Medicare Part D Drug Discount Included in Affordable Care Act is Saving Seniors Money

A new report issued by the U.S. Government Accountability Office (GAO) confirms that the Medicare Part D drug discount included in the Affordable Care Act (ACA) is working as intended and saving seniors’ money.

Before the passage of the act, seniors who were caught in the Medicare Part D coverage gap (known as the “donut hole”) often had to pay the full cost of their prescription drugs.  These seniors now receive a 50% discount on all brand name drugs when they hit the coverage gap, as a result of the ACA.  These discounts increase gradually until 2020, when the “donut hole” is completely closed.

The GAO report findings reveal that that the Centers for Medicare & Medicaid Services' (CMS) implemented the program in a timely manner, establishing systems to ensure that seniors were provided with the required discounts. According to Senate Finance Committee Chairman Max Baucus, “The report shows how health reform is working to save seniors $4.8 billion and helping them afford their prescription drugs, closing the donut hole. We need to help seniors save every dollar they can and that’s exactly what the Affordable Care Act does – reducing seniors’ out-of-pocket costs while providing more benefits.”

At The Law Firm of Evan H. Farr, P.C., we agree that seniors should be able to access their medications without being forced to pay steep prices on brand name drugs. The CMS’s successful implementation of the ACA has improved the quality of life for many seniors and we commend the CMS for their swift implementation.

The full GAO report, “Medicare Part D Coverage Gap: Discount Program Effects and Brand-Name Drug Price Trends”, is available online here.

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Veterans Awareness Week – Personal Stories of Veterans and How Veterans Aid and Attendance Has Helped Them

Attention Veterans: Take advantage of a 20% discount this month, just by mentioning this posting!

This week is Veterans Awareness Week!  In recognition of this important week, we will focus on personal stories based on real veterans and the long term care decisions they have made.  (Although we have of course changed names and certain facts, the stories are real).

John Archer is a 70 year old Vietnam Veteran from Burke who recently had a stroke.  He has some leg weakness from an injury he sustained during his time in Vietnam and has been in and out of rehabilitation ever since. The effect of the stroke and the weakness he feels in his leg has made it difficult for Mr. Archer to take care of himself.  He is eager to remain at home where he lives alone, but is concerned he won't be able to manage without help.

Mr. Archer doesn’t have too much of a support system locally. He rarely sees his neighbors socially and is used to being independent and not relying on others for help. His son, William, lives in Fredericksburg and usually visits twice a month. William is also concerned about his father's ability to live alone.

The Law Firm of Evan H. Farr, P.C. recommended to Mr. Archer that he may be eligible for the Veterans Aid and Attendance Benefit now, but may also need Medicaid for in-home care or eventually, nursing home care.  Evan H. Farr is an Accredited Attorney with the U.S. Dept. of Veterans Affairs who understands both the Veterans Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs. Mr. Farr worked with Mr. Archer and his son to obtain the financial assistance to which he were entitled – over $20,000 per year at the rate of over $1,700 per month. Mr. Archer now lives in his home, where he is most comfortable, and has in-home care to help him manage things his activities of daily living.  The extra $1,700 per month from the Veteran’s Aid and Attendance program is vital in helping Mr. Archer afford the care that he needs.

If you are a Veteran or spouse of a Veteran and you need assistance, make an appointment for a free consultation.  We can work with you to evaluate whether you qualify for The Veterans Aid and Attendance Benefit and help you file the paperwork.

P.S. For the remainder of the month of November 2012, Veterans can take advantage of a special 20% discount in honor of Veterans Awareness Week by mentioning this posting.  Evan H. Farr on Google +

Attention Veterans: Special Offer to Celebrate Veterans Awareness Week!

Next week, November 4 through 10, is Veterans Awareness Week!  In 2002, President George W. Bush proclaimed that the week before Veterans Day will be recognized as National Veterans Awareness Week to recognize the contributions of our service men and women.

