GRAY MATTERS
Notes, News & Musings on Elder Care

Category:

Medicare

sample-medicare-cardMedicare cards presently have the holder’s Social Security Number (SSN) printed on the front of the card. This increases the possibility of identity theft. When President Obama signed a bipartisan bill changing the way healthcare providers are paid by Medicare, that bill also included a provision that affects our Medicare cards, The Bill directs that the Health and Human Services (HHS) remove Social Security Numbers, and refrain from displaying, coding or embedding a person’s SSN on the Medicare card.

Congress allocated $50 million to fund this project, and gave HHS four years to make the change for new enrollees and an additional four years to reissue cards for people already in the system.  HHS will also have to come up with a new card to replace the existing Medicare cards with a number unrelated to the person’s Social Security Number. Strategic planning is in the works now, but it will take some time for HHS to develop a card, a system, and then issue the new cards. The removal of Social Security Numbers from the Medicare cards will provide peace of mind to older adults that their Medicare card will not be used to steal their identity.

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We are proud to announce that our very own Monica Franklin honored to participate in the revision of  The Legal Handbook for Tennessee Seniors for 2014.  Monica’s contribution focused on Medicare and Long-Term Care Services and Support through Medicaid or CHOICES.

Please feel free to share this link with family and friends who may be dealing with one or more of the legal topics concerning seniors covered in the handbook.

Information from Elizabeth Todaro on the TBA site:

The TBA Public Education Committee has updated The Legal Handbook for Tennessee Seniors for 2014. The updated Handbook contains practical information on a wide range of topics, including issues such as applying for Social Security benefits, long-term care considerations and estate planning, as well as completely new sections addressing online security and new health care legislation. An updated list of resources relevant for Tennessee Seniors is also included.

Copies are available now for download or by order in printed form. For more information about the project, to request a presentation in your area or to volunteer to help promote the Handbook,  contact TBA Access to Justice / Public Education Coordinator Liz Todaro.

This publication is based largely on a previous edition of the handbook that was published and distributed in 2001 by the TBA Elder Law Section, the TBA Young Lawyers Division and the TBA Senior Lawyers Division. The TBA Public Education Committee worked this year under the leadership of Co-Chair Angelia Nystrom. The project was spearheaded by TBA President Cindy Wyrick, who identified this as a priority to help meet the needs of the growing and frequently underserved senior adult population in Tennessee.

Fortunately, there are many ways we can now distribute this valuable resource: via website download, electronic flashdrive or printed copy. The updated handbook is available (at no cost) to TBA Members via digital format for their use in counseling their clients. TBA Members are invited to add their firm’s logo and contact information to the Handbook cover for distribution to their clients. Electronic and printed copies are also available to the public directly from the TBA. This book promises to be a great benefit for the members of our communities and for the clients that we serve and all resources are available here on the TBA website and will be updated regularly.

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Center for Medicare Advocacy
(November, 2013 Update)
Late November is often a time for gatherings with family and friends – Thanksgiving and Hanukkah, soon followed by Christmas and the New Year. Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Residents and their families can put their minds at ease. According to Medicare law, nursing home residents may leave the facility for holidays without losing their Medicare coverage. However, depending on the length of their absence, beneficiaries may be charged a “bed hold” fee.

The Medicare Benefit Policy Manual recognizes that although most beneficiaries are unable to leave their facility,

“an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care.”[1]

A facility should NOT notify patients that leaving the facility will lead to loss of Medicare coverage. The Medicare Benefit Policy Manual says that such a notice is “not appropriate.”[2]

If the resident begins a leave of absence and returns to the facility by midnight, the facility can bill Medicare for the day’s stay.[3] If the resident is gone overnight (i.e., past midnight) and returns to the facility the next day, the day the resident leaves is considered a leave of absence day. Clarifying what seemed to be conflicting provisions in the Manuals, the Centers for Medicare & Medicaid Services (CMS) confirms that the facility can bill a beneficiary for bed-hold days during a SNF absence.[4]

Chapter 6 of the Medicare Claims Processing Manual provides that the facility cannot bill a beneficiary during a leave of absence, “except as provided in Chapter 1 of the manual at §30.1.1.1.”[5] That section authorizes skilled nursing facilities (SNFs) to bill a beneficiary for bed-hold during a temporary “SNF Absence” if the SNF informs the resident in advance of the option to make bed-hold payments and of the amount of the charge and if the resident “affirmatively elect[s]” to make bed-hold payments prior to being billed.[6] Charges to hold a bed and maintain the resident’s “personal effects in the particular living space…are calculated on the basis of a per diem bed-hold payment rate multiplied by however many days the resident is absent, as opposed to assessing the resident a fixed sum at the time of departure from the facility.”[7] CMS distinguishes bed-hold payments from payments for admission or readmission, which are “not allowed.”[8]

Residents can leave their SNFs for short periods, such as a day or two, to enjoy the holidays with their families and friends without losing Medicare coverage. Their SNFs are, however, allowed to bill them to hold their beds under Medicare rules.

For more information, contact attorney Toby S. Edelman (tedelman@medicareadvocacy.org) in the Center for Medicare Advocacy’s Washington, DC office at (202) 293-5760.

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Medicare Open Enrollment is October 15-December 7th.  For some helpful tools in reviewing insurance options, go here.

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The Associated Press recently released a great article from Kaiser Health News answering some of the most frequently asked questions from Medicare recipients about the new Affordable Care Act.  Read the entire article here.

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Choosing a nursing home for a loved one is a difficult decision, one with many factors to consider.  To assist you in comparing nursing homes and transitional care units in your area,  there is a helpful search engine found on the Medicare.gov website.  In addition to viewing various facilities’ proximity to you and other key relatives, you can also see their overall ratings, staffing, health inspections, and quality measures ratings.  Go here to start your search.

While these ratings are not the only issues to consider when making this important decision, they can serve as a starting place for you to begin to compare and contrast your options.  Remember that your elder care coordinators are here to help.  Feel free to contact us with questions.

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Join Elder Care Coordinator Gabrielle Blake at Faith United Methodist Church on Tuesday, September 3rd at 10:00am for a discussion on Medicare Part B and Hospitalization.  Faith’s senior adult group Young at Heart will host the meeting and following potluck.  All are welcome.

Faith UMC is located on the corner of Dry Gap Pike and Rifle Range Road at 1120 Dry Gap Pike, Knoxville, TN  37918.  (865)-688-1000.

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As many of you with Medicare know, the open enrollment period is just around the corner (October 15-December 7). In hopes of helping you to prepare, we have collected some useful links below.

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