinion from Liberty.  The court in that case granted the defendant's (federal government) motion to dismiss the case.  In opining on possible application of The Guarantee Clause, the court said:

The Guarantee Clause provides that “[t]he United States shall guarantee to every State in this Union a Republican Form of Government . . . .” U.S. CONST. art. IV, § 4. The meaning of the Guarantee Clause has not been clearly delineated, but it is rarely a basis for finding an act of Congress unconstitutional. See Largess v. Sup. Jud. Ct. for the State of Mass., 373 F.3d 219, 226-27 (1st Cir. 2004) (“If there is any role for federal courts under the Clause, it is restricted to real threats to a republican form of government.”) (Emphasis added).

The U.S. District Court in Sebelius, however, reached a different conclusion: read the opinion here.   That opinion, representing the Republican consensus, states:

Section 1501 of the Patient Protection and Affordable Care Act – specifically the Minimum Essential Coverage Provision – exceeds the constitutional boundaries of congress.”  The court held that “Article I, Secion 8 of the Constitution confers . . . only discrete enumerated governmental powers…The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the states respectively, or to the people.

There is no skirting around the reality that this is a partisan issue.  By and large, Republicans feel the Individual Mandate is unconstitutional, whereas Democrats think just the opposite.

You may recall earlier this year, just a few months ago, when the Senate blocked an effort to repeal the reform bill.  There has even been chatter that Republicans may attempt to prevent funding of the bill, and so today’s cases are critical…but there will be many cases to follow.  After all, the provision that is at the center of this debate is not event scheduled to take effect for three years. 

What exactly is this “Individual Mandate?” From the Liberty opinion referenced above:

According to the “Requirement to Maintain Minimum Essential Coverage,” § 1501 . . .  [requires that] . . .  every “applicable individual” must obtain “minimum essential coverage” for each month or pay a penalty, which is included with the individual’s tax return. Act § 1501(a)-(b).  An “applicable individual” is any individual except one who qualifies for a religious exemption, who is not a United States citizen, national, or an alien lawfully present in the United States, or who is incarcerated. Act § 1501(d).

But note:

An “applicable individual” may still be exempted from the requirement to purchase health insurance if she cannot afford such coverage because the required contribution exceeds eight percent of her household income.  Act § 1501(e). Taxpayers with income under 100 percent of the poverty line, members of Indian tribes, and individuals determined to suffer “a hardship” with respect to the capability to obtain coverage are also exempted.

Alluding to the ongoing nature of this controversy, the opinion from the Richmond U.S. District Court, which ruled against the federal government and in favor of Virginia, states . . .

“[T]his case . . . turns on atypical and uncharted applications of constitutional law interwoven with subtle political undercurrents. The outcome of this case has significant public policy implications. And the final word will undoubtedly reside with a higher court.”

Check back with us as we continue to provide you with updates on the status of health care reform in America.  

Image: anankkml / FreeDigitalPhotos.net

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Friday, May 6, 2011

Advocacy Group on New Medicare Hospice Law: “An Issue that Must be Closely Watched”

Hospice is “a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments, explains the Hospice Foundation of America.

For families with a loved one currently receiving Hospice care, a new law is under debate and analysis by some advocacy groups. At the very least, they are keeping a close watch on the real-world effect of the law.

The new Medicare Home Health Face-to-Face Requirement is a condition of receiving payment for hospice services. “A physician must order Medicare home health services and must certify a patient’s eligibility for the benefit,” according to Center for Medicare and Medicaid Services (CMS). Moreover, “[before certifying] a patient’s eligibility for the home health benefit . . . [he or she] . . . must document . . . a face-to-face encounter with the patient.”

Why did Congress enact this law? Will the administrative burdens be worthy of debate? The rationale appears to have been; “[to ensure] that the orders and certification for home health services are based on a physician’s current knowledge of the patient’s clinical condition.” What remains unclear is whether Congress is trying to prevent some sort of perceived abuse of the Hospice process, whether Congress perceived physicians as lacking in diligence in this regard, or if it is a means to ensure money is not wasted.

Some groups ARE raising questions. For example, an article recently was published by CMS, entitled, “New Hospice Face-to-Face Requirement: Help or Hindrance? The group expresses hope that the law will encourage more physician involvement, but also concern that “caring for hospice patients in their third and subsequent certification periods . . . [might become more] . . . difficult and potentially more expensive for providers than caring for patients in their first and second certification periods.” The group ends its article by noting it will continue to watch the issue, so that Medicare beneficiaries who are nearing the end of their lives will not bear any unintended burdens or care shortcomings as a result of this new law.

Image: Sura Nualpradid / FreeDigitalPhotos.net