There are currently more than 25 million living American Veterans, many of whom put their lives on the line to preserve our freedoms. Many of these Veterans and their spouses are unaware of an important benefit that they may be entitled to that could help them pay for in-home care or assisted living as they age. This benefit is called the Aid and Attendance benefit, and is a special type of Veteran’s pension.  While the Aid and Attendance benefit is extremely helpful, there are strict eligibility requirements regarding income, assets, need and service. 

Some important things to know about the Aid and Attendance benefit:

• Aid & Attendance is not dependent upon service-related injuries.
• There must have been a discharge that was other than dishonorable.
• “Wartime Veterans” and their surviving spouses may be eligible.
• A “Wartime Veteran” for this purpose is someone who served at least 90 days on active duty, with at least one day during a period of wartime.
• Certain medical and financial requirements must be met.

Read more about Veterans Aid and Attendance on The Law Firm of Evan H. Farr website.

The application for Aid and Attendance Benefits is a painstaking process. The forms are available for you to do it yourself, but be advised if your assets and income do not show up properly, you could be denied the benefit or you could miss out on the complete benefit. Additionally, be careful of making asset transfers without the assistance of an elder law attorney because certain asset transfers could disqualify a Veteran from Aid and Attendance and Medicaid if a nursing home level of care is needed in the future.  Lastly, Aid and Attendance benefits are not as widely recognized as other types of benefits for Veterans and incomplete applications can take longer for a decision. For these reasons, it is highly encourage that you seek assistance in completing the application.

Evan H. Farr is an Accredited Attorney with the U.S. Dept. of Veterans Affairs. The Law Firm of Evan H. Farr, P.C. specializes in helping Veterans and their spouses obtain the financial assistance to which they are entitled.  If you are a Veteran or spouse of a Veteran and you need assistance in your home, or are living in or considering moving into an Assisted Living Facility or Continuing Care Retirement Community, make an appointment for a free consultation.  We can work with you to evaluate whether you qualify for the Veterans Aid and Attendance Special Pension Benefit and assist you with filing the paperwork.

P.S. For the month of November 2012, Veterans can take advantage of our special 20% discount in honor of Veterans Awareness Week, just by mentioning this posting.  Evan H. Farr on Google +

Evan H. Farr Honored For Career And Community Achievements And Leadership

Mr. Farr is the only elder law attorney in the commonwealth to receive the 2012 Virginia Lawyers Weekly “Leader in the Law” distinction.

Certified Elder Law Attorney Evan H. Farr of The Law Firm of Evan H. Farr, P.C. (http://www.farrlawfirm.com), an Elder Law and Estate Planning firm based in Fairfax, was recently honored as one of 2012’s “Leaders in the Law” – an annual award presented by Virginia Lawyers Weekly.

The “Leaders in the Law” award honors those within the legal community who are working to better the legal profession through mentoring and involvement within their community, as well as going above and beyond in their everyday job. Honorees set the standard for other lawyers in Virginia and represent the most influential individuals within Virginia’s legal community.

Here is a sampling of Evan’s accomplishments in 2012:

• Evan co-authored (along with other top attorneys from across the country), a consumer-oriented book, entitled "Protect & Defend." Americans proved their desire to learn more about protecting their assets: the book ranked #1 on two best seller lists and made it on to a total of four best seller lists total.  The book is available on Amazon.com. 
• Evan is the current President of the Virginia Academy of Elder Law Attorneys.  He has been an integral part of the push towards developing and mastering legal strategies to help middle class citizens protect their assets from the expenses of Long-Term Care.  Specifically, Evan's Living Trust Plus™ is an asset protection trust Evan has created and uses to protect assets from general creditors as well as long-term care creditors.  Clients are thrilled and surprised when they learn of the capabilities of the Living Trust Plus™ and how it can literally change their life and their loved ones' lives, too.  In fact, Evan started a national network of Living Trust Plus™ attorneys who license the software from him and are able to use this trust for their clients.  The website LivingTrustPlus.com brings in traffic from across the U.S., where visitors can then search for attorneys in their state whom Evan has licensed.

Farr was honored at the seventh annual Leadership in the Law event hosted by Virginia Lawyers Weekly  on Oct. 25 at the Science Museum of Virginia in Richmond.

About Evan Farr, CELA

Evan Farr is the Principal Attorney of The Law Firm of Evan Farr, P.C., an Elder Law firm serving Virginia, DC, and Maryland. The Firm is dedicated to helping protect seniors and their families by preserving dignity, quality of life, and financial security. Evan has been named by Virginia Super Lawyers Magazine as one of the top 5% of attorneys in VA since 2007, and by Washington, DC Super Lawyers Magazine as one of the top 5% of attorneys in DC since 2008.  In 2011 and 2012, Evan was named by Washingtonian and Northern Virginia Magazine as one of the top attorneys in the Washington, DC Metropolitan area, and was named in Newsweek Magazine as one of the top attorneys in the country. Evan is also a well-known public media figure, having been quoted or cited as an elder law expert by the Washington Post, Newsweek Magazine, Northern Virginia Magazine, Trusts & Estates Magazine, The American Institute of Certified Public Accountants, and the American Bar Association, and has appeared on television on PBS, MSNBC, Fox News, and CNN.

To learn more about Evan Farr, visit the Farr Law Firm’s website at http://www.FarrLawFirm.com, or call 703-691-1888.
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The Power of Music: Bringing Alzheimer’s Patients “Back to Life”

Alzheimer's disease is the most common cause of dementia, affecting 5.4 million people in the United States. The disease swiftly deprives patients of their memories and other brain functions. Many Alzheimer’s patients’ who need around the clock skilled nursing and medical care reside in nursing homes.

Ninety-two year old Ron sits in a wheelchair and hardly speaks or moves, until a nursing home worker puts on his headphones and he hears familiar music. Suddenly, his feet tap, and he hums his favorite songs out loud. His daughter Tina explains how Ron always loved singing and dancing when she was growing up. "He used to walk my sister and I to school and he would often be humming a tune or singing his favorite songs. It is no wonder he is reacting to the music as he is."

In nursing homes that use music, the personalized playlists are often meaningful songs chosen by loved ones.  According to Alzheimer’s experts, music helps patients become more alert, more cooperative, more attentive, and more engaged. In many cases, even if they can't recognize loved ones and they've stopped speaking, when the patients hear music, they “come alive”.

Geri Hall, a clinical nurse specialist at the Banner Alzheimer's Institute, explains how music activates a part of the brain that stays active despite the dementia. "There is something about music that gets through to Alzheimer’s patients right up until the very end of the disease," she said, adding that “familiar music from the past can help people with dementia feel at home. It calms them, increases socialization, and even decreases the need for mood controlling medications."

At The Law Firm of Evan Farr, P.C., we were intrigued by the power that music has on Alzheimer’s patients, and wanted to share this information with you.  If you have a loved one with Alzheimer’s and want to find quality care for them in Virginia, get tips from expert Evan H. Farr, in “The Virginia Nursing Home Survival Guide.” One of the greatest concerns people have about nursing home care is how to afford it.  Read more about this in Chapter 5 of the book or on The Law Firm of Evan H. Farr, P.C. website. Evan H. Farr on Google +

Are You Childless and Aging? Be Sure to Plan for Future Care.

Jennifer and her brother always kept an eye on their mother, Ann, who was 91 and suffering from a stroke when she died three months ago.  Both siblings made sure they lived near their mother in Oakton, and together they brought her food, took care of the bills, drove her to doctors’ appointments, and oversaw her caretakers. 

But Jennifer, a 66-year old real estate agent, cannot hope for the same kind of care when she gets older, because she is divorced and doesn’t have any children.  While taking care of her mother, she sometimes thought, “Who will take care of me?” Her brother, Michael, who is four years younger and also childless, may be able to help care for her (and vice versa), but maybe not. 

According to census data, in 2010, almost 19 percent of women between the ages of 40 and 44 had not given birth, compared with around 10 percent thirty years prior.  Even for those with children, some children are better at caring for aging parents than others, but at least the expectations are clear.  As was the case with Jennifer and Michael, children are often the ones to hire caregivers and check up on their parents.  With childless people, the lines of responsibility can be unclear.

Do you want to stay at home for as long as possible and receive in-home care?  Do you prefer a particular type of assisted living facility?  At The Law Firm of Evan Farr, P.C., we recommend that you set up both an Advance Medical Directive that designates someone who could view medical records and handle medical decisions and a Power of Attorney that designates someone to handle your finances.  Having these documents in place will ensure that people you trust will carry out your wishes should you become incapacitated.  Not having these documents in place puts more stress on the people who are trying to help you. Even worse, these people may not have the legal authority to help you, to speak for you, or to handle your finances!  In addition, if childless people don’t want their assets to go to relatives whom they dislike or barely know, they should have a Will or a properly drafted Living Trust.

 

Childless or not, couples who are unmarried (straight or gay) should understand that without proper legal documents, the partner of an incapacitated person may not be given a say in health care decisions.  In addition, without proper planning, the partner of a deceased person may not be allowed to stay in the couple’s house or to gain access to retirement funds or many of the benefits that a traditional married couple would have. 

Lastly, but importantly, don’t forget about your pets!  A Pet Trust ensures that they will be cared for. Although Jennifer will almost certainly outlive her cocker spaniel, Maggie, she has arranged for her brother to take care of him, just in case.

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Important Medicare Change: Patients No Longer Need to Show Progress to Receive Nursing Coverage

Medicare coverage of short-term rehabilitation in a nursing home is about to undergo a major policy change, resulting in beneficiaries with chronic conditions such as Alzheimer’s disease, Parkinson’s disease, ALS (Lou Gehrig’s disease), diabetes, multiple sclerosis, hypertension, arthritis, heart disease, and stroke no longer need to show ongoing improvement to maintain Medicare coverage.

For decades, when short-term rehabilitation patients in nursing homes failed to show improvement but still needed skilled nursing in the form of custodial care or therapy, Medicare would routinely terminate their Medicare coverage, forcing these patients prematurely into private pay or, if they could financially qualify, Medicaid.  This need for ongoing “improvement” was a pervasive, though unwritten ”rule of thumb” followed by Medicare and by Medicare contractors when doing Medicare evaluations in nursing homes.  However, nothing in the Medicare statute or its regulations has ever stated that “improvement” is required for continued skilled care. 

A class action lawsuit, Jimmo v. Sebelius, was filed against the Obama administration in January 2011 in federal court. This case and a similar case in Pennsylvania aimed at ending the government’s use of the “improvement standard” were both settled by the Government.  This settlement should result in Medicare no longer focusing on “the presence or absence of an individual’s potential for improvement.”  Rather, Medicare must continue to provide short-term care whether or not the patient is improving, provided the patient needs skilled care.

It must be understood that Medicare coverage for nursing home care is still a very limited type of short-term benefit, as it only covers a maximum of 100 days per benefit period, and only if the patient requires skilled nursing care. However, under the new settlement, Medicare coverage should no longer be terminated just because the patient’s medical condition is no longer improving. On the contrary, coverage should remain available for services that are needed to maintain the person's condition or to prevent further deterioration.

In summary, Medicare coverage in the past has often been erroneously denied for individuals with chronic conditions, for people who are not improving, or who are in need of services to maintain their condition. With this new government settlement, it should no longer be necessary for an individual’s underlying condition to be improving in order to continue to get Medicare coverage!   I emphasize the word should because the people who implement these policies may not conform to the new settlement as quickly as they should, so coverage appeals may be necessary in the short run until the local workers on the ground all get educated about this new shift in governmental policy. 

Luckily, the Medicare program has an appeal system to contest improper termination of coverage. Beneficiaries and their advocates should use this system to appeal Medicare determinations that unfairly deny or limit coverage.

For more information about this settlement, see:

http://www.medicareadvocacy.org/hidden/highlight-improvment-standard

To appeal what you believe is an improper Medicare termination in a nursing home, please download this self-help packet:                                                                                 

MEDICARE SKILLED NURSING FACILITY SELF HELP PACKET

To appeal what you believe is an improper Medicare termination of home health care, please download this self-help packet:  

MEDICARE HOME HEALTH SELF HELP PACKET
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